Abstract:
Objective
To assess the value of breast imaging reporting and data system ultrasonography(BI-RADS-US) in the diagnosis of breast ductal intraepithelial neoplasia(DIN).
Methods
Totally 135 cases of breast ductal intraepithelial lesions (including 116 cases of DIN)confirmed in surgery or biopsy in Beijing Tianyi Breast Hospital from January 2010 to October 2012, were retrospectively analyzed to compare the pathological results with high-frequency color Doppler ultrasound findings. According to the BI-RADS, the imaging characteristics of breast and Doppler blood flow features, we applied the classification of BI-RADS-US.The cases in BI-RADS-US 3-4 diagnosed with DIN were regarded as positive, non-DIN as false-positive. The cases in BI-RADS-US 1-2 diagnosed with DIN were considered as false negative, non-DIN as negative.Thereby the area under ROC curve was calculated.
Results
In the patients with DIN, there were 35 cases of usual ductal hyperplasia (UDH), including 20 cases (57.14%, 20 /35) in BI-RADS-US 2, whose US manifestations showed crushed-stone like echoes or hypoechoic nodules; there were 4 cases of flat epithelial atypia (FED) and 50 cases of atypical ductal hyperplasia (ADH), including 37 cases (68.52%,37/54) in BI-RADS-US 3-4a, whose US manifestations showed breast ductal ectasia associated with intraluminal convex papilate, or regional thickening of gland with hypoechoic nodules, and mainly gradeⅠblood flow signals in the lesions; there were 27 cases of ductal carcinoma in situ (DCIS), including 19 cases (70.37%,19/27) in BIRADS-US 4,whose US manifestations showed irregular ductal widening,wall thickening associated with intraluminal clustered microcalcifications, or irregular hypoechoic nodules, or aggregation of small cysts, and mainly grade Ⅱblood flow signals in the lesions. The area under the ROC curve for BI-RADS-US 3-4 was 0.699.
Conclusion
BIRADS-US was helpful in the diagnosis of breast DIN.
Key words:
Breast neoplasms,
Echocardiography, doppler, color,
Pathology,
Breast imaging reporting and data system
Chi-bing ZHANG, Mei-qin GUO, Ning XUE, Yu-jing WANG. Value of breast imaging reporting and data system ultrasonography in diagnosis of breast ductal intraepithelial neoplasia[J]. Chinese Journal of Breast Disease(Electronic Edition), 2013, 07(06): 419-426.