Correlation of the BI‐RADS assessment categories of Papua New Guinean women with mammographic parenchymal patterns, age and diagnosis

Abstract

Introduction: Women with increased breast density are at increased risk of breast cancer. The aim of this research is to evidence for the first time the mammographic breast findings of Papua New Guinean (PNG) women and the relationship between Breast Imaging-Reporting and Data System (BI-RADS) assessment, mammographic parenchymal patterns (MPPs) and age. Methods: A retrospective analysis of 1357 mammograms of women imaged at the Pacific International Hospital (PIH) from August 2006 to July 2010 was undertaken. Mammographic findings were categorised using the BI-RADS Atlasâ 5th Edition. MPPs were recorded for each woman using the Tab ar Pattern I-V classification system. Age was recorded in years. Statistical analysis was by descriptive analysis and Kruskal-Wallis with Dunn's post-test and Spearman's rho correlation for inferential analysis. Results: True pathological findings (benign and malignant); BI-RADS 2-5 were noted in 111 women (8.2%); 1242 (91.5%) were negative. BI-RADS categories for malignancy were reported in 16 (88.9%) of women aged 30 to 60 years. The lower risk Tab ar Type I, II and III MPPs were associated with 94.4% (n = 17) of malignancies. Linear correlations between variables were weak and not statistically significant: age and Tab ar pattern r = 0.031, P = 0.0261; age and BI-RADS r = 0.018, P = 0.517; Tab ar pattern and BI-RADS r = 0.020, P = 0.459 (n = 1357). Conclusion: There was no correlation demonstrated between BI-RADS category, age and MPP. Importantly, there was no correlation demonstrated between BI-RADS categories 4 and 5 for breast malignancy and high-risk Tab ar Type IV and V MPPs. The results of this study again reflect that the incidence of breast cancer in PNG cannot be explained by breast density and suggest that any formalised screening program in PNG has a target age group aimed at women younger than that of Western screening programs.

A review of mammographic image quality in Papua New Guinea

“…In addition, the PMGH mammography services more closely resemble Western diagnostic services in that age is not targeted, and that the burden of breast cancer in PNG affects younger women compared with most Western countries, including Australia. 22 The mean age of women in the study was 49.51 years, which is just younger than the BSA target age group which is 50–74 years. 9…”

“…The age profile of the women undergoing imaging at PMGH is younger than those of Western screening programs and is consistent with the population demographics for PNG where the median age is 22 years and the average life expectancy for females is 65.8 years. In addition, the PMGH mammography services more closely resemble Western diagnostic services in that age is not targeted, and that the burden of breast cancer in PNG affects younger women compared with most Western countries, including Australia 22 . The mean age of women in the study was 49.51 years, which is just younger than the BSA target age group which is 50–74 years 9…”