Pathological and radiological assessment of benign breast lesions with BIRADS IVc/V subtypes. should we repeat the biopsy?
Abstract Background Timely diagnosis is a crucial factor in decreasing the death rate of patients with breast cancer. BI-RADS categories IVc and V indicate a strong suspicion of cancer. The categorisation of each group is determined by the characteristics of the lesion. Certain benign breast lesions...
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2025-02-01
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| Series: | BMC Women's Health |
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| Online Access: | https://doi.org/10.1186/s12905-025-03569-7 |
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| author | Wesam Rjoop Anwar Rjoop Alia Almohtaseb Lama Bataineh Zeina Nser Joubi Maha Gharaibeh Abdalrahman Al-Qwabah Yousef Alasheh Ismail Matalka |
| author_facet | Wesam Rjoop Anwar Rjoop Alia Almohtaseb Lama Bataineh Zeina Nser Joubi Maha Gharaibeh Abdalrahman Al-Qwabah Yousef Alasheh Ismail Matalka |
| author_sort | Wesam Rjoop |
| collection | DOAJ |
| description | Abstract Background Timely diagnosis is a crucial factor in decreasing the death rate of patients with breast cancer. BI-RADS categories IVc and V indicate a strong suspicion of cancer. The categorisation of each group is determined by the characteristics of the lesion. Certain benign breast lesions might have radiological features indicative of malignancy; thus, biopsy is mandatory. This study aimed to identify the histopathological diagnosis of benign breast masses classified into BIRADS IVc and V subgroups, investigate the radiological characteristics of these masses, and identify ultrasound features that could lead to false positive results (benign lesions that mimic malignancy on imaging). Methods This was a retrospective cross-sectional study at a single facility. Breast lesions reported as BIRADS IVc and V that underwent needle core/stereotactic vacuum-assisted biopsy were reviewed. Patients with benign pathologic diagnoses were analysed, delineating pathological diagnoses. Radiological descriptors were compared to those of a matched control of 50 malignant cases with BIRADS IVc. Results A total of 828 breast lesions classified as BIRADS IVc or V were detected during the period spanning from 2015 to 2022. Forty-four lesions (44/828, 5.3%) were benign at initial biopsy, while 784 lesions (784/828, 94.7%) were malignant. After histopathological testing and repeat biopsy, 26/828 (3.14%) patients had discordant benign diagnosis. Half of the repeated biopsies (10/20, 50%) showed malignant pathology. Compared to that in the control group, the presence of an oval shape of the mass was significantly more common in patients with benign pathology (p = 0.035). Conversely, the presence of posterior shadowing was significantly less common (p = 0.050) in benign lesions. No significant differences were observed for the other radiological characteristics. The most common histopathological diagnosis was fibrocystic change. Conclusion This study highlights key findings regarding the sonographic imaging descriptors and histopathological diagnoses of benign breast lesions categorised as BIRADS IVc/V. The study recommends a correlation between clinical and radiological findings and encourages multidisciplinary decision-making among radiologists, pathologists, and clinicians to determine if a repeat biopsy is warranted. There is a need for continuous research to improve the diagnosis and treatment of breast lesions and reduce false-positive rates by incorporating other methodologies such as sonoelastography and incorporating deep learning and artificial intelligence in the decision-making to eliminate unnecessary procedures. |
| format | Article |
| id | doaj-art-83185adb64564536835ba9952ead3937 |
| institution | Kabale University |
| issn | 1472-6874 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj-art-83185adb64564536835ba9952ead39372025-02-09T12:52:49ZengBMCBMC Women's Health1472-68742025-02-012511810.1186/s12905-025-03569-7Pathological and radiological assessment of benign breast lesions with BIRADS IVc/V subtypes. should we repeat the biopsy?Wesam Rjoop0Anwar Rjoop1Alia Almohtaseb2Lama Bataineh3Zeina Nser Joubi4Maha Gharaibeh5Abdalrahman Al-Qwabah6Yousef Alasheh7Ismail Matalka8Primrose Breast Care Center, University Hospitals Plymouth NHS TrustDepartment of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and TechnologyDepartment of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and TechnologyDepartment of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and