title: Concordance of breast imaging reporting and data system assessments and management recommendations in screening mammography.
abstract: 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.
authors.affiliation: Center for Health Studies, Group Health Cooperative of Puget Sound, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. taplin.s@ghc.org
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Taplin
authors.forename: Laura E
authors.initials: LE
authors.lastname: Ichikawa
authors.forename: Karla
authors.initials: K
authors.lastname: Kerlikowske
authors.forename: Virginia L
authors.initials: VL
authors.lastname: Ernster
authors.forename: Robert D
authors.initials: RD
authors.lastname: Rosenberg
authors.forename: Bonnie C
authors.initials: BC
authors.lastname: Yankaskas
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Carney
authors.forename: Berta M
authors.initials: BM
authors.lastname: Geller
authors.forename: Nicole
authors.initials: N
authors.lastname: Urban
authors.forename: Mark B
authors.initials: MB
authors.lastname: Dignan
authors.forename: William E
authors.initials: WE
authors.lastname: Barlow
authors.forename: Rachel
authors.initials: R
authors.lastname: Ballard-Barbash
authors.forename: Edward A
authors.initials: EA
authors.lastname: Sickles
mesh_terms: 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