Assessment of BI-RADS reliability in sonomammographic diagnosis of breast Masses confirmed by postoperative histopathology: A multicenter observational study

Ghanem, Hazem Gamal; Abdelrafeh, Ibrahim; Moneir, Mohammad Ibrahim; Elseddik, Mohamed Abobakr

doi:10.21608/arcmed.2025.387688.1129

Assessment of BI-RADS reliability in sonomammographic diagnosis of breast Masses confirmed by postoperative histopathology: A multicenter observational study

Document Type : Original Research

Authors

¹ General surgery department Armed Forces college of medicine

² General surgery department Armed forces college of medicine

³ Radiodiagnosis department, Armed forces college of Medicine, Cairo, Egypt

10.21608/arcmed.2025.387688.1129

Abstract

Background: The typical manifestation of both benign and malignant tumours is a breast lump, and triple assessment increases the accuracy of the diagnosis. BI-RADS based on sonomammography provides malignancy risk classification and standardized reporting. Its diagnostic accuracy in determining breast masses is assessed in this study.
Methods: This observational analysis included 77 surgical patients with breast masses who had their diagnoses confirmed by histopathology after undergoing sonomammography and BI-RADS scoring in accordance with ACR standards. Although limited by selection bias, the inclusion of surgical cases ensured diagnostic accuracy, supporting the BI-RADS-malignancy correlation in a high-risk population.
Results: The distribution of BI-RADS among the benign lesions was as follows: one lesion was categorised as BI-RADS 5, twelve as BI-RADS 4b, three as BI-RADS 4c, eight cases as BI-RADS 3, and fourteen as BI-RADS 4a.
No cases were identified as BI-RADS 3 among the malignant lesions; two were identified as BI-RADS 4a, three as BI-RADS 4b, eleven as BI-RADS 4c, and twenty-three as BI-RADS 5.
Higher BI-RADS categories were positively correlated with a higher risk of malignancy, as evidenced by the following data: 0% in BI-RADS 3, 12.5% in 4a (2/16), 20% in 4b (3/15), 78.6% in 4c (11/14), and 95.8% in BI-RADS 5 (23/24). The diagnostic performance metrics addressed in discussion .
Conclusion: Although the results should be interpreted cautiously due to the limited sample size and potential interobserver variability, this study supports the relevance of higher BI-RADS categories in surgical decision-making by confirming a robust association between them and malignancy.

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