Microcalcifications of the breast: how does radiologic classification correlate with histology?

Abstract

Purpose: To assess the correlation between the pre-biopsy classification of microcalcifications and the underlying histology. Material and Methods: Using the morphology and distribution patterns according to the Breast Imaging-Reporting and Data System (BI-RADS®) lexicon, the microcalcifications of 199 lesions in 163 consecutive patients scheduled to undergo 11 G vacuum core biopsy were classified within the BI-RADS® categories. The correlation between BI-RADS® assessment categories 3, 4, and 5 and the final histological results was statistically evaluated with the χ2 test. The diagnostic indices were calculated. Results: The prospectively classified BI-RADS® 3/4/5 findings revealed a malignant histology in 5.9%/17.6%/90.9% of all lesions, respectively. The relationship between BI-RADS® categories 3, 4, and 5 and histology was statistically highly significant ( P<0.0001). The sensitivity, specificity, positive and negative predictive values were 95.7%/21.2%/37.8%/94.3%, respectively. Conclusion: The BI-RADS® lexicon describes microcalcifications of the breast and provides diagnostic categories that lead to standardized biopsy recommendations. Nevertheless, how to link description to classification of microcalcifications is still a difficult diagnostic task. The evaluation of microcalcifications as proposed in this article may help to set standards in the clinical routine and in the comparability of scientific data.