Abstract:
The BI-RADS system (Breast Imaging Reporting and Data System) of the ACR (American College of Radiology) makes it possible to define the attitude to adopt in the face of a radiological abnormality of the breast. It has become the gold standard for the classification of objectified images in radiology.Considered as a standardized lexicon used throughout the world, it simplifies management, thus classifying radiological anomalies according to their severity into 7 groups: ACR 0 to ACR 6, however, there are still significant variations. inter-observers. Various studies have been conducted to assess the radio-histological correlation, which has thus made it possible to evaluate the probability of malignancy according to the ACR and to define the positive predictive value (PPV) for breast cancer in each radiological category. .The ACR4 category corresponds to suspicious abnormalities requiring histological proof, the PPV for breast cancer is variable from 2 to 95 percent according to the literature. This wide range of VPP prompted us to conduct a retrospective study of 110 cases conducted at the gynecology-obstetrics II department of the Hassan II hospital center in Fes spanning 3 years, from 2018 to 2021. Our objective is to report the histological results of breast lesions classified radiologically ACR4 in order to highlight the radio-histological correlation in order to improve our course of action. The PPV for breast cancer being 32%: only 21% of our patients benefited from simple monitoring after biopsy, while 79% were operated on. Data from the literature show that the degree of suspicion is variable with an ACR4 PPV which remained very wide between 2% and 95%. In this sense, Bi-rads of the ACR has proposed a subdivision of the BIRADS 4 category into three subgroups 4A, 4B, 4C, allowing to be even more precise in the positive predictive values, and thus reduce surgical interventions. useless, Adenofibroma is the most common histological finding and infiltrating ductal carcinoma remains the most common histological type of malignant lesion. Through our work, we emphasize that the VPP which is 32% is satisfactory, the adoption of this sub-classification seems more logical to us in order to improve our results and reduce unnecessary and costly interventions in the public health system.
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