Coding mammograms using the classification "probably benign finding - Short interval follow-up suggested"

OBJECTIVE. Many benign breast lesions revealed by mammography show features indicating that the lesions have a high, but not complete, likelihood of b eing benign. The Breast Imaging Reporting and Data System (BI-RADS) allows radiologists to classify these mammograms as "probably benign finding-short interval follow-up suggested" (category 3). We explored whether certain fa ctors are associated with the use of category 3 in a national cancer detect ion program. MATERIALS AND METHODS. We analyzed data from the National Breast and Cervic al Cancer Early Detection Program, a comprehensive nationwide program that provides cancer screening for low-income and medically underserved women. T he study population included all women at least 40 years old who had underg one mammography on or before September 30, 1996 (n = 372,760). RESULTS. Of the 372,760 mammograms, 7.7% were classified as category 3. The probability of receiving a category 3 classification decreased as patients ' ages increased. Women who were symptomatic were nearly twice as likely as women who were asymptomatic to receive a category 3 classification, and wo men whose clinical breast examinations had abnormal findings were more than twice as likely as women with examinations having normal findings to recei ve a category 3 classification. The percentage of mammograms classified as category 3 by state or tribal organization ranged from 1.4% to 14.0%. CONCLUSION. Several patient variables, including patient symptomatology, we re associated with the probability of having a mammogram classified as cate gory 3. One of the most important determinants was where the patient underw ent mammography, which suggests that variability exists among radiologists themselves in using this BI-RADS code for "probably benign" mammographic le sions.