Influence of Age on PPV of Sonographic BI-RADS Categories 3, 4, and 5

Zusammenfassung

Ziel: Ziel dieser retrospektiven Studie war die Berechnung des positiv prädiktiven Wertes (PPV) der sonografischen Breast-Imaging-Reporting-and-Data-System (BI-RADS)-Kategorien 3, 4 und 5 in verschiedenen Altersgruppen, um zu prüfen, ob das Patientenalter den PPV von BI-RADS-Kategorien in der Mammasonografie beeinflusst. Material und Methoden: Aus unserer US-gestützen Stanzbiopsie-Datenbank wurden aus dem Zeitraum von 2003 bis 2006 2817 BI-RADS-Kategorie-3-, -4- und -5-Läsionen bei 2587 Frauen mit bekannter Histopathologie identifiziert. Alle hatten zunächst eine Mammasonografie mit Einschätzung anhand des BI-RADS-Lexikons und danach eine US-gezielte Stanzbiopsie. Alle Läsionen wurden in 3 Altersgruppen eingeteilt (< 45, 45 – 59 und > 59 Jahre). Die altersbezogenen PPVs für jede BI-RADS-Kategorie innerhalb der 3 Altergruppen wurden auf der Basis der histopathologischen Diagnosen kalkuliert und mittels des χ²-Tests verglichen. Ergebnisse: Der PPV für die jeweilige BI-RADS-Kategorie war: 2,2 % in Kategorie 3, 6,5 % in Kategorie 4a, 35,2 % in Kategorie 4b, 79,6 % in Kategorie 4c und 99,6 % in Kategorie 5. Die altersbezogenen PPVs aus Kategorie 3 variierten signifikant zwischen den 3 Altergruppen (0,9 % versus 3,9 % versus 2,0 % p = 0,048); bemerkenswerterweise war der altersbezogene PPV in Gruppe 2 höher als in den anderen Gruppen. Zudem gab es eine signifikante positive Korrelation zwischen den altersbezogenen PPVs und zunehmendem Alter in Kategorie 4a und 4b (4a, p < 0,0001 und 4b, p = 0,0139), aber nicht in Kategorie 4c und 5 (4c, p = 0,1853 and 5, p = 0,2871). Schlussfolgerung: Die Inzidenz des weiblichen Brustkrebses differiert nicht nur in den unterschiedlichen sonografischen BI-RADS-Kategorien, sondern auch in verschiedenen Altersgruppen. Daher sollte spezifischen Altersgruppen, die wir für die sonografischen BI-RADS-Kategorien 3, 4a und 4b fanden, besondere Aufmerksamkeit geschenkt werden.

Abstract

Purpose: The purpose of this retrospective study was to calculate the positive predictive value (PPV) of sonographic Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 in different age groups to investigate whether age influences the PPV of the BI-RADS category in breast ultrasound. Materials and Methods: From our sonography-guided core biopsy database of breasts between 2006 and 2008, we identified 2817 BI-RADS category 3, 4, and 5 lesions with known pathological diagnosis in 2587 women, all of whom underwent the earlier breast assessment via ultrasound with a sonographic BI-RADS lexicon and later sonography-guided core biopsy. All lesions were classified into three age groups (< 45, 45 – 59, and > 59 years). The age-related PPVs of each BI-RADS category among three age groups were calculated on the basis of pathological diagnoses and were compared using a χ²-test. Results: The overall PPV of each BI-RADS category was 2.2 % in category 3, 6.5 % in category 4a, 35.2 % in category 4b, 79.6 % in category 4c, and 99.6 % in category 5. The age-related PPVs of category 3 varied significantly among the three age groups (0.9 % versus 3.9 % versus 2.0 % p = 0.048), and notably, the age-related PPV in group 2 was higher than the others. Additionally, there was a significant positive association between the age-related PPVs and increasing age in categories 4a and 4b (4a, p < 0.0001 and 4b, p = 0.0139), but not in categories 4c and 5 (4c, p = 0.1853 and 5, p = 0.2871). Conclusion: The incidence of female breast cancer differs not only in different sonographic BI-RADS categories, but also in different age groups. Therefore, more attention should be paid to the special age group that we found for sonographic BI-RADS categories 3, 4a, and 4b.

Key words

breast - BI-RADS - sonography - positive predictive value

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