Interobserver concordance in the BI-RADS classification of breast ultrasound exams

Calas, Maria Júlia Gregório; Almeida, R. M. V. R.; Gutfilen, Bianca; Pereira, Wagner Coelho de Albuquerque

doi:10.6061/clinics/2012(02)16

Cited by 15 publications

(24 citation statements)

References 28 publications

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“…This could contribute to a higher interobservational agreement in tests categorized as BI-RADS 5 18 . This reasoning also seems to be sustained for the BI-RADS classification through magnetic nuclear resonance 19,20 . Even though the study has suffered with limitations -such as the lack of histopathological confirmation for BI-RADS 3, 4 and 5 mammograms -, it offered important results.…”

Section: Discussionmentioning

confidence: 99%

Impact of the pink october in the mammographic screening adherence in a reference center in oncology

Vazzoller¹,

Fernandes²,

Gotardo³

et al. 2017

Rev. Bras. Mastol. (Impr.)

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Objective: To analyze the impact of Pink October in the mammographic screening adherence in a reference center in oncology. Methods: This is a cross-sectional, descriptive and retrospective study of a population of women who underwent mammographic screening in the years 2014, 2015 and 2016. Mammography reports were used for data collection. Comparing the months of October with the other months of the studied years, we observed if there were changes in the number of mammograms and in the proportion of mammograms Breast Imaging Reporting and Data System (BI-RADS) 3, 4 and 5. To verify statistical significance, the Z-score (95% confidence interval -CI95%) and the χ 2 test (p<0.05) were used. Results: 105,698 mammograms were performed. There was a significant difference in the number of mammograms performed in October compared to the other months of the study. In addition, there was an absolute increase in the number of mammograms BI-RADS 3, 4 and 5; however, their proportion in the months of October did not presented difference in comparison to the other months. Conclusion: Population-based campaigns to prevent breast cancer appear to be effective in increase of demand for mammographic screening, possibly leading to an increase in the number of cancers discovered, allowing more women to receive timely treatment.KEYWORDS: Mammography; breast neoplasms; health promotion; mass screening; early diagnosis. ABSTRACT RESUMOObjetivo: Analisar o impacto do Outubro Rosa na adesão ao rastreamento mamográfico para câncer de mama em um serviço de referência em oncologia. Métodos: Trata-se de um estudo transversal, descritivo e retrospectivo em uma população de mulheres que realizaram rastreamento mamográfico nos anos de 2014, 2015 e 2016. Foram utilizados laudos de mamografia para coleta de dados. Foram comparados os meses de outubro com os demais meses dos anos estudados, observando se houve alterações no número total de mamografias e no número de mamografias Breast Imaging Reporting and Data System (BI-RADS) 3, 4 e 5. Para verificar significância estatística foram utilizados o escore Z (intervalo de confiança de 95% -IC95%) e o teste do χ 2 (p<0,05). Resultados: Realizaram-se 105.698 mamografias. Houve diferença significativa na quantidade de mamografias efetuadas nos meses de outubro em comparação aos outros meses do estudo. Além disso, ocorreu aumento absoluto de mamografias BI-RADS 3, 4 e 5; porém, sua proporção nos meses de outubro não apresentou diferença significativa em relação aos outros meses. Conclusão: As campanhas populacionais de prevenção de câncer de mama parecem ser efetivas no aumento da procura por serviços de rastreamento, de forma a elevar o total de cânceres descobertos e possibilitando, assim, que mais mulheres recebam tratamento adequado. PALAVRAS-CHAVE:Mamografia; neoplasias da mama; campanhas de prevenção de câncer de mama; programas de rastreamento; diagnóstico precoce.

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Section: Discussionmentioning

confidence: 99%

Impact of the pink october in the mammographic screening adherence in a reference center in oncology

Vazzoller¹,

Fernandes²,

Gotardo³

et al. 2017

Rev. Bras. Mastol. (Impr.)

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“…This may lead to further refinements of BI-RADS 3 ultrasound criteria. With the increasing use of breast US screening in women with dense breasts, category 3 lesions are being found more often [6][7][8] .…”

Section: Discussionmentioning

confidence: 99%

“…Interobserver concordance studies in breast ultrasound have Kappa indexes ranging from 0.28 (poor) to 0.83 (substantial) in the literature. This variation is very broad based on a subjective characterization of the images by the radiologist, depending on his experience 7,15 . According to Calas et al 6 , the main difference features between a benign and a malignant mass are the contour and shape, the contour with the highest sensitivity and the shape the highest specificity.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of BI-RADS 3 lesions on US has been reported between 15.7 and 32.2%, and the malignancy rate between 0 and 2.6% [16][17][18] . Due to their high frequency and low probability of cancer, by both ultrasound screening and diagnosis, these nodules arouse in the professionals dedicated to breast radiology a great interest in improving their characterization and in establishing the most appropriate conduct [7][8][9][10][11][12][13][14][18][19][20][21][22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

