Diagnostic Accuracy of ultrasonographic BI-RADS scoring compared with histopathologic features of breast lumps in Nigerian adult females

Abstract

Background: Breast Imaging Reporting and Data System (BI-RADS) provides a standardized method of lesion classification using mammography, ultrasonography, and magnetic resonance imaging. Ultrasonography has found greater use in resource-challenged environments where other imaging modalities are not readily available. Objectives: The study aimed to determine the accuracy of ultrasonography in the evaluation of breast lumps using BI-RADS categorization. Materials and Methods: This was a cross-sectional prospective study of 110 women referred for sonographic evaluation of breast lumps. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of sonographic BI-RADS category 2–5 scored lumps were compared with histopathologic features as the gold standard. The generated data was analyzed using the Statistical Package for Social Sciences version 25.0 software and significance was set at P ≤ 0.05. Results: The age range of the participants was 18–65 years (mean 32.4 ± 11.4 years). Ultrasonography characterized 81 lumps (73.6%) as benign and 29 (26.4%) as malignant while histopathologic evaluation confirmed 83 (75.5%) benign and 27 (24.5%) malignant lesions. Comparative evaluation of ultrasonography and histopathology showed that in diagnosing breast lesions with ultrasound (US), the sensitivity, specificity, PPV, NPV, and accuracy of benign lesions were 94%, 83.9%, 88.8%, 93.9%, and 92.7%, respectively, whereas that for malignant lesions were 93.2%, 88.6%, 89.3%, 95%, and 92.7% and 100% scores for all the parameters on histology. Conclusion: The spectrum of breast lesions can be accurately characterized by using a US BI-RADS score of 2–5 with reliable differentiation between benign and malignant lesions.

Keywords

• bi-rads score
• breast lumps
• female
• histopathology
• ultrasonography