BI-RADS for Mammography

(1)

Chennai Breast Centre, Chennai, India

Breast Imaging Reporting and Data System (BI-RADS) for Mammography (Based on the Fifth Edition of ACR BI-RADS)

BI-RADS was conceived as a framework for standardizing mammography reports. It is organized into a general framework for breast evaluation, including a dictionary of defined terms and a reporting structure that is decision oriented.

Not only is BI-RADS important for radiologists, but the distinctions between these functions and their definitions are important for all physicians to understand.

Standardized terms are used to describe breast density, mammographic findings, assessment, and further management.

Report Relevant Points

Reasons for Examination
- Screening or diagnostic mammogram
- Previous breast surgery or needle biopsy
Imaging Protocol
- Standard CC and MLO
- Additional views

Report-Relevant Imaging Points

Breast composition

A.

Almost entirely fat

B.

Scattered fibroglandular densities

C.

Heterogeneously dense

D.

Extremely dense

Mass

A mass is a three-dimensional, space-occupying lesion that should be seen in two views with complete or partial convex borders. If a potential mass is seen in only a single projection, it should be called a density until its three-dimensionality is confirmed. Its shape, margin, density, and associated findings are noted.

Mass: Shape

Oval	Elliptical including two or three gentle undulations
Round	Circular lesions
Irregular	Lesions that are neither round nor oval

Mass: Margin

Circumscribed (well-defined or sharply defined) margins:

At least 75 % of the margins are sharply demarcated with an abrupt transition between the lesion and the surrounding tissue.
Obscured

25 % of the margins are hidden by superimposed fibroglandular tissue.
Microlobulated

Margins are characterized by short cycle undulations.
Indistinct (ill defined)

The poor definition of the margins raises concern that there may be infiltration by the lesion, and this is not likely due to superimposed normal breast tissue.
Spiculated

The lesion is characterized by lines radiating from the margins of a mass.