title: US of breast masses categorized as BI-RADS 3, 4, and 5: pictorial review of factors influencing clinical management.
abstract: 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.
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA. sraza1@partners.org
authors.forename: Sughra
authors.initials: S
authors.lastname: Raza
authors.forename: Allison L
authors.initials: AL
authors.lastname: Goldkamp
authors.forename: Sona A
authors.initials: SA
authors.lastname: Chikarmane
authors.forename: Robyn L
authors.initials: RL
authors.lastname: Birdwell
mesh_terms: D001943:Breast Neoplasms / Q000145:classification* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D009626:Terminology as Topic; D016217:Ultrasonography, Mammary / Q000592:standards*