Higher-Than-Expected PPV of BI-RADS 4A Lesions in Indian Tertiary Centre

In a retrospective study of 230 women with BI-RADS 4 lesions, positive predictive value (PPV) was 26.9%. Subcategory PPVs: 4A 18.7% (exceeding typical 2-10%), 4B 27.6%, 4C 50%. History of breast cancer increased malignancy risk (34.9% vs 21.5%, p=0.001).

• Retrospective, single-centre study of 230 women with BI-RADS 4 lesions correlated with histopathology.
• The PPV for BI-RADS 4A was 18.7%, substantially higher than the commonly cited 2-10% risk range.
• Key limitation: data from a tertiary cancer centre may not generalize; no external validation.

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