Do We Need Breast Magnetic Resonance Imaging or Biopsy for Breast Imaging and Reporting Data System Category 3 Lesions on Ultrasound?

Objective: Breast Imaging and Reporting Data System category 3 was established for lesions that were thought to be probably benign, and its aim was to limit the number of biopsies performed. Breast Imaging and Reporting Data System category 3 lesions are common, but they remain controversial due to high interob- server variability. Our aim is to examine how many cases with a sonographically identified Breast Imaging and Reporting Data System category 3 lesion were performed on breast magnetic resonance imaging and/or biopsy and whether the Breast Imaging and Reporting Data System category changes with the breast magnetic resonance imaging.

Methods: This retrospective study included 498 patients who underwent breast ultrasonography between November 1, 2022, and June 30, 2023, and who had Breast Imaging and Reporting Data System category 3 lesion(s). Among these patients, those who underwent breast magnetic resonance imaging and/or biopsy within 3 months were found. Magnetic resonance images were evaluated for sonographically identified Breast Imaging and Reporting Data System category 3 lesion(s). Tru-cut biopsy results were also evaluated.

Results: Of 498 patients who had Breast Imaging and Reporting Data System category 3 lesion(s) on ultrasonography, 66 (13.3%) underwent breast magnetic resonance imaging subsequently. With the magnetic resonance imaging, there were 17 patients (25.7%) whose Breast Imaging and Reporting Data System cat- egory downgraded, 12 (18.1%) whose category upgraded, and 37 (56.1%) whose category remained unchanged. The mean age of those who had a biopsy was found to be lower than those who did not have a biopsy (P = .028).

Conclusion: The aim of Breast Imaging and Reporting Data System category 3 was to limit the number of breast biopsies performed. Magnetic resonance imag- ing can be used as a problem solver for Breast Imaging and Reporting Data System category 3 lesions and can also update the Breast Imaging and Reporting Data System category. Biopsy of Breast Imaging and Reporting Data System category 3 lesions may not be cost effective due to the low probability of malignancy.

Cite this article as: Öztürk MÖ, Bilici E, Kösetürk T, Çetin T. Do we need breast MRI or biopsy for BIRADS 3 lesions on ultrasound? Current Research in MRI, 2023;2(2):22-26.