The Positive Predictive Value of BI-RADS Microcalcification Descriptors and Final Assessment Categories

The Positive Predictive Value of BI-RADS Microcalcification Descriptors and Final Assessment Categories
Chris K. Bent, Lawrence W. Bassett, Carl J. D'Orsi, and James W. Sayre
AJR 2010;194:1378-1383

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RESULTS. The overall positive predictive value of biopsies was 28.8%. The individual morphologic descriptors predicted the risk of malignancy as follows: fine linear/branching, 16 (70%) of 23 cases; fine pleomorphic, 14 (28%) of 50 cases; coarse heterogeneous, two (20%) of 10 cases; amorphous, 10 (20%) of 51 cases; and typically benign, zero (0%) of 12 cases. Fisher-Freeman-Halton exact testing showed statistical significance among morphology descriptors (p < 0.001) and distribution descriptors (p < 0.001). The positive predictive value for malignancy according to BI-RADS assessment categories were as follows: category 2, 0%; category 3, 0%; category 4A, 13%; category 4B, 36%; category 4C, 79%; and category 5, 100%.

CONCLUSION. BI-RADS morphology and distribution descriptors can aid in assessing the risk of malignancy of microcalcifications detected on full-field digital mammography. The positive predictive value increased in successive BI-RADS categories (4A, 4B, and 4C), verifying that subdivision provides an improved assessment of suspicious microcalcifications in terms of likelihood of malignancy

1H MR Spectroscopy of Invasive Ductal Carcinoma: Correlations With FDG PET and Histologic Prognostic Factors

1H MR Spectroscopy of Invasive Ductal Carcinoma: Correlations With FDG PET and Histologic Prognostic Factors
Mitsuhiro Tozaki and Kazuei Hoshi
AJR 2010;194:1384-1390

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The choline levels obtained using 1H MR spectroscopy with a 1.5-T unit were well correlated with the standardized uptake value obtained using PET/CT and with the histologic prognostic parameters (nuclear grade, estrogen receptor status, and triple-negative lesion status)

Adenoid Cystic Carcinoma of the Breast

Adenoid Cystic Carcinoma of the Breast
Katrina N. Glazebrook, Carol Reynolds, Robin L. Smith, Edgardo I. Gimenez, and Judy C. Boughey
AJR 2010;194:1391-1396

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Recognition of ACC is important to avoid delay in diagnosis because this tumor has a good prognosis with rare metastases to axillary lymph nodes. Axillary nodal sampling by fine-needle aspiration or core biopsy is rarely indicated

Atypical Papilloma Diagnosed by Sonographically Guided 14-Gauge Core Needle Biopsy of Breast Mass

Atypical Papilloma Diagnosed by Sonographically Guided 14-Gauge Core Needle Biopsy of Breast Mass
Ji Hyun Youk, Eun-Kyung Kim, Jin Young Kwak, and Eun Ju Son
AJR 2010;194:1397-1402

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Atypical papilloma diagnosed by use of sonographically guided 14-gauge core needle biopsy showed a high upgrade rate after surgical excision. Although some sonographic features may be helpful to predict an upgrade to malignancy, atypical papilloma should be excised surgically in any case