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Predictive values of breast imaging reporting and data system category 3 breast masses submitted to percutaneous biopsy by ultrasonography

Gonçalves¹,

Lemos²,

Calas³

2019

Mastology

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A classificação do Breast Imaging Reporting and Data System (BI-RADS) permite a padronização dos achados das massas mamárias, com recomendação para o manejo individualizado. Por causa de sua alta frequência, massas classificadas como 3, provavelmente benignas, despertam interesse em melhorar sua caracterização e em estabelecer o comportamento mais adequado. Objetivo: Primeiramente, demonstrar os valores preditivos positivos e negativos da classificação de massas sólidas BI-RADS 3 submetidos a biópsia percutânea por ultrassonografia. Em segundo lugar, sugerir conduta de acompanhamento por ultrassonografia diferente nesses achados. Metodologia: Estudamos, retrospectivamente, 480 massas BI-RADS 3, submetidas a biópsia a vácuo ou corebiopsia, com resultado histopatológico conclusivo considerado padrão-ouro. Resultados: De 480 massas em 396 pacientes, 473 eram benignas e 7 malignas. O valor preditivo positivo para malignidade de categoria 3 foi de 1,5% (7/480) e o valor preditivo negativo foi de 98,5%. Conclusão: Em vista da baixa probabilidade de câncer, recomenda-se a realização de ultrassonografia direcionada (second look) de massas classificadas como BI-RADS 3 por especialista em radiologia da mama antes da indicação de um procedimento invasivo, o que reduziria substancialmente o número de biópsias desnecessárias, ansiedade do paciente, bem como possíveis complicações. Isso aumentará a possibilidade de o especialista passar mais tempo em exames realmente necessários e direcionados, definindo melhor os casos de acompanhamento (anual ou semestral) da indicação da investigação em casos específicos.

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“…It increases the specificity of mammography; in particular, both the number of false-negative lesions in dense breasts and false-positive lesions that could lead to unnecessary biopsies are reduced (5, 6). However, lack of reproducibility concerning lesion assessment and operator-dependency of breast US interpretation still remains problematic (6-12). The breast imaging, reporting and data system (BI-RADS) was published by the American college of radiology (ACR) to offer a common description for the characterization of breast abnormalities, and to communicate effectively with the physician (5, 13-16).…”

Section: Introductionmentioning

confidence: 99%

Variability in Observer Performance Between Faculty Members and Residents Using Breast Imaging Reporting and Data System (BI-RADS)-Ultrasound, Fifth Edition (2013)

et al. 2016

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BackgroundUltrasonography (US) is a useful tool for breast imaging, yet is highly operator-dependent.ObjectivesWe evaluated inter-observer variability and performance discrepancies between faculty members and radiology residents when describing breast lesions, by the fifth edition of breast imaging reporting and data system (BI-RADS)-US lexicon, and then attempted to identify whether inter-observer variability could be improved after one education session.Patients and MethodsIn total, 50 malignant lesions and 70 benign lesions were considered in our retrospective study. Two faculty members, two senior residents, and two junior residents separately assessed the US images. After the first assessment, the readers received one education session, and then reassessed the images in a random order. Inter-observer variability was measured using the kappa coefficient (κ). Performance discrepancy was evaluated by receiver operating characteristic (ROC) curves.ResultsFor the faculty members, fair-to-good agreement was obtained in all descriptors and final assessment, while for residents, poor-to-moderate agreement was obtained. The areas under the ROC curves were 0.78 for the faculty members, 0.59 for the senior residents, and 0.52 for the junior residents, respectively. Diagnostic performance was significantly higher in the faculty members than the senior and junior residents (P = 0.0001 and < 0.0001, respectively). After one education session, the agreement in the final assessment was one level higher in the faculty members and senior residents, yet in the senior residents, the degree of agreement was still only fair. Moreover, in the junior residents, there was no improvement.ConclusionInvestigative assessment of breast US by residents is inadvisable. We recommend continued professional resident training to improve the degree of agreement and performance.

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Interobserver concordance in the BI-RADS classification of breast ultrasound exams

Cited by 15 publications

References 28 publications

Impact of the pink october in the mammographic screening adherence in a reference center in oncology

Impact of the pink october in the mammographic screening adherence in a reference center in oncology

Predictive values of breast imaging reporting and data system category 3 breast masses submitted to percutaneous biopsy by ultrasonography

Variability in Observer Performance Between Faculty Members and Residents Using Breast Imaging Reporting and Data System (BI-RADS)-Ultrasound, Fifth Edition (2013)

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