Diagnostic Accuracy of Mammography in Assessment of Breast Lesions (Breast Imaging Reporting and Data System Category IVA) Taking Histopathology as Gold Standard

Abstract

Background and Objective: Breast imaging-reporting and data system (BI-RADS) is intended for
standardizing mammography reporting, and class IV A represents low suspicion of malignancy. The
objective of this study was to assess the diagnostic accuracy of mammography in assessment of breast lesions
(BIRADS IVA) taking histopathology as gold standard.
Methods: It was a cross-sectional study conducted in the Department of Diagnostic Radiology, Sharif
Medical & Dental College, Hospital, Lahore from 16/08/2023 to 16/02/2024. A total of 215 patients who
fulfilled inclusion criteria were included from OPD and underwent mammography. Findings were recorded
and patients were labeled as malignant or benign. Then patients underwent biopsy and histopathology was
done. Reports were followed and the type of lesion was noted as malignant or benign. All the information was
recorded in Proforma and analyzed using SPSS version 25.0.
Results: In this study, 215 participants were included with the mean age of 53.88 ± 9.48 years. The BMI was
26.20 ± 3.60 kg/m2. Mean size of breast lesions was 4.00 ± 1.20 cm. Among these participants,
mammography identified 193 cases as BIRADS IVA, representing 89.8% of the total population.
Conversely, 22 participants (10.2%) did not exhibit BIRADS IVAfindings on mammography. Comparison of
findings of mammography with histopathological findings produced 98.44% sensitivity, 86.36% specificity,
98.45% PPV, 86.32% NPVand 97.21% accuracy.
Conclusion: This study provided evidence for the importance of mammography in assessing BIRADS IVA
breast lesions, demonstrating high sensitivity, specificity, positive predictive value, and negative
predictive value and diagnostic accuracy taking histopathological findings as gold standard. Further
advancements in diagnostic methods are warranted to enhance accuracy and patient care.
Key Words: Breast Feeding, Breast Lesions, BIRADS IVA, Diagnostic Accuracy, Histopathology,
Mammography