Breast Cancer in Patients Initially Assigned as BI-RADS Category 3

Objectives: To determine the Positive Predictive Value (PPV) for malignancy and characteristics of breast cancer found in patients who were initially categorized as having Breast Imaging Reporting and Data System (BI-RADS) 3. Material and Method: Medical records of patients assigned to BI-RADS 3 from January, 1st to December, 31st 2002 at the Breast diagnostic center, Ramathibodi Hospital who had imaging follow-up for at least 2 years or had biopsy performed were retrospectively reviewed. Results: Of 949 patients, 23 were found to have malignancy, i.e., 2.4 % PPV. The most common imaging findings of breast cancer were calcifications on mammogram and mass on sonogram. Mean interval from first imaging to biopsy was 13.1 months. Only 78 % of malignancies were diagnosed within 2 years. Less than 50 % of these were ductal carcinoma in situ or stage I invasive ductal carcinoma. Conclusion: PPV for malignancy in the present study was comparable to the previous studies. However, longer time to diagnosis and more advanced stage of breast cancer at diagnosis were found. Periodically short-interval mammogram and sonogram, at not less than 2 year-intervals, were recommended