Downgrade BI-RADS 4A Patients Using Nomogram Based on Breast Magnetic Resonance Imaging, Ultrasound, and Mammography

Yamie Xie; Ying Zhu; Weimin Chai; Shaoyun Zong; Shangyan Xu; Weiwei Zhan; Xiaoxiao Zhang

doi:10.3389/fonc.2022.807402

Downgrade BI-RADS 4A Patients Using Nomogram Based on Breast Magnetic Resonance Imaging, Ultrasound, and Mammography

Front Oncol. 2022 Jan 27:12:807402. doi: 10.3389/fonc.2022.807402. eCollection 2022.

Authors

Yamie Xie^{1

2}, Ying Zhu¹, Weimin Chai³, Shaoyun Zong², Shangyan Xu¹, Weiwei Zhan¹, Xiaoxiao Zhang¹

Affiliations

¹ Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² College of Medicine, Kunming University of Science and Technology, Department of Ultrasound, The First People's Hospital of Yunnan Province, Kunming, China.
³ Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract

Objectives: To downgrade BI-RADS 4A patients by constructing a nomogram using R software.

Materials and methods: A total of 1,717 patients were retrospectively analyzed who underwent preoperative ultrasound, mammography, and magnetic resonance examinations in our hospital from August 2019 to September 2020, and a total of 458 patients of category BI-RADS 4A (mean age, 47 years; range 18-84 years; all women) were included. Multivariable logistic regression was used to screen out the independent influencing parameters that affect the benign and malignant tumors, and the nomogram was constructed by R language to downgrade BI-RADS 4A patients to eligible category.

Results: Of 458 BI-RADS 4A patients, 273 (59.6%) were degraded to category 3. The malignancy rate of these 273 lesions is 1.5% (4/273) (<2%), and the sensitivity reduced to 99.6%, the specificity increased from 4.41% to 45.3%, and the accuracy increased from 63.4% to 78.8%.

Conclusion: By constructing a nomogram, some patients can be downgraded to avoid unnecessary biopsy.

Keywords: Breast Imaging Reporting and Data System; breast tumor; magnetic resonance imaging; mammography; ultrasound.