Breast Imaging Reporting And Data System (BIRADS)

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Breast Imaging Reporting And Data System (BIRADS)

Women's Health
Breast Imaging Reporting And Data System (BIRADS)
Breast Imaging Reporting And Data System (BIRADS)
Breast Imaging Reporting and Data System involves the use of a special code to determine the results of your mammography.
National Cancer Institute

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The American College of Radiology (ACR) has a standard way to describe mammogram findings and results. In this system, the results are sorted into categories numbered 0 through 6. This system is called the Breast Imaging Reporting and Data System (BI-RADS). Having a standard way of reporting mammogram results lets doctors use the same words and terms, which can help ensure better follow up of suspicious findings. Here’s a brief review of what the categories mean:

BI-RADS Category
What It Means
Follow Up

A possible abnormality may not be clearly seen or defined. 

More imaging, such as the use of spot compression (applying compression to a smaller area when doing the mammogram), magnified views, special mammogram views, or ultrasound is needed before a category can be assigned.
Your mammogram is normal. The breasts look the same (they are symmetrical) with no masses (lumps), distorted structures, or suspicious calcifications. In this case, negative means nothing bad was found.
Continue annual screening mammograms (for women over age 40).
Your mammogram shows benign (noncancerous) findings. This is also a negative mammogram result (there’s no sign of cancer). But the reporting doctor chooses to describe a finding known to be benign, such as benign calcifications, lymph nodes in the breast, or calcified fibroadenomas. This ensures that others who look at the mammogram will not misinterpret the benign finding as suspicious. This finding is recorded in the mammogram report to help when comparing to future mammograms.
Continue annual screening mammograms (for women over age 40).

The findings in this category have a very high chance (greater than 98%) of being benign (not cancer). The findings are not expected to change over time. But since it’s not proven benign, it’s helpful to see if the area in question does change over time.

Follow-up with repeat imaging is usually done in 6 months and regularly after that until the finding is known to be stable (usually at least 2 years). This approach helps avoid unnecessary biopsies, but if the area does change over time, it still allows for early diagnosis.

Your mammogram shows a suspicious abnormality.

Findings do not definitely look like cancer but could be cancer. The radiologist is concerned enough to recommend a biopsy. The findings in this category can have a wide range of suspicion levels. For this reason, some doctors divide this category further:

  • 4A: finding with a low suspicion of being cancer
  • 4B: finding with an intermediate suspicion of being cancer
  • 4C: finding of moderate concern of being cancer, but not as high as Category 5

Not all doctors use these subcategories.

You may need biopsy.
Your mammogram shows a change that is highly suggestive of cancer.
A biopsy is strongly recommended.
Your mammogram shows a cancer that has been proven by biopsy. This category is only used for findings on a mammogram that have already been shown to be cancer by a previous biopsy.
A biopsy confirms presence of cancer before treatment begins or to see how well the cancer is responding to treatment.

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Last updated June 18, 2014

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