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Mammography BI-RADS Lexicon and Usage
Wendie A. Berg, MD, PhD
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Abbreviations

          • Breast Imaging Reporting and Data System (BI-RADS) for mammography (MMG)
            • Terms may undergo revision; consult current edition of lexicon published by American College of Radiology (ACR)
            • Minor changes in phrasing have been made
        • Definitions

          • Standardized terms to describe breast density, mammographic findings, assessment, and management recommendations
          • Includes guidance on report organization and audits
          • Facilitates communication across facilities, disciplines
          • Descriptors listed from least to most suggestive of malignancy
            • Combination of features leads to management decision
          • "Baseline" = 1st mammogram

        IMAGING

        • Anatomy-Based Imaging Issues

          • Findings

            PATHOLOGY

            • Pathology-Based Imaging Issues

              DIAGNOSTIC CHECKLIST

              • Assessments and Recommendations

                Selected References

                1. Alshafeiy TI et al: Outcome of architectural distortion detected only at breast tomosynthesis versus 2D mammography. Radiology. 288(1):38-46, 2018
                2. Choudhery S et al: Masses in the Era of screening tomosynthesis: Is diagnostic ultrasound sufficient? Br J Radiol. 20180801, 2018
                3. Elezaby M et al: ACR BI-RADS assessment category 4 subdivisions in diagnostic mammography: utilization and outcomes in the National Mammography Database. Radiology. 170770, 2018
                4. Oligane HC et al: Grouped amorphous calcifications at mammography: frequently atypical but rarely associated with aggressive malignancy. Radiology. 288(3):671-679, 2018
                5. Grimm LJ et al: Suspicious breast calcifications undergoing stereotactic biopsy in women ages 70 and over: Breast cancer incidence by BI-RADS descriptors. Eur Radiol. 27(6):2275-81, 2017
                6. Nakashima K et al: Comparison of visibility of circumscribed masses on Digital Breast Tomosynthesis (DBT) and 2D mammography: are circumscribed masses better visualized and assured of being benign on DBT? Eur Radiol. 27(2):570-7, 2017
                7. Sickles EA et al: Breast Imaging Reporting and Data System (BI-RADS): Mammography. 5th ed. Reston: American College of Radiology, 2013
                8. Torres-Tabanera M et al: Analysis of the positive predictive value of the subcategories of BI-RADS(®) 4 lesions: preliminary results in 880 lesions. Radiologia. 54(6):520-531, 2012
                9. Youk JH et al: Scoring system based on BI-RADS lexicon to predict probability of malignancy in suspicious microcalcifications. Ann Surg Oncol. 19(5):1491-8, 2012
                10. Bent CK et al: The positive predictive value of BI-RADS microcalcification descriptors and final assessment categories. AJR Am J Roentgenol. 194(5):1378-83, 2010
                11. Burnside ES et al: The ACR BI-RADS experience: learning from history. J Am Coll Radiol. 6(12):851-60, 2009
                12. Venkatesan A et al: Positive predictive value of specific mammographic findings according to reader and patient variables. Radiology. 250(3):648-57, 2009
                13. Kim SJ et al: Application of sonographic BI-RADS to synchronous breast nodules detected in patients with breast cancer. AJR Am J Roentgenol. 191(3):653-8, 2008
                14. Burnside ES et al: Use of microcalcification descriptors in BI-RADS 4th edition to stratify risk of malignancy. Radiology. 242(2):388-95, 2007
                15. Berg WA et al: Does training in the Breast Imaging Reporting and Data System (BI-RADS) improve biopsy recommendations or feature analysis agreement with experienced breast imagers at mammography? Radiology. 224(3):871-80, 2002
                16. Varas X et al: Revisiting the mammographic follow-up of BI-RADS category 3 lesions. AJR Am J Roentgenol. 179(3):691-5, 2002
                17. Vizcaíno I et al: Short-term follow-up results in 795 nonpalpable probably benign lesions detected at screening mammography. Radiology. 219(2):475-83, 2001
                18. Liberman L et al: The breast imaging reporting and data system: positive predictive value of mammographic features and final assessment categories. AJR Am J Roentgenol. 171(1):35-40, 1998
                19. Sickles EA: Nonpalpable, circumscribed, noncalcified solid breast masses: likelihood of malignancy based on lesion size and age of patient. Radiology. 192(2):439-42, 1994
                Related Anatomy
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                References
                Tables

