Abstract:

Objective

To explore the diagnostic value of breast imaging reporting and data systemultrasound (BI-RADS US) for breast lesions in pregnant patients,and provide the guidance for the selection of biopsy method.

Methods

A total of 73 pregnant women with breast lesions in Chengdu Women & Children's Central Hospital from January 2010 to January 2015 were retrospectively analyzed in this study.All lesions were retrospectively categorized according to BI-RADS US. All patients were histopathologically diagnosed by core needle biopsy(n=44),vaccum assisted biopsy(n=23) or open biopsy(n = 4). The gold standard was postoperative pathology, and ROC curve was used to evaluate the performance of BI-RADS US. The positive likelihood ratio, the negative likelihood ratio, the sensitivity and specificity of the ultrasonic BI-RADS category were calculated. Chi-square test was used to compare the incidence of complications using different biopsy methods.

Results

There were 85 lesions in 73 patients. According to BI-RADS US, there were 7 lesions in grade 2 (benign), 29 in grade 3(benign), 45 in grade 4 (including 7 breast cancer) and 4 in grade 5(4 breast cancer). The area under curve(AUC)was 0.952 (95%CI:0.886-1.000). The selected optimal point was 4B based on diagnosis results, with the sensitivity of 83.33%(10/12), the specificity of 98.63%(72/73), the positive likelihood ratio of 59.17 and the negative likelihood ratio of 0.17. The diagnostic accuracy of all patients was 96.47%(82/85). The complication incidence of core needle biopsy was 4.55%(2/44), significantly lower than 34.78%(8/23) of vacuum assisted biopsy and that of open biopsy(3/6)(both P＜0.017).

Conclusions

BI-RADS US has a high sensitivity and specificity for the diagnosis of breast lesions during pregnancy, which can provide the guidance for biopsy. With advantages of less trauma and less complications, the core needle biopsy should be the first choice for the biopsy of breast lesions in pregnant women.

Key words: Breast neoplasms, Pregnancy woman, Ultrasonography, Biopsy