Correlation of Breast Imaging Reporting and Data System (BI-RADS) Classification with Histopathological Findings in Patients with Breast Lesions

Abstract

Background: Breast lesions encompass a wide spectrum of benign and malignant conditions requiring accurate diagnosis for appropriate clinical management. The Breast Imaging Reporting and Data System (BI-RADS) provides standardized radiological classification and malignancy risk assessment. This study aimed to correlate BI-RADS classification with histopathological findings and evaluate its diagnostic performance in patients with breast lesions.

Materials and Methods: This hospital-based, observational, cross-sectional study included 90 patients with breast lesions who underwent mammography, ultrasonography, or both, followed by histopathological examination. Lesions were categorized according to BI-RADS classification and correlated with histopathological diagnoses. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were evaluated.

Results: Among 90 patients, 96.67% were females, and breast lump was the predominant presenting complaint (72.22%). Histopathological examination revealed 58 benign (64.44%) and 32 malignant (35.56%) lesions. Fibroadenoma (31.11%) was the most common benign lesion, while invasive breast carcinoma of no special type (25.56%) was the predominant malignancy. Malignancy rates increased progressively from 4.17% in BI-RADS 3 to 11.11%, 50.00%, 90.00%, and 100% in BI-RADS 4A, 4B, 4C, and 5, respectively. BI-RADS demonstrated sensitivity of 96.88%, specificity of 60.34%, PPV of 57.41%, NPV of 97.22%, and overall diagnostic accuracy of 73.33%.

Conclusion: BI-RADS classification demonstrated high sensitivity and negative predictive value in identifying malignant breast lesions. Radiological–histopathological correlation remains essential for accurate diagnosis, appropriate biopsy selection, and effective clinical management.