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1.  Observer Variability of the Breast Imaging Reporting and Data System (BI-RADS) Lexicon for Mammography 
Breast Care  2010;5(1):11-16.
We aimed to determine the inter- and intra-observer variabilities between breast radiologists and a general radiologist in categorizing mammographic lesions using the Breast Imaging Reporting and Data System (BI-RADS), and to evaluate the effects of the histopathologic results on the variability.
Mammograms from 142 women who underwent biopsy were evaluated. 3 breast radiologists (2 with >10 years experience and 1 with 1 year experience) and 1 general radiologist retrospectively reviewed mammograms twice within an 8-week interval. Inter- and intra-observer variabilities were assessed with Cohen's kappa statistic, and the positive predictive value for final assessments was calculated.
The intra-observer variability for mass and calcification assessments was moderate to almost perfect (kappa values: 0.41–1) for breast imagers and was fair to substantial for the general radiologist (kappa values: 0.21–0.8). Inter-observer agreement between the breast imagers was higher than between the breast and general radiologists. There was no apparent difference in agreement between observers for malignant and benign subgroups.
The differences in intra- and inter-observer agreement between the breast imagers and the general radiologist affirm the utility of the BI-RADS lexicon. The histopathologic results of the lesions do not affect the agreement. BI-RADS is a simple and adequate tool for assessing mammograms, even after only 1 year of training.
PMCID: PMC3357160  PMID: 22619635
Inter-observer variability; Intra-observer variability; BI-RADS lexicon; Mammography
2.  The Diagnostic Accuracy of Mammography and Ultrasound in the Evaluation of Male Breast Disease: A New Algorithm 
Breast Care  2009;4(4):255-259.
The purpose of this study was to define the diagnostic accuracy of mammography and ultrasound in the evaluation of male breast disease, and to suggest a diagnostic protocol for male breast disease.
Material and Methods
We retrospectively reviewed clinical, radiographic, and pathologic records of 75 patients. Breast Imaging Reporting and Data System (BI-RADS) category 4-5 mammograms and ultrasonograms were suggested as suspicious for malignancy.
Of the 75 patients, 23 (31%) were considered to have suspicious lesions by mammography and/or ultrasonography. 13 of the patients were shown to have breast cancer. The remaining 52 (69%) were referred for biopsy by clinicians; all of the biopsy specimens were benign (gynecomastia). The accuracy data of mammography and ultrasonography are: sensitivity, 69 and 100%; specificity, 87 and 97%; positive predictive value, 53 and 87%; negative predictive value, 93 and 100%; and accuracy, 84 and 97%, respectively.
We suggest a new diagnostic algorithm for the evaluation of male breast disease in which ultrasonography may be used to evaluate palpable abnormalities as the first diagnostic tool of choice. To use and to trust imaging would decrease the number of false-positive biopsies that would be generated by physical examination alone.
PMCID: PMC2941655  PMID: 20877664
Male breast cancer; Ultrasound; Mammography

Results 1-2 (2)