                Tables

                KEY FACTS

                • Terminology

                  • Imaging

                    • Diagnostic Checklist

                      TERMINOLOGY

                      • Abbreviations

                        • Breast Imaging Reporting and Data System (BI-RADS) for mammography (MMG)
                          • Terms may undergo revision; consult current edition of lexicon published by American College of Radiology (ACR)
                          • Minor changes in phrasing have been made
                      • Definitions

                        • Standardized terms to describe breast density, mammographic findings, assessment, and management recommendations
                        • Includes guidance on report organization and audits
                        • Facilitates communication across facilities, disciplines
                        • Descriptors listed from least to most suggestive of malignancy
                          • Combination of features leads to management decision
                        • "Baseline" = 1st mammogram

                      IMAGING

                      • Anatomy-Based Imaging Issues

                        • Findings

                          PATHOLOGY

                          • Pathology-Based Imaging Issues

                            DIAGNOSTIC CHECKLIST

                            • Assessments and Recommendations

                              Selected References

                              1. Alshafeiy TI et al: Outcome of architectural distortion detected only at breast tomosynthesis versus 2D mammography. Radiology. 288(1):38-46, 2018
                              2. Choudhery S et al: Masses in the Era of screening tomosynthesis: Is diagnostic ultrasound sufficient? Br J Radiol. 20180801, 2018
                              3. Elezaby M et al: ACR BI-RADS assessment category 4 subdivisions in diagnostic mammography: utilization and outcomes in the National Mammography Database. Radiology. 170770, 2018
                              4. Oligane HC et al: Grouped amorphous calcifications at mammography: frequently atypical but rarely associated with aggressive malignancy. Radiology. 288(3):671-679, 2018
                              5. Grimm LJ et al: Suspicious breast calcifications undergoing stereotactic biopsy in women ages 70 and over: Breast cancer incidence by BI-RADS descriptors. Eur Radiol. 27(6):2275-81, 2017
                              6. Nakashima K et al: Comparison of visibility of circumscribed masses on Digital Breast Tomosynthesis (DBT) and 2D mammography: are circumscribed masses better visualized and assured of being benign on DBT? Eur Radiol. 27(2):570-7, 2017
                              7. Sickles EA et al: Breast Imaging Reporting and Data System (BI-RADS): Mammography. 5th ed. Reston: American College of Radiology, 2013
                              8. Torres-Tabanera M et al: Analysis of the positive predictive value of the subcategories of BI-RADS(®) 4 lesions: preliminary results in 880 lesions. Radiologia. 54(6):520-531, 2012
                              9. Youk JH et al: Scoring system based on BI-RADS lexicon to predict probability of malignancy in suspicious microcalcifications. Ann Surg Oncol. 19(5):1491-8, 2012
                              10. Bent CK et al: The positive predictive value of BI-RADS microcalcification descriptors and final assessment categories. AJR Am J Roentgenol. 194(5):1378-83, 2010
                              11. Burnside ES et al: The ACR BI-RADS experience: learning from history. J Am Coll Radiol. 6(12):851-60, 2009
                              12. Venkatesan A et al: Positive predictive value of specific mammographic findings according to reader and patient variables. Radiology. 250(3):648-57, 2009
                              13. Kim SJ et al: Application of sonographic BI-RADS to synchronous breast nodules detected in patients with breast cancer. AJR Am J Roentgenol. 191(3):653-8, 2008
                              14. Burnside ES et al: Use of microcalcification descriptors in BI-RADS 4th edition to stratify risk of malignancy. Radiology. 242(2):388-95, 2007
                              15. Berg WA et al: Does training in the Breast Imaging Reporting and Data System (BI-RADS) improve biopsy recommendations or feature analysis agreement with experienced breast imagers at mammography? Radiology. 224(3):871-80, 2002
                              16. Varas X et al: Revisiting the mammographic follow-up of BI-RADS category 3 lesions. AJR Am J Roentgenol. 179(3):691-5, 2002
                              17. Vizcaíno I et al: Short-term follow-up results in 795 nonpalpable probably benign lesions detected at screening mammography. Radiology. 219(2):475-83, 2001
                              18. Liberman L et al: The breast imaging reporting and data system: positive predictive value of mammographic features and final assessment categories. AJR Am J Roentgenol. 171(1):35-40, 1998
                              19. Sickles EA: Nonpalpable, circumscribed, noncalcified solid breast masses: likelihood of malignancy based on lesion size and age of patient. Radiology. 192(2):439-42, 1994