OBJECTIVE: To evaluate radiological findings in patients submitted to surgical treatment for medullary breast cancer at Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil, correlating them with histological results. MATERIALS AND METHODS: A retrospective descriptive study was developed with patients submitted to surgery at INCA, in the period from January 1997 to December 2006, for identifying the presence of medullary breast carcinoma and analyzing radiological findings. RESULTS: Among 21,287 patients diagnosed with carcinoma, 76 (0.357%) had typical medullary breast carcinoma. The age range of these patients was 32-81 years (mean = 59.1 years). Mammography demonstrated lesions in 19 of these patients, 17 (89.5%) of them with masses, and 2 with focal asymmetry. Among the patients with masses, 15 (88.1%) presented with high density and 2 (11.9%) with isodensity. Twelve patients presented sonographic findings, 11 (91.6%) of them with hypoechoic masses, and one with an anechoic mass with areas of cystic degeneration. CONCLUSION: Nodular mass was the predominant radiological finding (89.5%), 88.1% of them corresponding to masses with high density and circumscribed margins. Despite the radiological characteristics of benignity, a solid, fast-growing, highly dense mass with circumscribed margins should be further investigated to confirm the diagnosis.

Keywords: Medullary breast cancer, Radiological findings, Diagnosis

OBJECTIVE: To review the literature about the positive predictive value of Breast Imaging Reporting and Data System (BI-RADS®) categories 3, 4 and 5. MATERIALS AND METHODS: A research was performed in the online Medline database, entering the terms "predictive value" and "BI-RADS". Eleven studies were included in this review. RESULTS: The positive predictive values ranged respectively between 0% and 8%, 4% and 62%, and 54% and 100% for BI-RADS® categories 3, 4 and 5. Three studies have also evaluated morphological criteria with higher positive predictive value in mammography, mass with spiculated margins being the finding with highest positive predictive value for malignancy. CONCLUSION: A high variability was found in the reviewed literature among positive predictive values of BI-RADS® categories 3, 4 and 5, although methodological differences have been identified, limiting the comparative analysis.

Keywords: Mammography, BI-RADS®, Breast cancer