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Breast Imaging-Reporting and Data System. A quality assurance system and lexicon originally designed for reporting mammography results from patients with breast cancer, and published as an atlas by the American College of Radiology. The BI-RADS Atlas is a peer-reporting (i.e., not for lay or patient use) tool which now includes three imaging modalities: mammography, ultrasound and MRI.

There is considerable variability in the correct interpretation of mammograms among radiologists—there is a moderate agreement among radiologists in reporting an abnormal finding when cancer is present (kappa = 0.52) and substantial agreement when cancer is not present (kappa = 0.62); BI-RADS was designed by the American College of Radiology (ACR) to provide the verbal uniformity to be used in descriptions of mammogram results, required for data submission to the ACR National Mammography Database (NMD), and to ensure concise reporting of breast-imaging findings among various practitioners and specialties.

On dictation, there may be reference to an ACR, a BI-RADS or an ACRBI-RADS classification or category related to findings. These are:
1 or N: normal;
2 or B: benign;
3 or P: probably benign;
4 or S: suspicious ;
5 or M: malignant.

BI-RADS Assessment Categories
0: Incomplete;
1: Negative;
2: Benign finding(s);
3: Probably benign;
4: Suspicious abnormality;
5: Highly suggestive of malignancy;
6: Known biopsy—proven malignancy.

Breast Composition Categories
1: Almost entirely fat;
2: Scattered fibroglandular densities;
3: Heterogeneously dense;
4: Extremely dense.