(1)
Chennai Breast Centre, Chennai, India
Breast Imaging Reporting and Data System (BI-RADS) for Ultrasound (Based on the 5th Edition of ACR BI-RADS)
The consistent use of BI-RADS descriptors for breast ultrasound as for mammography helps in lesion assessment and communication with physicians and patients.
Report Relevant Points
The indication for the examination
The scope and technique of breast ultrasound
Description of breast composition
Clear description of relevant findings
Comparison with previous studies if available, clinical exam and mammogram or MRI
Composite reports
Assessment
Management recommendation
Indication of Examination
The most common indication to perform an ultrasound scan is to confirm and characterize lesions seen on mammogram or as second look after an MRI scan. Very young women, pregnant and lactating women may also have breast ultrasound as the first imaging technique. Breast ultrasound is also used to do guided core biopsy or wire localization.
Breast Composition
Breast composition should be mentioned when ultrasound is done as a screening examination.
Three US descriptors for composition have been described. Breast tissue composition is determined by echogenicity of the fat. Subcutaneous fat is medium gray and relative to this the fibroglandular tissue is lighter gray.
1.
Homogeneous backgraound echotexture – fat
2.
Heterogeneous background echotexture – fibroglandular
3.
Heterogeneous background echotexture
Clear Description of Findings
Masses
A mass occupies space and should be seen in two different projections. Characterization of the mass using morphological descriptors of shape, margin, orientation, boundary zone, echotexture, posterior acoustic features, and techniques like vascularity and echogenicity should be done.
Mass: Shape
Oval
Elliptical or egg shaped (may include 2 or 3 undulations, i.e., “gently lobulated” or “macrolobulated”)
Round
Spherical, ball-shaped, circular, or globular
Irregular
Neither round nor oval shape
Mass: Orientation
Parallel
Long axis of lesion parallels the skin line (“wider than tall” or horizontal).
Not parallel
Long axis, not oriented along the skin line (“taller than wide” or vertical, includes round)
Mass: Margin
Circumscribed
A margin that is well defined or sharp, with an abrupt transition between the lesion and surrounding tissue
Not circumscribed
The mass has one or more of the following features: indistinct, angular, microlobulated, or spiculated
Indistinct
No clear demarcation between a mass and its surrounding tissue
Angular
Margins with sharp corners, often forming acute angles
MicrolobulatedRelated posts:
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