Valores preditivos dos nódulos mamários categoria 3 pelo sistema de laudos e registro de dados de imagem da mama submetidos à biópsia percutânea por ultrassonografia
Palavras-chave:
neoplasias de mama, diagnóstico, biópsia, ultrassonografiaResumo
Introdução: A classificação do Breast Imaging Reporting and Data System (BI-RADS) permite a padronização dos achados das massas mamárias, com recomendação para o manejo individualizado. Por causa de sua alta frequência, massas classificadas como 3, provavelmente benignas, despertam interesse em melhorar sua caracterização e em estabelecer o comportamento mais adequado. Objetivo: P rimeiramente, d emonstrar o s v alores p reditivos p ositivos e n egativos d a c lassificação d e m assas s ólidas B I-RADS 3 submetidos a biópsia percutânea por ultrassonografia. Em segundo lugar, sugerir conduta de acompanhamento por ultrassonografia diferente nesses achados. Metodologia: Estudamos, retrospectivamente, 480 massas BI-RADS 3, submetidas a biópsia a vácuo ou corebiopsia, com resultado histopatológico conclusivo considerado padrão-ouro. Resultados: De 480 massas em 396 pacientes, 473 eram benignas e 7 malignas. O valor preditivo positivo para malignidade de categoria 3 foi de 1,5% (7/480) e o valor preditivo negativo foi de 98,5%. Conclusão: Em vista da baixa probabilidade de câncer, recomenda-se a realização de ultrassonografia direcionada (second look) de massas classificadas como BI-RADS 3 por especialista em radiologia da mama antes da indicação de um procedimento invasivo, o que reduziria substancialmente o número de biópsias desnecessárias, ansiedade do paciente, bem como possíveis complicações. Isso aumentará a possibilidade de o especialista passar mais tempo em exames realmente necessários e direcionados, definindo melhor os casos de acompanhamento (anual ou semestral) da indicação da investigação em casos específicos.
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Copyright (c) 2019 Leticia Pereira Gonçalves, Mariana Loureiro Lemos, Maria Julia Gregorio Calas
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
