The Breast Imaging-Reporting and Data System (BI-RADS) is a

quality assurance Quality assurance (QA) is the term used in both manufacturing and service industries to describe the systematic efforts taken to assure that the product(s) delivered to customer(s) meet with the contractual and other agreed upon performance, design ...

tool originally designed for use with

mammography Mammography (also called mastography; DICOM modality: MG) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cance ...

. The system is a collaborative effort of many health groups but is published and trademarked by the

American College of Radiology The American College of Radiology (ACR), founded in 1923, is a professional medical society representing nearly 40,000 diagnostic radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians and medical physicists ...

(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 a cancer that develops from breast tissue. Signs of breast cancer may include a Breast lump, lump in the breast, a change in breast shape, dimpling of the skin, Milk-rejection sign, milk rejection, fluid coming from the nipp ...

, particularly for patients with dense breast tissue. 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''. the ''Atlas'' is divided into three publications: * Mammography, Fifth Edition *

Ultrasound Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...

, Second Edition *

MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and rad ...

, Second Edition

Assessment categories

While BI-RADS is a

quality control Quality control (QC) is a process by which entities review the quality of all factors involved in production. ISO 9000 defines quality control as "a part of quality management focused on fulfilling quality requirements". This approach plac ...

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 specialty that uses medical imaging to diagnose diseases and guide treatment within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiation), but tod ...

after interpreting a mammogram. This allows for concise and unambiguous understanding of patient records between multiple doctors and medical facilities. The assessment categories were initially 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 three 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 A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, an interventional radiologist, or an interventional cardiology, interventional cardiologist. The process involves the extraction of sampling (medicine), sample ...

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 of 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 an automatic parser available for BI-RADS final category inference by parsing only the semi-formatted finding section of the textual mammography report.

References

External links

{{Commons category
The American College of RadiologyBI-RADS AtlasShort tutorial, with actual mammogram pictures
Diagnostic obstetrics and gynaecology Medical imaging