CORRELATION ANALYSIS OF RADIOLOGICAL AND PATHOHISTOLOGICAL CHARACTERISTICS OF BENIGN AND MALIGNANT BREAST TUMORS
DOI:
https://doi.org/10.32782/health-2025.3.6Keywords:
breast tumors, digital mammography, pathohistological examination, BI-RADS, ACR, differential diagnosisAbstract
Breast tumors represent a significant challenge in modern medicine due to their high prevalence and clinical heterogeneity. Accurate differentiation between benign and malignant neoplasms is critically important for timely and effective treatment. Despite advances in imaging and morphological techniques, the integration of data from these modalities remains the cornerstone of high-precision diagnostics.Objective. To compare the radiological (based on digital mammography using the BI-RADS and ACR classifications) and pathohistological criteria of benign and malignant breast tumors in order to identify diagnostic markers that improve the accuracy of their differentiation and assess the diagnostic capabilities.Materials and Methods. This study involved a retrospective analysis of 145 digital mammograms (115 benign and 30 malignant) along with corresponding histological samples obtained through biopsy or surgical intervention.Mammographic images were evaluated according to the BI-RADS and ACR classifications. Pathohistological examination was conducted using standard methodology, with verification of histological type and degree of invasiveness in accordance with the WHO Classification of Breast Tumours, 5th Edition. Results. The BI-RADS distribution analysis showed that the largest proportions were BI-RADS category 2 (24.1%) and category 6 (20.7%). According to the ACR classification, types B (53.7%) and A (28.9%) were predominant. A correlation was identified between increased breast density according to ACR (particularly types C and D) and a higher frequency of BI-RADS categories 4–6, indicating challenges in visualizing pathologies in dense breast tissue.Radiologically, benign tumors were often characterized by well-defined, smooth margins and regular shapes with macrocalcifications (such as «popcorn» type), whereas malignant tumors typically exhibited irregular, spiculated margins, irregular shapes, high density, and amorphous microcalcifications.Pathohistologically, invasive carcinoma of no special type accounted for 73% of malignant lesions, correlating with spiculated margins and desmoplastic stromal reaction.Conclusions. The combined use of digital mammography and pathohistological examination significantly improves the accuracy of differential diagnosis of malignant breast tumors. Identified radiological and histological markers – such as margin characteristics, shape, density, and type of calcifications – are key to distinguishing between benign and malignant lesions. The BI-RADS system, together with ACR-based breast density assessment, plays a critical role in risk stratification and in guiding further patient management strategies.
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