BI-RADS is an
acronym
An acronym is a word or name formed from the initial components of a longer name or phrase. Acronyms are usually formed from the initial letters of words, as in ''NATO'' (''North Atlantic Treaty Organization''), but sometimes use syllables, as ...
for Breast Imaging-Reporting and Data System, a quality assurance tool originally designed for use with
mammography. The system is a collaborative effort of many health groups but is published and trademarked by the
American College of Radiology (ACR).
The system is designed to standardize reporting and is used by medical professionals to communicate a patient's risk of developing
breast cancer
Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a r ...
, particularly for patients with
dense breast tissue
Dense breast tissue, also known as dense breasts, is a condition of the breasts where a higher proportion of the breasts are made up of glandular tissue and fibrous tissue than fatty tissue. Around 40–50% of women have dense breast tissue and o ...
. The document focuses on patient reports used by medical professionals, not "lay reports" that are provided to patients.
Published Documents
The BI-RADS is published by ACR in the form of the BI-RADS Atlas. As of 2013 the Atlas is divided into 3 publications:
* Mammography, Fifth Edition
*
Ultrasound
Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies ...
, Second Edition
*
MRI
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...
, Second Edition
Assessment Categories
While BI-RADS is a quality control system, in day-to-day usage the term "BI-RADS" refers to the mammography assessment categories. These are standardized numerical codes typically assigned by a
radiologist
Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiat ...
after interpreting a mammogram. This allows for concise and unambiguous understanding of patient records between multiple doctors and medical facilities.
The assessment categories were developed for mammography and later adapted for use with MRI and Ultrasound findings. The summary of each category, given below, is nearly identical for all 3 modalities.
Category 6 was added in the 4th edition of the BI-RADS.
BI-RADS Assessment Categories are:
*0: Incomplete
*1: Negative
*2: Benign
*3: Probably benign
*4: Suspicious
*5: Highly suggestive of malignancy
*6: Known biopsy – proven malignancy
An incomplete (BI-RADS 0) classification warrants either an effort to ascertain prior imaging for comparison or to call the patient back for additional views and/or higher quality films. A BI-RADS classification of 4 or 5 warrants biopsy to further evaluate the offending lesion. Some experts believe that the single BI-RADS 4 classification does not adequately communicate the risk of cancer to doctors and recommend a subclassification scheme:
*4A: low suspicion for malignancy, about > 2% to ≤ 10% likelihood of malignancy
*4B: intermediate suspicion of malignancy, about > 10% to ≤ 50% likelihood of malignancy
*4C: moderate concern, but not classic for malignancy, about > 50% to < 95% likelihood of malignancy
Breast Composition Categories
As of the BI-RADS 5th edition
*a. The breasts are almost entirely fatty
*b. There are scattered areas of fibroglandular density
*c. The breasts are heterogeneously dense, which may obscure small masses
*d. The breasts are extremely dense, which lowers the sensitivity of mammography
Automated Extraction
Automatic parsers have been developed to automatically extract BI-RADS features, categories and breast composition from textual mammography reports.
There is also automatic parser available for BI-RADS final category inference by parsing only the semi-formatted finding section of the textual mammography report
External links
The American College of RadiologyBI-RADS AtlasShort tutorial, with actual mammogram pictures
References
{{reflist
Diagnostic obstetrics and gynaecology
Medical imaging