Abstract
PURPOSE: This study aims to evaluate the effectiveness of the Kaiser score (KS) system in assessing breast lesions with uncertain malignant potential (B3). METHODS: Breast magnetic resonance imaging (MRI) scans from a total of 76 patients with histologically proven B3 lesions were included in this study. The KS was recorded for each MRI scan. The patients were classified based on biopsy results, and upgraded lesions were identified. Statistical analysis was conducted to evaluate the association between high KS values and upgraded lesions. RESULTS: The mean age of the 76 patients was calculated as 49.6 ± 10.1. A significant association was observed between the KS system and the prediction of malignancy upgrade (P < 0.001). Furthermore, among the descriptors, spiculation, margin, and upgrading prediction demonstrated a statistically significant difference (P < 0.001). Additionally, the specificity improved when the accepted KS cut-off value was set at seven instead of five. A significant association was also observed between the KS system and the papilloma upgrade rate within the B3 lesion subgroups (P < 0.001). CONCLUSION: Breast radiology plays a crucial role in the diagnosis of B3 lesions. Our findings suggest that the KS system holds promise as a tool for predicting the upgrade potential of B3 lesions. CLINICAL SIGNIFICANCE: This study demonstrated that the KS system may assist in predicting the upgrade potential of B3 breast lesions. It also demonstrated that spiculation and margin descriptors within the KS system possess a high positive predictive value for upgrade prediction. Additionally, we believe that the KS system can help prevent unnecessary surgeries in patients with B3 lesions.