BIRADS 3 in mammography and ultrasound: imaging challenges and main confounding factors.

Congress:

ECR 2020

Poster Number:

C-03768

Type:

Educational Exhibit

Keywords:

Not applicable, Education and training, Education, Diagnostic procedure, Ultrasound, Mammography, Breast

Authors:

�. Cordeiro de Macedo Pontes, E. Francolin, R. Leme, M. A. Rudner, V. C. Zanetta, G. Ciconelli Del Guerra, N. R. L. Mágero, A. Inácio Gomes, F. A. Sulla Lupinacci; São Paulo/BR

DOI:

10.26044/ecr2020/C-03768

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-03768

Fig. 1: a. Non calcified, oval mass with circumscribed margins (arrow). b. Grouped...

Fig. 2: Focal asymmetry in the left breast (circles).

Fig. 3: Hypoechoic, circumscribed, oval and parallel lesions which have shown stability...

Fig. 4: Thin-walled cystic lesion which contained debris, consisted of a complicated...

Learning objectives

Identify the main imaging features from category BI-RADS 3 in mammography and ultrasound. Recognize some specific situations in which the BI-RADS 3 category may be used. Expose pitfalls in regards the identification and correct classification of BI-RADS 3 category.

Background

The percentage of BI-RADS 3 lesions varies in literature from 2,34% to 11,2%. Malignancy is detected in less than 2% of the cases, usually in the first follow-up, resulting in early cancer detection, with no impact on the prognosis. In regards to mammography, BI-RADS 3 category can be used just after diagnostic workup has been made, with a complete imaging evaluation (complementary views) and correlation with other imaging methods. The BI-RADS 3 category is not used in screening mammograms. Recall is used to exclude malignant...

Findings and procedure details

A pictorial review of the imaging findings of BI-RADS 3 category are described. The main mammographic and sonographic features as well as some specifc conditions in which the category may be used are specified. There are three suitable findings for BIRADS 3 category in mammography: Non calcified, round or oval mass with at least 75% circumscribed margins(Fig. 01a).This lesion was not identified as benign or suspect in complementary studies, it has a stability less than 3 years and can be palpable. Grouped round or punctate...

Conclusion

BI-RADS 3 is the category with the highest error rate. Therefore, it is essential to identify the main imaging findings which integrate this group and reassess findings at follow-up as well as recognizethe importance of complementary exams to guide the management of the breast lesions.

Personal information and conflict of interest

Í. Cordeiro de Macedo Pontes; São Paulo/BR - nothing to disclose N. R. L. Mágero; São Paulo, SÃO PAULO/BR - nothing to disclose A. Inácio Gomes; São Paulo/BR - nothing to disclose G. Ciconelli Del Guerra; São Paulo/BR - nothing to disclose V. C. Zanetta; São Paulo/BR - nothing to disclose E. E. Françolin; São Paulo/BR - nothing to disclose R. Leme; São Paulo/BR - nothing to disclose M. A. Rudner; São Paulo/BR - nothing to disclose F. A. Sulla Lupinacci; São Paulo/BR - nothing...

References

Michaels AY, Birdwell RL, Chung CS et al. Assessment and Management of Challenging BI-RADS Category 3 Mammographic Lesions. Radiographics. Aug 2016; 36 (5):1261-1272. D’Orsi CJ,Sickles EA,Mendelson EBet al.Breast Imaging Reporting and Data System: ACR BI-RADS breast imaging atlas.5th edition. Reston, Va: American College of Radiology,2013 Lehman CD, Rutter CM, White E et al. Lesion and patient characteristics associated with malignancy after a probably benign finding on community practice mammography. AJR Am J Roentgenol. Feb 2018; 190 (2): 511 – 515. Messinger J, Crawford S, Roland...