Abstract

SURRIDGE, Clare A.  and  GOODIER, Matthew D.M.. An analysis of diagnostic practices in a mammography unit in a tertiary hospital in South Africa. S. Afr. J. radiol. (Online) [online]. 2017, vol.21, n.1, pp.1-8. ISSN 2078-6778.  http://dx.doi.org/10.4102/sajr.v21i1.1059.

BACKGROUND: Breast cancer is the most common cancer in females in South Africa. The reporting of breast imaging has been standardised internationally using the Breast Imaging and Reporting Data System (BI-RADS), which includes guidelines for reporting of breast lesions and further management. Ultrasound-guided core-needle breast (UGCNB) biopsy is a widely used method of obtaining histological diagnoses of breast lesions to assist with planning definitive management. OBJECTIVES: To perform an audit of the UGCNB biopsies performed at the Grey's Hospital Mammography Department and assess the accuracy of the radiologists' use of the BI-RADS scoring system. METHODS: Records of all patients who underwent UGCNB biopsy between 01 January 2014 and 31 October 2015 were reviewed. A retrospective study was performed. RESULTS: A total of 304 UGCNB biopsies were performed on 291 patients. The mean age was 49.2 (s.d. = 15.9) years. Tissue samples from 303 lesions were adequate for histological assessment, and of these, 51% of the lesions were malignant whilst 49% were benign. The most common malignant and benign diagnoses were invasive ductal carcinoma and fibroadenoma respectively. The BI-RADS scoring of the radiologists demonstrated a positive predictive value of 61.6% for the identification of possible malignant lesions. CONCLUSION: This study describes the patient and lesion profile and unit practices in a tertiary hospital setting in South Africa. The radiologists' application of the BI-RADS scoring largely conforms to the BI-RADS guidelines. The study highlights several challenges encountered by a breast imaging programme in an under-resourced setting as well as making recommendations in overcoming these challenges.

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