Evaluation of Stereotactic Biopsy Diagnostic Efficacy in Verification of Suspicious Breast Lesions (BI-RADS Categories 4–5)

Background. Breast cancer remains the leading oncological pathology among the female population, which underscores the critical importance of methods for its early and accurate detection. Stereotactic biopsy (STB) is one of them: it is a minimally invasive procedure that provides histological confirmation of a diagnosis based on mammographic findings. However, its diagnostic performance when working with different subcategories of Breast Imaging Reporting and Data System (BI-RADS) requires further clarification in real-world clinical practice.

Objective: to evaluate STB diagnostic efficacy in detecting breast cancer in patients with suspicious mammographic findings (BI-RADS 4a, 4b, 4c, 5) in the context of correlation between radiologic conclusions and histological diagnosis.

Material and methods. A retrospective single-center study analyzed data from 102 patients who underwent STB. In 54 cases, STB results were compared with postoperative histological analysis findings. Key diagnostic performance indicators and the Cohen's kappa (κ) agreement coefficient were calculated.

Results. According to STB, malignant, precancerous, and benign processes were identified in 18.6% (19/102), 11.8% (12/102), and 69.6% (71/102) of cases, respectively. When compared with excision biopsy data (n=54), STB demonstrated the following metrics: diagnostic accuracy 90.7%, sensitivity 84%, specificity 100%, positive and negative predictive values 100% and 81.4%, respectively. The false negative rate was 9.2% (5/54). Agreement between the methods was very high (κ=0.85). The highest frequency of cancer confirmation was associated with the BI-RADS 4c subcategory.

Conclusion. STB has proven to be a highly accurate and effective method for the morphological verification of suspicious breast lesions categorized as BI-RADS 4–5, contributing to a reduction in the number of unjustified surgical interventions. The primary direction for further improvement of the technique is to reduce the frequency of false negative results by optimizing the tissue sampling procedure.

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