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Review
. 2018 Mar 2:29:140.
doi: 10.11604/pamj.2018.29.140.13699. eCollection 2018.

[Radio-histological correlation of ACR4 microcalcifications in breast lesions: about 181 cases and literature review]

[Article in French]
Ahmed Guennoun  1 , Yousra Krimou  1 , Chahrazed Bouchikhi  1 , Nisrine Mamouni  1 , Sanaa Errarhay  1 , Abdelaziz Banani  1
Affiliations
Review

[Radio-histological correlation of ACR4 microcalcifications in breast lesions: about 181 cases and literature review]

[Article in French]
Ahmed Guennoun et al. Pan Afr Med J. .

Abstract
in English, French

The Bi-RADS (Breast Imaging Reporting and Data System) classification developed by the ACR (American College of Radiology) is the classification system for radiological images recommended for breast cancer screening. The ACR 4 microcalcification is an indeterminate or suspected abnormality with 2-95% probability of malignancy, according to studies. This disparity pushed us to conduct this retrospective study of 181 patients in the Department of Obstetrics and Gynecology I at the Hassan II University Hospital, Fez, over a period of 5 years. This study aimed to report the histological results of breast lesions radiologically classified as ACR4 in order to assess their radio-histological correlation and to improve therapeutic approach. All patients underwent breast imaging examinations and then anatomopathologic examination was performed using different techniques. There was a clear predominance of benign lesions with a rate of 62% versus 29% of malignant lesions and only 9% were intermediate lesions. Adenofibroma was the most common histological finding (30% of cases), invasive ductal carcinoma was the most frequent malignant lesion (17% of cases). We performed a literature review which showed that our results were in line with findings of other studies, with a positive predictive value of 29%. Nevertheless, ACR classification divided into subcategories 4a, b and c should be used due to the significant number of unnecessary surgical interventions.

La classification Bi-Rads (Breast Imaging Reporting and Data System) de l'ACR (American College of Radiology) est le système de classement des images radiologiques, recommandé pour le dépistage du cancer du sein. La lésion ACR IV correspond à une anomalie indéterminée ou suspecte avec probabilité de malignité de 2-95% selon des études. Cette disparité nous a poussés à réaliser notre étudequi est uneétude rétrospective de 181 patientes étalée sur 5 ans, conduite dans le service de gynécologie-obstétrique I du Centre hospitalier Hassan II de Fès. Notre objectif est de rapporter les résultats histologiques des lésions mammaires classées radiologiquement ACR4 dans le but d'évaluer la corrélation radio-histologique et d'améliorer notre conduite à tenir. Toutes nos patientes ont bénéficié d'une imagerie du sein puis d'une preuve anatomopathologique par différentes techniques. Nous avons noté une nette prédominance des lésions bénignes avec un taux de 62% contre 29% des lésions malignes et seulement 9% étaient intermédiaires. L'adénofibrome est le résultat histologique le plus retrouvé avec 30% des cas, le carcinome canalaire infiltrant reste le chef de file des lésions malignes avec 17% des cas. A travers une revue de la littérature, nos résultats semblent rejoindre ceux des autres études avec une Valeur prédictive positive de 29%. Néanmoins, l'adoption de la sous-classification ACR en ACR4a, b et c parait plus adaptée,en raison du nombre important des interventions chirurgicales inutiles.

Keywords: ACR4 sub-categories; Radio-histological correlation; positive predictive value of ACR4 lesions.

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References

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