A nomogram for diagnosis of BI-RADS 4 breast nodules based on three-dimensional volume ultrasound

Abstract Objectives The classification of malignant breast nodules into four categories according to the Breast Imaging Reporting and Data System (BI-RADS) presents significant variability, posing challenges in clinical diagnosis. This study investigates whether a nomogram prediction model incorporating automated breast ultrasound system (ABUS) can improve the accuracy of differentiating benign and malignant BI-RADS 4 breast nodules. Methods Data were collected for a total of 257 nodules with breast nodules corresponding to BI-RADS 4 who underwent ABUS examination and for whom pathology results were obtained from January 2019 to August 2022. The participants were divided into a benign group (188 cases) and a malignant group (69 cases) using a retrospective study method. Ultrasound imaging features were recorded. Logistic regression analysis was used to screen the clinical and ultrasound characteristics. Using the results of these analyses, a nomogram prediction model was established accordingly. Results Age, distance between nodule and nipple, calcification and C-plane convergence sign were independent risk factors that enabled differentiation between benign and malignant breast nodules (all P