Original Research

An analysis of diagnostic practices in a mammography unit in a tertiary hospital in South Africa

Clare A. Surridge, Matthew D.M. Goodier
South African Journal of Radiology | Vol 21, No 1 | a1059 | DOI: https://doi.org/10.4102/sajr.v21i1.1059 | © 2017 Clare A. Surridge, Matthew D.M. Goodier | This work is licensed under CC Attribution 4.0
Submitted: 07 July 2016 | Published: 30 March 2017

About the author(s)

Clare A. Surridge, Department of Radiology, Grey’s Hospital, University of KwaZulu-Natal, South Africa
Matthew D.M. Goodier, Department of Radiology, Grey’s Hospital, University of KwaZulu-Natal, South Africa


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Abstract

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.


Keywords

Breast biopsy; Core needle biopsy; Ultrasound guided core needle biopsy; BI-RADS

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