Correlation of Patterns of Mammographic changes and BI-RADS Assessment

Abstract

Background: Although breast cancer incidence is rising in Mongolia, little is known about how mammographic findings and BI-RADS final assessment categories are recorded in routine clinical practice. Aim: To describe report-derived finding categories and BI-RADS final assessments in a single-centre mammography registry, and to examine the association of age with BI-RADS ≥3. Materials and Methods: In this retrospective analytical cross-sectional analysis of 773 mammographic examination records, the earliest examination per participant was retained, yielding 733 women aged 20–74 years. Free-text findings were assigned to mutually exclusive categories using prespecified hierarchical keyword rules, and BI-RADS categories 3 and 4 were combined as “BI-RADS ≥3”. Group differences were examined with Pearson’s χ2 test and the age association with logistic regression; a body mass index (BMI)-adjusted model was fitted in 258 women with recorded height and weight. Results: Mean age was 44.2±10.8 years. The most frequent report categories were no lesion (28.4%), calcification (20.1%), density-related descriptors (19.8%) and other benign/structural findings (16.0%). BI-RADS categories 1, 2, 3 and 4 were recorded in 312 (42.6%), 342 (46.7%), 65 (8.9%) and 14 (1.9%) women, respectively, and BI-RADS ≥3 in 79 (10.8%; 95% CI 8.7–13.2). This proportion differed across age groups (χ2=12.72; P=0.026). Each additional decade of age was associated with higher odds of BI-RADS ≥3 (OR 1.44; 95% CI 1.16–1.79; P=0.001), and the association persisted after BMI adjustment (OR 1.62; 95% CI 1.10–2.36; P=0.013). BMI was not associated with BI-RADS ≥3. Conclusions: 1. Among the 733 women examined at a single hospital, the most common mammographic findings were no significant abnormalities (28.4%), calcifications (20.1%), density-related findings (19.8%), and other benign or structural changes (16.0%). 2. Of the final assessments, 89.2% were classified as BI-RADS 1–2, while 10.8% were classified as BI-RADS 3–4. No cases were classified as BI-RADS 0 or BI-RADS 5. 3. For every 10-year increase in age, the odds of receiving a BI-RADS score of ≥3 increased by a factor of 1.44. This association remained independent of body mass index (BMI).