TechnologyDepartment of Radiology, Faculty of Medicine, Jordan University of Science and TechnologyDepartment of Radiology, Faculty of Medicine, Jordan University of Science and TechnologyDepartment of Radiology, Faculty of Medicine, Jordan University of Science and TechnologyCollege of Medicine, Ajman UniversityCollege of Medicine, Ras Al Kaimah Medical and Health Sciences UniversityAbstract Background Timely diagnosis is a crucial factor in decreasing the death rate of patients with breast cancer. BI-RADS categories IVc and V indicate a strong suspicion of cancer. The categorisation of each group is determined by the characteristics of the lesion. Certain benign breast lesions might have radiological features indicative of malignancy; thus, biopsy is mandatory. This study aimed to identify the histopathological diagnosis of benign breast masses classified into BIRADS IVc and V subgroups, investigate the radiological characteristics of these masses, and identify ultrasound features that could lead to false positive results (benign lesions that mimic malignancy on imaging). Methods This was a retrospective cross-sectional study at a single facility. Breast lesions reported as BIRADS IVc and V that underwent needle core/stereotactic vacuum-assisted biopsy were reviewed. Patients with benign pathologic diagnoses were analysed, delineating pathological diagnoses. Radiological descriptors were compared to those of a matched control of 50 malignant cases with BIRADS IVc. Results A total of 828 breast lesions classified as BIRADS IVc or V were detected during the period spanning from 2015 to 2022. Forty-four lesions (44/828, 5.3%) were benign at initial biopsy, while 784 lesions (784/828, 94.7%) were malignant. After histopathological testing and repeat biopsy, 26/828 (3.14%) patients had discordant benign diagnosis. Half of the repeated biopsies (10/20, 50%) showed malignant pathology. Compared to that in the control group, the presence of an oval shape of the mass was significantly more common in patients with benign pathology (p = 0.035). Conversely, the presence of posterior shadowing was significantly less common (p = 0.050) in benign lesions. No significant differences were observed for the other radiological characteristics. The most common histopathological diagnosis was fibrocystic change. Conclusion This study highlights key findings regarding the sonographic imaging descriptors and histopathological diagnoses of benign breast lesions categorised as BIRADS IVc/V. The study recommends a correlation between clinical and radiological findings and encourages multidisciplinary decision-making among radiologists, pathologists, and clinicians to determine if a repeat biopsy is warranted. There is a need for continuous research to improve the diagnosis and treatment of breast lesions and reduce false-positive rates by incorporating other methodologies such as sonoelastography and incorporating deep learning and artificial intelligence in the decision-making to eliminate unnecessary procedures.https://doi.org/10.1186/s12905-025-03569-7BI-RADSCategory IVc and V subgroupsBreastNeedle core biopsyBreast imagingFibrocystic change |
| spellingShingle | Wesam Rjoop Anwar Rjoop Alia Almohtaseb Lama Bataineh Zeina Nser Joubi Maha Gharaibeh Abdalrahman Al-Qwabah Yousef Alasheh Ismail Matalka Pathological and radiological assessment of benign breast lesions with BIRADS IVc/V subtypes. should we repeat the biopsy? BMC Women's Health BI-RADS Category IVc and V subgroups Breast Needle core biopsy Breast imaging Fibrocystic change |
| title | Pathological and radiological assessment of benign breast lesions with BIRADS IVc/V subtypes. should we repeat the biopsy? |
| title_full | Pathological and radiological assessment of benign breast lesions with BIRADS IVc/V subtypes. should we repeat the biopsy? |
| title_fullStr | Pathological and radiological assessment of benign breast lesions with BIRADS IVc/V subtypes. should we repeat the biopsy? |
| title_full_unstemmed | Pathological and radiological assessment of benign breast lesions with BIRADS IVc/V subtypes. should we repeat the biopsy? |
| title_short | Pathological and radiological assessment of benign breast lesions with BIRADS IVc/V subtypes. should we repeat the biopsy? |
| title_sort | pathological and radiological assessment of benign breast lesions with birads ivc v subtypes should we repeat the biopsy |
| topic | BI-RADS Category IVc and V subgroups Breast Needle core biopsy Breast imaging Fibrocystic change |
| url | https://doi.org/10.1186/s12905-025-03569-7 |
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