Use of BI-RADS 3-Probably Benign Category in the American College of Radiology Imaging Network Digital Mammographic Imaging Screening Trial
Use of BI-RADS 3-Probably Benign Category in the American College of Radiology Imaging Network Digital Mammographic Imaging Screening Trial
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DOI：
10.1148/radiol.11101285
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发表时间：
2011-07-01
期刊：
影响因子：
19.7
通讯作者：
Pisano, Etta D.
中科院分区：
文献类型：
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作者：
Baum, Janet K.;Hanna, Lucy G.;Pisano, Etta D.
目的：确定(A)乳房影像报告和数据系统(BI-RADS)3类在美国放射成像网络(ACRIN)数字乳房影像筛查试验(DMIST)中的使用频率，无论是在筛查乳房X光检查时还是在工作后，(B)受试者实际返回进行推荐的后续检查的频率，以及(C)在建议进行短期间隔随访的受试者中随后发现的任何恶性肿瘤的比率和分期。材料和方法：这项研究得到了机构审查委员会在所有受试者登记的机构的批准。所有参与DMIST的受试者都表示知情同意，该研究符合HIPAA标准。共有47599名符合DMIST标准和可评估的受试者被纳入这项分析，他们都同意接受数字和屏幕胶片乳房X光检查。根据数字、屏幕-胶片或两者的影像检查进行短期间隔随访的病例被确定。结果：47599例受试者中，共有1114例(2.34%)肿瘤被归类为BI-RADS 3分类，并被建议接受短期随访。在这项研究中，1114名受试者中有791名(71%)遵守了建议，并返回进行短时间间隔的随访。在没有回来接受短期随访的女性中，70%(323人中的226人)确实回来进行下一年的乳房X光检查。在所有在筛查乳房X光检查或额外检查后将肿瘤归类为BI-RADS 3的受试者中，1114人中有9人(0.81%)被发现患有癌症。在9例经活检证实的癌症中，6例为浸润性癌，3例为Tis-T1c期导管原位癌。结论：在DMIST中，放射科医生很少使用BI-RADS 3分类(2.3%)。被归类为BI-RADS 3的肿瘤的恶性率较低。相对较高的不符合短期随访建议的比率(1114例中的323例，或29%)支持先前的建议，即放射科医生在将病变归入这一类别之前彻底评估病变。(C)RSNA，2011年
Purpose: To determine (a) how often the Breast Imaging Reporting and Data System (BI-RADS) category 3 was used in the American College of Radiology Imaging Network (ACRIN) Digital Mammographic Imaging Screening Trial (DMIST), either at the time of screening mammography or after work-up, (b) how often subjects actually returned for the recommended follow-up examination, and (c) the rate and stages of any malignancies subsequently found in subjects for whom short-term interval follow-up was recommended.Materials and Methods: This study was approved by the Institutional Review Board at all institutions where subjects were enrolled. All subjects participating in DMIST gave informed consent and the study was HIPAA-compliant. A total of 47 599 DMIST-eligible and evaluable subjects, all of whom consented to undergo both digital and screen-film mammography, were included in this analysis. Cases referred for short-term interval follow-up based on digital, screen-film, or both imaging examinations were determined. Compliance with the recommendations and the final outcome (malignancy diagnosis at biopsy or no malignancy confirmed through follow-up) of each evaluable case were determined.Results: A total of 1114 of the 47 599 (2.34%) subjects had tumors assigned a BI-RADS 3 category and were recommended to undergo short-interval follow-up. In this study, 791 of 1114 (71%) of the subjects were compliant with the recommendation and returned for short-interval follow-up. Of the women who did not return for short-interval follow-up, 70% (226 of 323) did return for their next annual mammography. Among all subjects whose tumors were assigned a BI-RADS 3 category either at screening mammography or after additional work-up, nine of 1114 (0.81%) were found to have cancer. Of the nine biopsy-proved cancers, six were invasive cancers and three were ductal carcinoma in situ stage Tis-T1c. The invasive cancers were all less than 2 cm in size.Conclusion: In DMIST, radiologists used the BI-RADS 3 classification infrequently (2.3% of patients). Tumors assigned a BI-RADS 3 category had a low rate of malignancy. The relatively high rate of noncompliance with short-interval follow-up recommendations (323 of 1114, or 29%) supports prior recommendations that radiologists thoroughly evaluate lesions before placing them in this category. (C) RSNA, 2011