Evaluation and correlation of mammographically suspicious lesions with histopathology at Addington Hospital, Durban

B D Cupido, F Vawda, A Sabri, C T Sikwila


Background. Stereotactic core-needle biopsies (SCNBs) are a reliable alternative to surgical biopsy for microcalcifications. The positive predictive value (PPV) of SCNB has been shown to be reproducible in several studies using the Breast Imaging Reporting and Data System (BIRADS) classification, which is the current gold standard in mammographic reporting. At this stage, no study has been done in KwaZulu-Natal to assess local outcomes against BIRADS. The current standard of care utilises vacuum-assisted breast biopsy, but is not available in a resource-constrained environment such as ours. The need, therefore, is for constant evaluation of existing practice to ensure that it is optimised for the challenges and limitations facing local radiologists.

Objective. To assess the PPV of SCNB in Addington Hospital, and to compare it with that of BIRADS.

Material and methods. Mammographically detected lesions were assigned to 3 categories: benign, indeterminate and suspicious. A retrospective review of 67 SCNBs was performed for lesions falling within the suspicious category, and the PPV and rates of ductal carcinoma in situ (DCIS) were determined.

Results. Our study demonstrated a PPV of 20.9%. This correlated well with international studies for BIRADS 4 and 5 lesions. DCIS accounted for 21.4% of detected malignancies, which is in keeping with current literature.

Conclusion. Despite resource limitations, local outcomes were comparable to those of BIRADS. Given our fairly general categorisation of lesions, however, it should be emphasised that BIRADS allows better organisation, consistency and clarity in breast imaging reporting, as well as accurate data comparison between centres facing limitations similar to our own.

Authors' affiliations

B D Cupido, Department of Radiology, Addington Hospital, Durban

F Vawda, Department of Radiology, School of Surgical Disciplines, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban

A Sabri, Cypress Health Region Hospital, Department of Radiology, Saskatchewan

C T Sikwila, Private practice, Glenwood, Durban

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Breast Neoplasms;Core Needle Biopsy;Stereotactic Biopsy;Breast Microcalcifications;Ductal Carcinoma In Situ(DCIS);BIRADS

Cite this article

South African Medical Journal 2013;103(4):251-254. DOI:10.7196/SAMJ.6361

Article History

Date submitted: 2012-10-01
Date published: 2013-03-04

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