Validity of bi-rads system mammography in detecting breast cancer at Kenyatta National Hospital

Abstract

In Kenya, breast cancer is the most common cancer reported among women at 17.5%1. In Nairobi, the incidence among women was reported at 23.3%, among all cancers for the period 2000- 20022. The diagnosis of breast cancer may be established by the physical and imaging examinations, but the definitive diagnosis is ascertained by morphologic study (histopathology or cytology). Within the various imaging modalities, mammography is an easy, noninvasive imaging method to detect breast cancer with good accuracy3. Previous studies done in Kenya concluded that the radiological accuracy of mammography in detection of breast cancer is high3, and another probed the usefulness of mammography in the investigation of symptomatic patients less than 30 years of age4. However, it was found that the mammographic reports were not standardized, lacked uniformity and there was inconsistent use of imaging terminology. Also there was no mandate to provide further patient management recommendations based on imaging findings5. Keeping this in mind, in 1993 the American College of Radiology (ACR) first developed the Breast Imaging-Reporting and Data System (BI-RADS), in an effort to provide a quality assurance tool that would standardize mammographic reporting, facilitate outcome monitoring and reduce the ambiguity surrounding breast imaging reports5. This study was done to assess the accuracy of the ACR BI-RADS categories in detecting breast cancer in Kenyatta National Hospital.