LESIONS CLASSIFIED ACR3 WITH THE BREAST CANCER SCREENING MAMMOGRAPHY PROGRAM OF L’ARIANA STATE : FEATURES AND PROBLEMS ENCOUNTERED

##plugins.themes.academic_pro.article.main##

Mehiri S
Arous Y
Salem A
Bouchlaka A
Kribi L
Sellemi M
Hamza R
Mnif N
Gueddana N

Abstract

Objective : This retrospective work is related to ACR3 mammograms of the program “Feasibility of breast cancer screening by mammography in Ariana Governorate” in order to evaluate the efficiency and short-term quality control of these probably benign lesions.
Materials and methods : Mammograms classified ACR3 raised the indication of further examination, futher mammogram (profile, expanded or compression). The monitoring and control period are explained to the patient by the radiologist.
Results : 6.6% mammograms were classified as ACR 3 with 71. 3% under the age of 50 years. Breast is very dense in 20.5% of cases, and transparent in 6% of cases. Further exams has been performed in 94. 5% of cases with a profile in 52% of cases, enlarged in 22.1%, compression in 24.9% and ultrasound in 82.5%.
The surveillance protocol was insufficient for 126 women lost to the 1st control, 32 women lost for the 2nd control and 19 women were lost to the 3rd control. After two years monitoring, 219 women were reclassified as ACR2 with a negative test. In 2 patients, we found an invasive ductal carcinoma at 4 months control.
Conclusion: ACR 3 mammograms are the most important operator dependent category. The diagnosis of probably benign lesion dependant of the analysis of images and requires a great experience of the radiologist and a comprehensive complementary examination. In this study, this assessment was often heavy in relation to the frequency of dense breasts itself in connection with the young age of patients. In addition, for this particular category, the need of training is important and in terms of public health cost, the management of ACR3 mammograms increases difficulties and cost of screening.

##plugins.themes.academic_pro.article.details##

References

  1. American College of Radiology. Breast Imaging Reporting and Data System (BIRADS). 3rd ed. Reston, Va: American College of Radiology, 1998.
  2. Sickles EA. Probably benign lesions: when should follow-up be recommended and what is the optimal follow-up protocol ? Radiology 1999;213:11-14.
  3. Adler DD, Helvie MA, Ikeda DM. Nonpalpable probably benign breast lesions: follow- up strategies after initial detection on mammography. Am J Roentgenol 1990;155:1195-1201.
  4. Sickles EA. Periodic mammographic follow-up of probably benign results in 3,184 consecutive cases. Radiology 1991;179:463-468.
  5. Helvie MA, Pennes DR, Rebner M, Adler DD. Mammographic follow-up of low suspicion lesions: compliance rate and diagnostic yield. Radiology 1991; 178:155-158.
  6. Varas X, Leborgne F, Leborgne JH. Non-palpable, probably benign lesions: role of follow-up mammography. Radiology 1992; 84:409-414.
  7. Charriais, K Kinkel, F Thibault: Le système BI-RADSâ„¢ en imagerie mammaire : Initiation à son utilisation en version française. J Radiol 2002;83:531-534.
  8. A Travade, A Isnard, C Bagard et F Bouchet : Les opacités et les microcalcifications de la classification ACR 3 liées à un cancer. J Radiol 2004;85:2111-22.
  9. Vizcaino I, Gadea L, Andreo L, Salas D, Ruiz-Perales F, Cuevas D,et al. Short-term follow-up results in 795 non palpable probably benign lesions detected at screening mammography. Radiology 2001;219:475-83.
  10. Varas X, Leborgne JH, Leborgne F, Mezzera J, Jaumandreu S, Leborgn F., Revisiting the mammographic follow-up of BI-RADS category 3 lesions. AJR 2002;179:691-695.
  11. Taplin SH, Ichikawa LE, Kerlikowske K, Ernester VL, RD, Yankaskas BC, et al. Concordance of Breast Imaging Reporting and Data System assessments and management recommendations in screening mammography. Radiology 2002;222:539-535.