US of breast masses categorized as BI-RADS 3, 4, and 5: pictorial review of factors influencing clinical management.
The Breast Imaging Reporting and Data System (BI-RADS) lexicon for ultrasonography (US) is based on the established lexicon used successfully in mammography and attempts to provide a common language to avoid ambiguity in interpreting, reporting, and teaching breast US. Proper and consistent use of the BI-RADS US lexicon has numerous advantages, including facilitating (a) communication of final assessment categories that clearly indicate management recommendations, (b) data tracking for self-audits, and (c) clinical review of outcome summaries. However, the literature to date does not include sufficient data on outcomes to validate clinical use of the BI-RADS US lexicon. In this article, a pictorial review of the BI-RADS US lexicon descriptors is provided, and specific cases from a retrospective review are used to highlight the challenges in using the BI-RADS US lexicon. With these examples, suggestions are offered for greater clarity in the use of this lexicon. The technical challenges in follow-up US imaging are described. The challenges in assigning final assessment categories are detailed, as well as the clinical factors that may influence decision making and the management of certain lesions.
Raza
Sughra
S
Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA. sraza1@partners.org
Goldkamp
Allison L
AL
Chikarmane
Sona A
SA
Birdwell
Robyn L
RL
D001943:Breast Neoplasms / Q000145:classification* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D009626:Terminology as Topic; D016217:Ultrasonography, Mammary / Q000592:standards*