Understanding the BI-RADS System
Translated by
ScribdTranslationsUnderstanding the BI-RADS System
Translated by
ScribdTranslationsDr. Ricardo M.
Rojas
What is Bi-Rads?
The acronym BI-RADS stands for in English: Breast Imaging Reporting and Data System.
and can be translated as Reporting system and image database
mammograms. It is a method used by radiologists to interpret and communicate the
mammography results.
The BI-RADS system was created in 1993 and is updated periodically; currently
it is considered the universal "language" for diagnosing pathology
mammary. By relying on a standardized classification, the reports allow
categorize the injuries, define the level of suspicion, and collaborate in the decision-making
decisions by the doctor who requested the study.
Moreover, by reducing the discrepancies in the interpretation of the images, the
The BI-RADS system is a quality assurance tool for studies by
images of the mom.
What is the BI-RADS classification?
First of all, it should be clarified that the reports must be interpreted by the
doctor who requested the study and if necessary, by a specialist in pathology
mammary, considering all the other individual factors that may be
important for defining the course of action to take. For example, one should consider
personal and family background, etc.
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The BI-RADS system is divided into six different categories. These categories
they are based on the description of the injuries or images that are observed in the
mammography.
BI-RADS 0: Not conclusive
Behavior: Additional imaging studies and/or comparisons are needed
with previous mammograms for the correct monitoring of the finding that
find in study.
It means that the radiologist may have observed some suspicious lesion but
that is not clearly defined. For that reason, it may be necessary to carry out a
focused or magnified mammography of the area of interest, or an ultrasound
additional. It can also help to compare with previous studies to
to know if changes have occurred over time.
BI-RADS 1: Normal breast
Behavior: Continue with the annual mammogram
It means that no suspicious image is identified, the structures are
normal and there are no comments to add. The study is considered
negative because there is no abnormal finding.
BI-RADS 2: Benign findings (non-cancerous)
Behavior: Continue with the annual mammogram
It means that the study shows benign findings and there are no signs of cancer.
the radiologist will describe in the report, for example, benign microcalcifications,
simple cysts that can be intramammary lymph nodes, or
fibroadenomas, or other typical benign images.
The description of these findings aids in comparisons with future ones.
mammograms.
The risk of cancer in these cases remains the same as that of the general population.
BI-RADS 3: Probably benign findings (< 2% risk of malignancy)
Conduct: An immediate assessment with additional projections is recommended.
the ultrasound and short-term monitoring, every 6 months, generally during
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two years, to determine if the suspicious image remains stable over time
of time, in size and appearance.
The findings in this category have a very high probability (over 98%) of being
benign (non-cancerous). The findings may include: solid nodules without calcium,
glandular asymmetry, punctate microcalcifications, identical, grouped.
If within a minimum period of two years, the suspicious finding remains stable,
it is recategorized as BI-RADS 2 and continues with annual checks. Of the
On the contrary, a biopsy puncture is evaluated to rule out a
possible diagnosis of breast cancer.
This approach helps avoid unnecessary biopsies, but if the suspicious area
changes over time, allows for an early cancer diagnosis, with
high probabilities of successful treatment.
BI-RADS 4: Suspicious abnormality; consider a biopsy
Conduct: In general, it is recommended to consider a biopsy to characterize the
definitive findings and have an accurate diagnosis.
It means that there is some suspicious mammographic finding. It does not seem to indicate that
it is a matter of cancer but, due to some suspicion, it should be carried out
a breast biopsy.
This category includes findings with different levels of suspicion of
malignancy, for which it is divided into subcategories:
BI-RADS 4A (BR4A): Low suspicion of cancer.
BI-RADS 4B (BR4B): Intermediate suspicion.
BI-RADS 4C (BR4C): Moderate suspicion, but not as high as in category 5.
Conduct: It is strongly recommended to perform a definitive biopsy and take the
appropriate actions, for example, surgical treatment.
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BI-RADS 5: Abnormality that suggests a malignant finding
It means that the findings appear to
cancer and there is a high probability that it is
cancer. The image can be a mass with
contours strange, microcalcifications
irregular with linear, ductal or
tree-like.
When there is a change in the breasts, it is about
to confirm the existence of illness and the
mammography helps to detect lesions
minimal, not palpable. The benefit of the
Digital mammography is maximum if the controls
are held annually, because it allows
discover initial modifications in the
breast anatomy.
BI-RADS 6: Malignant lesion already demonstrated.
Conduct: Take appropriate actions
This category is used solely for the
findings in a mammogram that have already been
demonstrated that they are cancerous, according to a
previously performed biopsy. The diagnosis
it was already defined with histology, before
start the treatment. The mammogram is
requests to see how cancer responds to the
therapy.
As a final comment, the value of
the annual mammogram in early detection
of breast cancer. 3D tomosynthesis is
another very useful tool that allows
obtain more information when the
mammographic images are questionable, in
especially if the breasts are dense.