ABSTRACT A blinded retrospective validation study was performed in a university-based hospital in northeastern China to determine whether the breast imaging reporting and data system (BI- RADS) defines a group of patients with non- palpable breast lesions (NPBLs) in whom fine- wire localization biopsy (FWLB) is appropriate. We reviewed 182 consecutive patients with NPBLs who underwent FWLB. The patients’ preoperative mammograms were categorized according BI-RADS by 2 radiologists blinded to the pathological findings. The positive predictive values of BI-RADS categories 3-5 were 3.4%, 42.1%, and 76.9%, respectively. For category 4 NPBLs, the percentage of cancer for those aged < 40 years was significantly lower than those aged ≥ 40 years. For category 3 NPBLs, the percentage of precancerous lesions for those aged < 40 years was significantly lower than those aged ≥ 40 years. Chinese NPBL patients aged ≥ 40 years with category 4 mammographic findings, and all patients with category 5 findings should undergo FWLB. FWLB should be offered as a treatment option for Chinese NPBL patients aged < 40 years with category 4 findings or aged ≥ 40 years with category 3 findings.
Cite this paper
nullChen, B. , Liu, C. , Jin, F. , Sun, Y. , Zhao, T. , Zhang, L. , Li, S. and Yeung, S. (2010) The role of fine-wire localization breast biopsy in the management of BI-RADS category 3-5 non-palpable breast lesions in northeastern Chinese women. Health, 2, 291-294. doi: 10.4236/health.2010.24042.
 Tabar, L., Vitak, B., Chen, H.H., et al. (2001) Beyond randomized controlled trials: Organized mammographic screening substantially reduces breast carcinoma mortality. Cancer, 91, 1724-1731.
 Elmore, J.G., Armstrong, K., Lehman, C.D., et al. (2005) Screening for breast cancer. Jama, 293, 1245-1256.
 Sarkeala, T., Heinavaara, S. and Anttila, A. (2008) Organized mammography screening reduces breast cancer mortality: A cohort study from Finland. International Journal of Cancer, 122, 614-619.
 Kopans, D.B. (1992) The positive predictive value of mammography. American Journal of Roentgenology, 158, 521-526.
 Virginia, American College of Radiology. (2003) Breast imaging reporting and data system. 4th Edition, Reston.
 Masroor, I. (2005) Prediction of benignity or malignancy of a lesion using BI-RADS. Journal of College of Physicians and Surgeons Pakistan, 15, 686-688.
 Tan, Y.Y., Wee, S.B., Tan, M.P., et al. (2004) Positive predictive value of BI-RADS categorization in an Asian population. Asian Journal of Surgery, Asian Surgical Association, 27, 186-191.
 Liberman, L., Abramson, A.F., Squires, F.B., et al. (1998) The breast imaging reporting and data system: Positive predictive value of mammographic features and final assessment categories. American Journal of Roentgenology, 171, 35-40.
 Farshid, G., Downey, P., Gill, P., et al. (2008) Assessment of 1183 screen-detected, category 3B, circumscribed masses by cytology and core biopsy with long-term follow up data. British Journal of Cancer, 98, 1182-1190.
 Nguyen, M., McCombs, M.M., Ghandehari, S., et al. (1996) An update on core needle biopsy for radiologically detected breast lesions. Cancer, 78, 2340-2345.
 Sickles, E.A. (1991) Periodic mammographic follow-up of probably benign lesions: Results in 3,184 consecutive cases. Radiology, 179, 463-468.
 Chadwick, D.R. and Shorthouse, A.J. (1997) Wire-di- rected localization biopsy of the breast: An audit of results and analysis of factors influencing therapeutic value in the treatment of breast cancer. European Journal of Surgical Oncology, 23, 128-133.
 Tan, B.K., Lim, G.H., Czene, K., et al. (2009) Do Asian breast cancer patients have poorer survival than their western counterparts? A comparison between Singapore and Stockholm. Breast Cancer Research, 11, R4.
 Kuo, W.H., Yen, A.M., Lee, P.H., et al. (2009) Cumulative survival in early-onset unilateral and bilateral breast cancer: An analysis of 1907 Taiwanese women. British Journal of Cancer, 100, 563-570.
 Ball, C.G., Butchart, M. and MacFarlane, J.K. (2002) Effect on biopsy technique of the breast imaging reporting and data system (BI-RADS) for nonpalpable mammographic abnormalities. Canadian Journal of Surgery, 45, 259-263.