May Gail Risk Score be Helpful in Predicting the Diagnosis of Malignancy for Non-Palpable Bi-Rads Category 4 Lesions Before Biopsy?

INTRODUCTION: BI-RADS 4 breast lesions are high probability of malignancy and the most comon indication of breast biopsy in this group. OBJECTIVES: In this study; we investigated the corralation between Gail risk scores and BI-RADS category of these patients for estimating malignancy befor biopsy. MATERIAL AND METHODS: In a prospective manner between 2007-2011, the age of over 35 patient's Gail risk scores who had biopsy indication for BI-RADS 4 category calculated before biopsy and final pathology results compared with the calculated risk scores. Statistically, P less than 0.05 was considered significant. Dependence between categorical variables were evaluated with chi-square test. RESULTS: In this study 246 women have been included, patient’s average age was 47.9 (35-82) year. Pathologic results were benign in 196 (%79.67), malign in 50 (%20.33) patients.The diagnosis of benign lesions were 4A in 178, 4B in 11, 4C in 7 patient. The diagnosis of malign lesions were 4A in 35, 4B in 9, 4C in 6 patient. Statistically, there was a relationship between advanced BI-RADS category with increased risk of malignancy (p=0.001). Total of 47 (%19.1) patients Gail risk score were above the critical value of 1.7. Patients with pathologically diagnosed malign were above the critical value of 1.7 only 8/35 (%22.85) in 4A, 1/9 (%11.1) in 4B, 1/6 (16.6) in 4C. Malign diagnosed patient’s of 9/50 of Gail risk score were above the value of 1.7. However patients with pathologically diagnosed benign were 39/178 (%21.81) in 4A, 3/11 (%27.27) in 4B and 3/7 (%42.85) in 4C above the value of 1.7. CONCLUSION: For women with Gail risk score above 1.7 is recommended close follow-up or prophylactic preventions. According to the results of our study before the biopsy, to determine the risk of malignancy BIRADS category is valuable. But Gail risk score to assess the risk of malignancy is thought to provide any contribution in Turkish women.