title: Modified Bi-Rads Scoring of Breast Imaging Findings Improves Clinical Judgment.
abstract: In contrast with the reporting requirements currently mandated under the Federal Mammography Quality Standards Act (MQSA), we propose a modification of the Breast Imaging Reporting and Data System (Bi-Rads) in which a concluding assessment category is assigned, not to the examination as a whole, but to every potentially malignant abnormality observed. This modification improves communication between the radiologist and the attending clinician, thereby facilitating clinical judgment leading to appropriate management. In patients with breast cancer eligible for breast conserving therapy, application of this modification brings to attention the necessity for such patients to undergo pretreatment biopsies of all secondary, synchronous ipsilateral lesions scored Bi-Rads 3-5. All contralateral secondary lesions scored Bi-Rads 3-5 also require pretreatment biopsies. The application of this modification of the MSQA demonstrates the necessity to alter current recommendations ("short-interval follow-up") for secondary, synchronous Bi-Rads 3 ("probably benign") image-detected abnormalities prior to treatment of the index malignancy.
authors.affiliation: Harold E. and Henrietta C. Lee Breast Center, Kenneth Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.|Department of Surgery, Kenneth Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Howard
authors.initials: H
authors.lastname: Silberman
authors.affiliation: Harold E. and Henrietta C. Lee Breast Center, Kenneth Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.|Radiology, Kenneth Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Pulin A
authors.initials: PA
authors.lastname: Sheth
authors.affiliation: Harold E. and Henrietta C. Lee Breast Center, Kenneth Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.|Radiology, Kenneth Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Yuri R
authors.initials: YR
authors.lastname: Parisky
authors.affiliation: Harold E. and Henrietta C. Lee Breast Center, Kenneth Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.|Radiology, Kenneth Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Hovanessian-Larsen
authors.affiliation: Radiology, Kenneth Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Sindu
authors.initials: S
authors.lastname: Sheth
authors.affiliation: Division of Medical Oncology, Kenneth Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Debasish
authors.initials: D
authors.lastname: Tripathy
mesh_terms: D000368:Aged; D001706:Biopsy; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology*; D003657:Decision Making; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008327:Mammography / Q000592:standards*; D019221:Mandatory Reporting; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology*; D010347:Patient Care Planning; D011871:Radiology; D014481:United States
keywords: Bi-Rads scoring; breast imaging; mammography