Value of BI-RADS 3 Audits

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Breast Imaging Reporting and Data System (BI-RADS) 3 signifies a probably benign finding with ≤2% malignancy risk.
• Monitoring adherence to BI-RADS 3 criteria and establishing quality benchmarks remain challenging.
• Effective quality control is essential for managing clinical practice and patient outcomes.

Purpose of the Study:

• To explore quantifiable parameters for quality control in BI-RADS 3 assessments.
• To evaluate the adherence of BI-RADS 3 assignments to established malignancy probability benchmarks.
• To provide insights for clinical practice management through regular auditing of BI-RADS 3 metrics.

Main Methods:

• Retrospective analysis of BI-RADS 3 cases in women over 40 recalled from screening exams (Jan 2014-Dec 2017).
• Inclusion criteria: initial BI-RADS 3 assignment after diagnostic workup.
• Quantitative quality control metrics assessed over a 2-year follow-up period.

Main Results:

• 1,037 BI-RADS 3 cases were analyzed from 135,765 screening exams.
• The 24-month follow-up rate was 86.7%.
• Cancer yield was 2.51%, consistent with the ≤2% malignancy probability of BI-RADS 3. Upgrade rate was 7.4%, and PPV3 was 33.8%.

Conclusions:

• Regular auditing of BI-RADS 3 metrics offers valuable insights for clinical practice management.
• Establishing benchmarks through data from diverse clinical settings and expert input is recommended.
• The study supports the continued appropriate use of BI-RADS 3 in breast cancer screening quality control.