2024 Volume 33 Issue 1 Pages 69-74
Mammography-guided aspiration mammary tissue biopsy (MG-VAB) is performed to diagnose category (C) 3 or higher calcified lesions that cannot be detected by ultrasound. However, it is important to decide whether biopsy is indicated or not. We have developed a scoring system to classify C3-1 and C3-2 lesions, especially in the recent softcopy diagnosis, which can be difficult to evaluate because of its detailed morphological observation. The J-RADS 4th edition states that “a large number and high density is considered C3-2,” but there was no significant difference in the number and density between benign and malignant cases. The items with significantly higher malignancy rate were: (1) heterogeneity of density, small and large difference in density, shading, and background density, and (2) heterogeneity of density, small and large difference in density, and angle. Using this system, the malignancy rate of C3-1/C3-2 was (1) 11.6%/32.3% and (2) 6.5%/45.8%, making it possible to create a system that is easy to evaluate even for those inexperienced in MG and may help in determining the indication for biopsy.
