Concordance of breast imaging reporting and data system assessments and management recommendations in screening mammography.
OBJECTIVE
To examine how frequently Breast Imaging Reporting and Data System (BI-RADS) mammographic screening assessments were associated with expected clinical management recommendations.


METHODS
Seven Breast Cancer Surveillance Consortium mammography registries recorded screening assessments and recommendations in 1997 to identify the proportion of women in each BI-RADS category. The first screening assessment for a woman without cancer or a prior mammogram within 9 months was associated with its independently recorded recommendation.


RESULTS
Among 292,795 women, screening assessments included 269,022 (91.9%) with a "negative" or "benign finding," and 267,103 (99.3%) of these women were recommended for normal interval follow-up. Among 11,861 (4.1%) women with screening assessments of "probably benign finding," 4,782 (40.3%) were recommended for short interval follow-up as expected on the basis of the BI-RADS, but a high proportion (36.9%) were recommended for additional imaging. Among 1,625 (0.6%) women with "suspicious abnormality," most were recommended for biopsy (48.7%) or clinical examination and/or surgical consult (9.0%), but many were recommended for additional imaging (38.7%). Among 243 (0.1%) women with screening assessments "highly suggestive of malignancy," a majority were recommended for biopsy (73.3%) or clinical examination and/or surgical consult (18.1%) consistent with BI-RADS, but some were recommended for additional imaging (6.6%).


CONCLUSIONS
BI-RADS assessments and management recommendations are consistent for negative and benign assessments, but inconsistencies were found in assessments and recommendations for mammographic abnormalities.
Taplin
Stephen H
SH
Center for Health Studies, Group Health Cooperative of Puget Sound, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. taplin.s@ghc.org
Ichikawa
Laura E
LE
Kerlikowske
Karla
K
Ernster
Virginia L
VL
Rosenberg
Robert D
RD
Yankaskas
Bonnie C
BC
Carney
Patricia A
PA
Geller
Berta M
BM
Urban
Nicole
N
Dignan
Mark B
MB
Barlow
William E
WE
Ballard-Barbash
Rachel
R
Sickles
Edward A
EA
D000328:Adult; D000368:Aged; D001941:Breast Diseases / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007256:Information Systems; D008327:Mammography / Q000379:methods*; D008403:Mass Screening; D008875:Middle Aged; D012042:Registries