Join Now
Sign In
Would you elaborate on what BI-RADS is and its use in breast cancer screening and its significance?
Diseases:
Diseases:
1
Expert Answers
ZevaHermanMD (Physician - Radiology (Verified) ) - 12 / 02 / 2011
BI-RADS stands for Breast Imaging Reporting and Data System. The American College of Radiology, AMA, and other medical organizations have agreed upon a reporting system that standardizes how radiologists describe findings on a mammogram, and more importatly how they make their recommendations so that the recommendation is clear, for the referring physician.
BI-RADS-1: NEGATIVE
This means no findings, nothing on which to comment.
BIRADS-2: BENIGN FINDINGS
This means that there is a normal finding such as a cyst or coarse (benign) calcification. No further intervention is indicated.
BIRADS-3: PROBABLY BENIGN FINDING, SHORT INTERVAL FOLLOW-UP IS SUGGESTED
This is used when there is finding that is most likely benign, but the radiologist cannot say so for certain. A radiologist will only use this category when they believe the finding has less than 2% risk of malignany. This may be used for example, for something such as a lymph node, which has a characteristic appearance and location, but is not definitvely fulfillling criteria of such. Or for calcifications that look very benign, but this is the first time they are appearing. The six month follow-up is to establish stability. The radiologist does not expect this finding to change during the follow-up interval.
Unfortunately, some gynecologists and patients have a hard time accepting this category. They think "what does the radiologist mean by "probably" it does not sound very scientific," but indeed it is the official term of the BIRADS lexicon. Some patients will push for a biopsy of a finding in this category, it is technically an option, but usually overkill. If radiologists recommended biopsy on all of these "probably benign" findings we would really be doing a disservice and an inordinant number of biopsies on benign entities.
BIRADS-4: SUSPICIOUS FINDING, BIOPSY SHOULD BE CONSIDERED
This is used for a finding that is not definitively benign and requires biopsy. This includes lesions that the radiologist believes are likely to be benign, such as fibroadenomas, as well as cancers. To differentiate, some people divide this category into 4A and 4B, low degree of suspicion and higher degree of suspicion. If your report has this category you can ask your doctor to elaborate if the findings has features highly suggestive of cancer, or not. The radiologist usually knows. Statistically, most nodules in this category turn out to be benign (fibroadenomas).
BIRADS-5: HIGHLY SUGGESTIVE OF MALIGNANCY-APPROPRIATE ACTION SHOULD BE TAKEN
These lesions have a high probablility (greater than 95%) of being cancer. Honestly, many radiologists do not use this category since BIRADS4 is already recommending biopsy. But it is true that often a finding is so characteristic that the radiologist knows it is cancer, but still nothing gets treated without a biopsy first.
BIRADS-6: KNOWN MALIGNANCY
This is used when the patient has a biopsy proven cancer, but additional imaging is still needed. A common scenario of this, is the MRI that is done when cancer has been diagnosed but we are looking if there are any additional sites of cancer (extent of disease work-up).
BIRADS-O: NEEDS ADDITIONAL IMAGING (OR OLD FILMS)
This is basicaly saying that the work-up is incomplete and a final interpretation cannot be given. This is used in a screening situation. In most facilities four images are taken by the technologist and the radiologist interprets the study at a later time. If there is a finding, the radiologist will often require additional views (compression spot views or magnification views) to clarify the finding. The patient will be notified that they need to return to the radiology office. Statistically, most of these call backs will be normal, the patient will not end up having any abnormality or require biopsy. In a small percentage, a biopsy might be ordered, but most of these will still turn out to be benign.
BI-RADS-1: NEGATIVE
This means no findings, nothing on which to comment.
BIRADS-2: BENIGN FINDINGS
This means that there is a normal finding such as a cyst or coarse (benign) calcification. No further intervention is indicated.
BIRADS-3: PROBABLY BENIGN FINDING, SHORT INTERVAL FOLLOW-UP IS SUGGESTED
This is used when there is finding that is most likely benign, but the radiologist cannot say so for certain. A radiologist will only use this category when they believe the finding has less than 2% risk of malignany. This may be used for example, for something such as a lymph node, which has a characteristic appearance and location, but is not definitvely fulfillling criteria of such. Or for calcifications that look very benign, but this is the first time they are appearing. The six month follow-up is to establish stability. The radiologist does not expect this finding to change during the follow-up interval.
Unfortunately, some gynecologists and patients have a hard time accepting this category. They think "what does the radiologist mean by "probably" it does not sound very scientific," but indeed it is the official term of the BIRADS lexicon. Some patients will push for a biopsy of a finding in this category, it is technically an option, but usually overkill. If radiologists recommended biopsy on all of these "probably benign" findings we would really be doing a disservice and an inordinant number of biopsies on benign entities.
