Title Važnost upotrebe BI-RADS kategorija kod pisanja nalaza slikovne dijagnostike raka dojke
Title (english) The importance of using BI-RADS categories in writing imaging diagnostic reports for breast cancer
Author Lucija Šabarić
Mentor Tade Tadić (mentor)
Committee member Zenon Pogorelić (predsjednik povjerenstva)
Committee member Maja Marinović Guić (član povjerenstva)
Committee member Ana Čarić (član povjerenstva)
Granter University of Split School of Medicine Split
Defense date and country 2024-07-15, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Radiology
Abstract Cilj istraživanja: Rana detekcija raka dojke ima ključnu ulogu u smanjenju mortaliteta, poboljšanju prognoze i povećanju šansi za uspješno liječenje. Od 2006. godine u Republici Hrvatskoj počinje Nacionalni program ranog otkrivanja raka dojke – „MAMMA“. Cilj ovog istraživanja je ukazati na važnost standardizacije pisanja nalaza kod slikovne dijagnostike raka dojke, koristeći BI-RADS kategorije.
Ispitanici i metode: U istraživanju je sudjelovalo ukupno 7104 žena iz Splitsko-dalmatinske županije, u dobi od 49 do 69 godina, koje su bile dio sedmog ciklusa Nacionalnog programa probira za rano otkrivanje raka dojke. Ženama je upućen poziv na mamografiju, na koji su se odazvale. Sedmi ciklus provodio se u periodu od 2. ožujka 2021. do 21. ožujka 2023. Podatci žena prikupljeni su iz baze podataka Službe za epidemiologiju NZJZ-a Splitsko-dalmatinske županije. U istraživanju su se uspoređivala tri tima radiologa s KBC-a Split – Firule, koji su tijekom sedmog ciklusa svrstali žene u BI-RADS kategorije na temelju mamografskih nalaza. Svaka žena svrstana je u jednu od ukupno šest BI-RADS kategorija (BI-RADS 0 – BI-RADS 5).
Rezultati: Svaki od tri tima radiologa nasumično je dobio podjednak broj žena za procjenu BI-RADS kategorije. Timu 1 dodijeljeno je 2302 žene (32,4%), Timu 2 2388 žena (33,6%), a Timu 3 2414 žena (34%). Utvrđeno je da postoji značajna razlika među timovima u distribuciji BI-RADS kategorija (P<0,001). Posebna pažnja posvećena je BI-RADS 0 kategoriji, zbog njezinog opterećenja koje zahtijeva dodatne preglede kao što su ultrazvuk, MRI ili dodatna mamografija. Tim 1 imao je 200 žena s BI-RADS 0 (8,7%), Tim 2 imao je 414 žena s BI-RADS 0 (17,3%), a Tim 3 imao je 144 žene s BI-RADS 0 (6%). Dokazano je značajno odstupanje učestalosti BI-RADS 0 kategorije u usporedbi s ostalim kategorijama između tri tima (P<0,001).
Zaključci: Provedeno istraživanje pokazalo je značajne razlike među timovima radiologa u dodjeli BI-RADS kategorija, s posebnim odstupanjem u učestalosti BI-RADS 0 kategorije između Tima 2 (17,3%) i Tima 3 (6%). Dobiveni rezultati ukazuju na potrebu za dodatnim analizama i dugoročnim praćenjem žena s BI-RADS 0 kategorijom, kako bi se točno utvrdilo imaju li karcinom te procijenio utjecaj na zdravstveni sustav. Također je potrebno standardizirati proces pisanja nalaza i smanjiti varijabilnosti u interpretaciji mamografskih nalaza koristeći BI-RADS kategorije. To bi se moglo postići dodatnom edukacijom radiologa, međusobnim savjetovanjem, sustavom mentorstva te korištenjem naprednih softverskih programa i umjetne inteligencije.
Abstract (english) Objectives: Early detection of breast cancer plays a crucial role in reducing mortality, improving prognosis, and increasing the chances of successful treatment. Since 2006, the Republic of Croatia has implemented the National Program for Early Detection of Breast Cancer – “MAMMA.” This study aims to highlight the importance of standardizing the reporting of imaging findings in breast cancer diagnostics by utilizing BI-RADS categories.
Subjects and methods: The study involved 7,104 women aged 49 to 69 from Split-Dalmatia County, who participated in the seventh cycle of the National Breast Cancer Screening Program. This cycle took place from March 2, 2021, to March 21, 2023. Data were collected from the Epidemiology Service of the Split-Dalmatia County Public Health Institute. Three teams of radiologists from the University Hospital of Split – Firule classified the mammographic findings of these patients into one of six BI-RADS categories (BI-RADS 0 to BI-RADS 5).
Results: Each of the three radiologist teams randomly received a roughly equal number of women for BI-RADS category assessment. Team 1 assessed 2,302 patients (32.4%), Team 2 assessed 2,388 patients (33.6%), and Team 3 assessed 2,414 patients (34%). Significant differences were found among the teams in the distribution of BI-RADS categories (P<0.001). Special attention was given to the BI-RADS 0 category, due to its burden requiring additional examinations such as ultrasound, MRI, or additional mammography. Team 1 had 200 patients with BI-RADS 0 (8.7%), Team 2 had 414 patients with BI-RADS 0 (17.3%), and Team 3 had 144 patients with BI-RADS 0 (6%). A significant discrepancy in the frequency of BI-RADS 0 category was demonstrated compared to other categories between the three teams (P<0.001).
Conclusions: The conducted study showed significant differences among radiologist teams in the assignment of BI-RADS categories, with a particular discrepancy in the frequency of the BI-RADS 0 category between Team 2 (17.3%) and Team 3 (6%). The obtained results indicate the need for additional analyses and long-term follow-up of women with BI-RADS 0 category to accurately determine the presence of carcinoma and assess the impact on the healthcare system. Furthermore, it is necessary to standardize the reporting process and reduce variability in the interpretation of mammographic findings using BI-RADS categories. This could be achieved through additional radiologist education, inter-consultation, mentoring systems, and the use of advanced software programs and artificial intelligence.
Keywords
rak dojke
mamografija
BI-RADS kategorije
Nacionalni preventivni program
Keywords (english)
breast cancer
mammography
BI-RADS categories
National Prevention Program
Language croatian
URN:NBN urn:nbn:hr:171:951003
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access Embargo expiration date: 2024-07-15
Terms of use
Created on 2024-07-15 06:52:54