Indication
Breast composition
| 4th ACR BI-RADS, 2003 | 5th ACR BI-RADS, 2013 | ||
| 1 | almost entirely fat | a | almost entirely fatty |
| 2 | scattered areas of fibroglandular densities | b | scattered areas of fibroglandular density |
| 3 | heterogeneously dense, which could obscure detection of small masses | c | heterogeneously dense, which may obscure small masses |
| 4 | extremely dense. May lower the sensitivity of mammography | d | extremely dense, which lowers the sensitivity of mammography |
Important findings
- Mass
- Calcifications
- Architectural distortion
- Asymmetries
- Intra-mammary LN
- Skin lesion
- Solitary dilated duct
- Associated findings
- Skin retraction
- Nipple retraction
- Skin thickening
- Trabecular thickening
- Axillary adenopathy
- Architectural distortion
- Calcifications
- Location of leasion
- Laterality
- UOQ/UIQ/LOW/LIQ
- Depth: anterior, middle, posterior 1/3
- Distance from nipple
Comparison to previous exams
Assessment & Management
| Category 0: | Imcomplete | 陽性 | 複檢。需進一步檢查。 |
| Category 1: | Negative | 陰性 | 定期追蹤。 |
| Category 2: | Benign | 陰性 | 定期追蹤。可能為Involuted, calcified fibroadenoma; secretory calcifications, fat-containing lesions(hamartoma, galactocele), intramammary lymph nodes, implants, prior surgery related architectural distortion, ... |
| Category 3: | Probably benign | 陽性 | 短期追蹤。可能是良性。惡性機會≦2%。患部應安排半年後追蹤 |
| Category 4: | Suspicious | 陽性 | 組織生檢。 |
| 4a | 惡性機會2-10% | ||
| 4b | 惡性機會10-50% | ||
| 4c | 惡性機會50-95% | ||
| Category 5: | Highly suggestive of Malignancy | 陽性 | 組織生檢。惡性機會≧95% |
| Category 6: | Proven Malignancy | 陽性 | 可以的話應手術 |
若已有症狀，則非screening，為diagnostic。臨床上要小心寫以免被核刪
