Impact of the Kaiser score on clinical decision-making in BI-RADS 4 mammographic calcifications examined with breast MRI.
Eur Radiol
; 30(3): 1451-1459, 2020 Mar.
Article
em En
| MEDLINE
| ID: mdl-31797077
ABSTRACT
OBJECTIVES:
To investigate whether the application of the Kaiser score for breast magnetic resonance imaging (MRI) might downgrade breast lesions that present as mammographic calcifications and avoid unnecessary breast biopsiesMETHODS:
This IRB-approved, retrospective, cross-sectional, single-center study included 167 consecutive patients with suspicious mammographic calcifications and histopathologically verified results. These patients underwent a pre-interventional breast MRI exam for further diagnostic assessment before vacuum-assisted stereotactic-guided biopsy (95 malignant and 72 benign lesions). Two breast radiologists with different levels of experience independently read all examinations using the Kaiser score, a machine learning-derived clinical decision-making tool that provides probabilities of malignancy by a formalized combination of diagnostic criteria. Diagnostic performance was assessed by receiver operating characteristics (ROC) analysis and inter-reader agreement by the calculation of Cohen's kappa coefficients.RESULTS:
Application of the Kaiser score revealed a large area under the ROC curve (0.859-0.889). Rule-out criteria, with high sensitivity, were applied to mass and non-mass lesions alike. The rate of potentially avoidable breast biopsies ranged between 58.3 and 65.3%, with the lowest rate observed with the least experienced reader.CONCLUSIONS:
Applying the Kaiser score to breast MRI allows stratifying the risk of breast cancer in lesions that present as suspicious calcifications on mammography and may thus avoid unnecessary breast biopsies. KEY POINTS ⢠The Kaiser score is a helpful clinical decision tool for distinguishing malignant from benign breast lesions that present as calcifications on mammography. ⢠Application of the Kaiser score may obviate 58.3-65.3% of unnecessary stereotactic biopsies of suspicious calcifications. ⢠High Kaiser scores predict breast cancer with high specificity, aiding clinical decision-making with regard to re-biopsy in case of negative results.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mama
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Neoplasias da Mama
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Calcinose
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Carcinoma Lobular
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Carcinoma Ductal de Mama
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Carcinoma Intraductal não Infiltrante
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Sistemas de Apoio a Decisões Clínicas
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Tomada de Decisão Clínica
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Áustria