BIRADS-4: SUSPICIOUS FINDING, BIOPSY SHOULD BE CONSIDERED
This is used for a finding that is not definitively benign and requires biopsy. This includes lesions that the radiologist believes are likely to be benign, such as fibroadenomas, as well as cancers. To differentiate, some people divide this category into 4A and 4B, low degree of suspicion and higher degree of suspicion. If your report has this category you can ask your doctor to elaborate if the findings has features highly suggestive of cancer, or not. The radiologist usually knows. Statistically, most nodules in this category turn out to be benign (fibroadenomas).
BIRADS-5: HIGHLY SUGGESTIVE OF MALIGNANCY-APPROPRIATE ACTION SHOULD BE TAKEN
These lesions have a high probablility (greater than 95%) of being cancer. Honestly, many radiologists do not use this category since BIRADS4 is already recommending biopsy. But it is true that often a finding is so characteristic that the radiologist knows it is cancer, but still nothing gets treated without a biopsy first.
BIRADS-6: KNOWN MALIGNANCY
This is used when the patient has a biopsy proven cancer, but additional imaging is still needed. A common scenario of this, is the MRI that is done when cancer has been diagnosed but we are looking if there are any additional sites of cancer (extent of disease work-up).
BIRADS-O: NEEDS ADDITIONAL IMAGING (OR OLD FILMS)
This is basicaly saying that the work-up is incomplete and a final interpretation cannot be given. This is used in a screening situation. In most facilities four images are taken by the technologist and the radiologist interprets the study at a later time. If there is a finding, the radiologist will often require additional views (compression spot views or magnification views) to clarify the finding. The patient will be notified that they need to return to the radiology office. Statistically, most of these call backs will be normal, the patient will not end up having any abnormality or require biopsy. In a small percentage, a biopsy might be ordered, but most of these will still turn out to be benign.
Similar Questions
Note: All content on this site is informational and not a substitute for professional medical advice.
Always seek the advice of your physician or other qualified health provider with questions regarding your health.
Note: Usernames have been made anonymous and profile images are not shown to protect the privacy of our members.
Thank you for flagging this content. We will look into it right away.
Add Answer
1) Question:
2) Background Info (optional): What context or background information is relevant to this request?
Notes:
The more clear and thorough your request, the more likely you will receive support.
Many of our members are learning from this information or english might not be their first language. Please use standard english and spell out all words. For example, use 'you' instead of 'u'.
The more clear and thorough your request, the more likely you will receive support.
Many of our members are learning from this information or english might not be their first language. Please use standard english and spell out all words. For example, use 'you' instead of 'u'.
Newsletters
Share Conversation
To tell people about this conversation, type their email addresses here (separated by commas):
From:
Add a personal note here:
Breast Cancer Updates
Sign up for our
Breast Cancer
updates for the latest news, best answers and featured experts.
Ads keep TalkAboutHealth freeadvertisement
Similar Questions
Updates
Sign up for email updates of the latest news, best answers, and featured experts.
Benefits
Custom health, wellness, & medical offers from our partners including clinical trials, market research opportunities & new programs.
Upcoming Workshops
-
Breast Cancer Oncology
Mon., May 20th
Expert: Katherine Crew, MD -
Melanoma Oncology
Mon., May 20th
Expert: Steven O'Day, MD -
Gastric (Stomach) Cancer Oncology
Tues., May 21st
Expert: Manish Shah, MD -
T-cell Lymphoma
Tues., May 21st
Expert: Francine Foss, MD -
Breast Cancer Oncology
Wed., May 22nd
Expert: Linnea Chap, MD -
Cancer Support and Psychosocial Education
Thurs., May 23rd
Expert: Jeff Kane, MD -
CLL - Chronic Lymphocytic Leukemia
Fri., May 24th
Expert: Jennifer Brown, MD, PhD
SHARE Support
1) Call SHARE at: 866-891-2392
to speak directly to a trained breast cancer survivor for support and guidance.
2) Direct message the trained peer supporter you select.
3) E-mail us at support@talkabouthealth.com, and we will find the right match for you.
More info
to speak directly to a trained breast cancer survivor for support and guidance.
2) Direct message the trained peer supporter you select.
3) E-mail us at support@talkabouthealth.com, and we will find the right match for you.
More info
3 Quick Ways You Can Help
1) Spread the word! Tell people you think might want some support. Tell medical professionals, health providers, and organizations.
2) Like us on Facebook and follow us on Twitter!
3) Volunteer - email us at volunteer@talkabouthealth.com for more information.
More Ways To Help!
2) Like us on Facebook and follow us on Twitter!
3) Volunteer - email us at volunteer@talkabouthealth.com for more information.
More Ways To Help!
View All Newsletters
