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Purpose: BI-RADS 3 and 4 constitute the most debated group of the BI-RADS classification used in the evaluation of breast masses. The aim of the present study was to compare radiological and histopathological results of the patients who were radiological determined as BI-RADS 3, 4 or 5, and who underwent biopsy, and to review proper approach to such lesions. Methods: The medical charts of the patients who were found to have a breast mass on physical examination and/or using radiological investigation between January 2011 and August 2013, and who were classified as BI-RADS 3, 4 or 5 using ultrasonography, mammography, and/or magnetic resonance imaging, and who subsequently underwent biopsy examination were retrospectively reviewed. Results: A total of 97 patients were included in the study. Of the cases in BI-RADS 3 group, 11% had malignant lesion, 58.8% of the patients in the BI-RADS 4 group had malignant lesion, and all patients in the BI-RADS 5 group had malignant lesion. When the patients in BI-RADS 4 were divided into subgroups, the rate of malignant was 23% in the 4A group and 88% in the 4C group. Conclusion: The lesions in BI-RADS 3 group often have benign character, but it must be remembered that they may be rarely malignant lesions. In BI-RADS 4 group, the lesions in 4A have low malignancy potential and the lesions in 4C group have extremely high malignancy potential. [ABSTRACT FROM AUTHOR]

Intracystic papillary carcinoma of the breast (IPC) is usually seen in postmenopausal elderly women. Its prognosis is much better than other type of breast tumors, and usually do not contain invasive components. Surgical excision with negative margins and axillary sentinel lymph node sampling is the recommended treatment. Two cases of intracystic papillary carcinoma of the breast that was treated at our clinic are herein presented. Both cases were postmenopausal, were both positive for estrogen and progesterone receptors and negative for HER 2. They underwent breast-conserving surgery. One patient had an invasive focus, therefore axillary lymph node sampling was performed, and the sentinel lymph node was not metastatic. This patient received hormonal therapy as well as radiotherapy. In the other case, there was no invasive focus and the surgical margins were negative, therefore, additional surgery was not performed. The patient is receiving hormonal therapy. Intracystic carcinoma of the breast should be kept in mind especially in elderly patients with breast cysts, with clinically or radiologically suspicious features, and biopsy and local excision should be considered. Although there is not any standard approach for patients with IPC, each patient must be evaluated for surgery and should be individually assessed in terms of adjuvant therapy [ABSTRACT FROM AUTHOR]