BIRADS


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BIRADS

(bī′rădz″) [Acronym fm. Breast Imaging Reporting and Data System]
A classification system developed by the American College of Radiology to characterize findings obtained during breast imaging. Breast imaging may be done by mammography, magnetic resonance imaging, and/or ultrasonography. Category 1 findings are considered normal. Categories 2 and 3 are considered to have minor abnormalities, and those in category 3 require follow-up testing within a half year. Categories 4 and 5 are “suspicious” and “worrisome” for cancer, respectively.
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The BIRADS 4 lesions consist of a heterogeneous mixture of cases in which the probability of malignancy is greater than 2% and less than 90%.
The BIRADS 5 lesions have the classic features of malignancy.
Using multicase and multireader analyses, the diagnostic accuracy (area under the curve) improved significantly for the forced BIRADS score from 0.
Patients with BIRADS scores of 3 or 4 who received radiotherapy were 3.
The reasons for this are not completely clear, but a common view is that BIRADS is limited in advising how descriptive findings used in the BIRADS Lexicon should be linked to the final BIRADS assessment categories.
These include a decrease in number of benign biopsies, a reduction in the costs of lesion work-up, incorporation into the BIRADS classification system, and possibly the prediction of breast cancer grade.
BIRADS category 3 is assigned to the study to ensure proper follow-up and to avoid a delay in establishing potential cancer diagnosis.
BSGI also detected cancer in 4 of the 14 patients with a mammographic BIRADS 2 rating, typically indicative of benign findings such as cysts or fibroadenomas.
All mammograms were interpreted independently by 2 radiologists--one read the film and the other read the digital image--using a 7-point malignancy scale and the BIRADS classification.
Amorphous or pleomorphic microcalcifications, classified as BIRADS 4 or 5, may occur in areas of duct hyperplasia or papillomatosis.
The report form also supports compliance with the new ACR BIRADS Ultrasound Lexicon, which is expected to be adopted as the standard reporting format by the Mammography Quality Standards Act (MQSA).
In patients with BIRADS category 3 or 4 density breast tissue, bilateral whole-breast ultrasound is useful in detecting breast cancer not discovered with mammography or clinical examination.