A REVIEW OF BIOPSY PRACTICES IN BI-RADS 3 BREAST LESIONS IN A SRI LANKAN COHORT m39899@pgim.cmb.ac.lk

 

A REVIEW OF BIOPSY PRACTICES IN BI-RADS 3 BREAST LESIONS IN A SRI LANKAN COHORT

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Sri Lanka

Oral or Poster

BI-RADS-3 are benign lesions with a malignancy risk less than 2%. If not clinically suspicious of malignancy they are recommended to undergo follow-up. Inter-observer variations in categorization may result in unnecessary biopsying, false negative results and patient stress.

BI-RADS-3 lesions at a tertiary care hospital in Colombo between 2020-2022 years were retrospectively analyzed. Categorization done according to ultrasonography (in all) and mammography (in those over 40 years). Lumps with clinical evidence of malignancy underwent percutaneous or surgical biopsy. Histologically proven malignancy individuals underwent conservative surgery or mastectomy.

Among 628 with BI-RADS-3 lesions (mean age 45.3±15.8years), 81.7% (n=512) were histologically benign, 15.4% (n=97) malignant, and 2.9% (n=18) were inconclusive. Those with benign histology had a mean age of 43.7±15.6 years, while malignancy mean age was 53.3±13.8 years. Malignant lesions were invasive ductal carcinoma-(non specific type) 62.9% (n=61), ductal carcinoma in-situ 14.4%(n=14), invasive lobular 11.3% (n=11) and invasive mucinous 4.1% (n=4). Of 32% (31/97) of the malignant lesions, the maximum size was 18.6 mm. Nottingham grading showed that 39.7% (n=29) were grade I, 41.1% (n=30) grade II, and 19.2% (n=14) grade III.

15.4% were malignant in this cohort, which is higher than the 2% malignancy reported. An age disparity was observed between benign and malignant cases, with malignant lesions occurring in older individuals (mean age 53.3 vs. 43.7 years). High malignancy rate advocates re-evaluation of BI-RADS 3 follow-up protocols, especially for older patients in addition to those with risk factors.