Diagnostic Accuracy of Sonographic Breast Imaging Reporting and Data System Classification in Distinguishing Benign from Malignant Masses.

Abstract

Abstract

Background: Worldwide, breast cancer is the leading cause of death for women. Early identification of breast tumors enhances patient recovery and contributes to more effective treatment approaches. Breast masses can be quickly and non-invasively diagnosed with ultrasound. A standardized method for classifying breast lesions can be obtained by the Breast Imaging Reporting and Data System (BI-RADS), and sonographic BI-RADS facilitates in distinguishing between benign and malignant breast masses.

Methods: This cross-sectional validation study was carried out in the radiology department of KRL, hospital Islamabad. This study was conducted over a period of six months.  For suspected breast cancer evaluation, 80 adult female patients, aged 18 to 65, who presented with breast lumps were selected for the study. In order to classify their tumor according to BI-RADS, patients underwent breast ultrasound scanning. The imaging findings from sonographic BI-RADS were validated against histopathology. A 2x2 table was used to calculate diagnostic metrics such as sensitivity, specificity, positive predictive value, and negative predictive value.

Results: The study assessed the diagnostic accuracy of the Sonographic Breast Imaging Reporting and Data System (BI-RADS) classification among patients aged 18–65 years (mean 32.4 ± 11.3 years). Higher breast density (ACR C and D) was prevalent, observed in 77.5% of participants. BI-RADS 2 (benign) accounted for 56.25% of breast masses, while 22.5% of cases were histopathologically confirmed as malignant, predominantly invasive ductal carcinoma (61.1%). Ultrasonography showed excellent performance, with a sensitivity of 84.4%, specificity of 96.3%, and an overall accuracy of 92.4%, underscoring its effectiveness in distinguishing benign from malignant breast masses.

Conclusion: High diagnostic accuracy was proven by sonographic BI-RADS classification in differentiating between benign and malignant breast lesions. The findings emphasize the utility of ultrasonography and BI-RADS in routine breast lesion assessment.

Keywords: Breast cancer, BI-RADS, Ultrasound, Diagnostic Accuracy, Benign Breast Lesions, Malignant Breast Lesions, Histopathology.