• Hadeel A Ghunaim.
• Hadeel A Ghunaim, MBBS. Assistant Professor and Consultant Radiologist, Department of Radiology, College of Medicine, Taibah University, Madinah, Saudi Arabia.
• Pak J Med Sci. 2024 Nov 1; 40 (10): 235623622356-2362.

Background & ObjectivesBI-RADS (Breast Imaging-Reporting and Data System) is a standard radiological risk assessment for breast lesions, including six categories, of which category four is the widest range of likelihood cancer risk (2% to 95%). This study aimed to evaluate the effect of patient age and ACR breast density on the positive predictive value (PPV) of BI-RADS 4 subcategorization (4A, 4B, and 4C).MethodsA retrospective study was conducted at King Fahed Hospital (KFH) between September 1, 2021, and June 30, 2022. PPV was calculated based on a histopathological report for all lesions. The correlation was made with patients' age groups ranging from < 45 years, 45-55 years, and > 55 years and four types of breast density on mammography. We used IBM-SPSS for data synthesis. The Chi-square test was used to assess any correlation between variables. A p-value < 0.05 was considered statistically significant.ResultsThe mean age was 44.62 ±14.32. Of the 248 cases, 81% were benign, 17% were malignant, and 2% were high-risk lesions. The age-related PPV of each BI-RADS category showed no significant differences among all age groups. However, the breast composition-related PPV cases with BI-RADS categories differed significantly within subcategory 4C (p-value<0.001).ConclusionsThere were no positive relationships between increasing age and PPV in BI-RADS 4 subcategories 4A, B, and C. Breast composition-related PPV showed significant differences with BI-RADS 4C subcategories.Copyright: © Pakistan Journal of Medical Sciences.

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