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e-CASES: BI-RADS Assessment Categories

Dr Antoine Micheau , CHU ARNAUD DE VILLENEUVE , Montpellier , Herault , FRANCE

0: Incomplete: Your mammogram or ultrasound didn’t give the radiologist enough information to make a clear diagnosis; follow-up imaging is necessary

 

1: Negative: There is nothing to comment on; routine screening recommended

 

2: Benign: A definite benign finding; routine screening recommended

 

3: Probably Benign: Findings that have a high probability of being benign (>98%); six-month short interval follow-up

 

4: Suspicious Abnormality: Not characteristic of breast cancer, but reasonable probability of being malignant (3 to 94%); biopsy should be considered

 

5: Highly Suspicious of Malignancy: Lesion that has a high probability of being malignant (>= 95%); take appropriate action

 

6: Known Biopsy Proven Malignancy: Lesions known to be malignant that are being imaged prior to definitive treatment; assure that treatment is completed

 

 

Some experts believe that the single BI-RADS 4 classification does not adequately communicate the risk of cancer to doctors and recommend a subclassification scheme:

4A: low suspicion for malignancy

4B: intermediate suspicion of malignancy

4C: moderate concern, but not classic for malignancy