Breast pathology and mammography BI-RADS category correlation study - A single institute experience

Although recent technological advances, there is still discordance between mammography findings and pathologic diagnoses, especially for certain racial/ethnic populations. In this study we correlated the mammography BI-RADS categories with pathologic diagnoses, aiming to evaluate the performance of mammography in breast cancer detection in a unique poor population consisting of mostly Hispanics and African Americans. A total of 3935 female patients with a breast mammography and a subsequent breast pathology report within 90 days were retrospectively analyzed. There were 875 (22.2%) patients with a negative or probably benign mammography (BI-RADS 1, 2 and 3), and 33 (3.8%) of them had a malignant pathologic diagnosis. Patients with malignant pathologic diagnoses were older, higher in socioeconomic status (SES), and more likely to be African American or White, compared to those with non-malignant pathologic findings. They mostly presented with related symptoms (e.g. breast pain, mass or discharge) and/or family history or past history of breast cancers, which triggered secondary imaging examination and subsequent breast biopsy/excision, and eventually resulted to the diagnosis of breast cancers. In conclusion, our studies indicated that the performance of mammography is comparable in detection of breast cancers among Hispanics, African American and White populations, if it was done in the same facility. Our results also suggested that for patients with presenting symptoms, past history of breast cancer or strong family history of breast cancer, a secondary breast imaging examination may be warranted following a negative to probably benign mammography (BI-RADS 1-3).