Objectives: The purpose of this study was to evaluate the accuracy of the results of BIRADS classification (Grade 3 and Grade 4) using sonography in evaluating the level of malignancy of breast masses and comparing it with pathological outcomes. Materials and Methods: After obtaining the consent of the Ethics Committee of Mashhad University of Medical Sciences, patients with palpable breast mass who were ultrasound candidates for further examination of the nature of mass were selected. Then, an axilla breast ultrasound was performed by two radiology professors of Mashhad university of medical sciences with at least 10 years of experience in this field. Based on the classification of the American Society for Radiology and the BIRADS system, various degrees of breast masses malignancy were identified. In a group of patients categorized as BIRADS-4 and also in a number of patients classified in the BIRADS-3 that for some reason (such as the patient's request or doctor's opinion), they needed to undergo a biopsy, ultrasound was conducted for patients. The pathologic results were compared with ultrasound reports, and consistency of the results and accuracy of ultrasound were examined with the help of statistical tests. In this study, SPSS software version 16 was used. This case-series study was performed on 139 patients referred to Imam Reza Hospital, Omid Hospital and some private clinics in Mashhad. Results: In this study, 139 patients with mean age of 42.4 years were examined and went under core needle biopsy from breast masses. Out of 37 biopsies of lesions with BIRADS-3 in ultrasound, two (5.4%) of the lesions resulted in malignant pathology. Out of 102 biopsies of lesions with BIRADS4 in ultrasound, 65 (64%) of them resulted in benign pathology. The sensitivity of the BIRADS-3 system for diagnosis of benign breast mass is 94% and its specificity is 64%. The sensitivity of the BIRADS-4 system is 75% for diagnosis of breast cancer while its specificity is 79%. Conclusion: Our study confirms the consistency between the results obtained from the classification by the BIRADS method with the pathology, and given the relatively high accuracy of this method, radiologic-pathologic consistency can be used to determine how to follow the patients and choose the appropriate treatment.
