• The BI-RADS lexicon was developed by the American College of Radiology (ACR) and was mandated by the Mammographic Quality and Standard Act of 1992. This act pertains only to mammography.
  • Since this lexicon was successful, ACR has now developed a similar lexicon for breast ultrasound and breast MRI.
  • The 5th edition of the BI-RADS system for mammography is the most current edition.
  • Mammographic findings are grouped into seven categories including masses, calcifications, architectural distortion, asymmetries, intramammary lymph node, skin lesions, and solitary dilated duct (see the table).
  • A group of calcifications is defined as 5 calcifications within a 1-cm area of tissue but less than 2 cm.
  • BI-RADS is reported on a scale from 0 to 6, with BI-RADS 0 indicating further work-up is needed and BI-RADS 6 indicating biopsy-proven malignancy.
  • BI-RADS 3 indicates that a short-term follow-up is needed.
  • The table shows the term associated with each of the six BI-RADS categories, the recommended action, and the likelihood of malignancy.
  • References:
  • D’Orsi CJSE, Mendelson EB, Morris EA, et al. ACR BI RADS Atlas, Breast Imaging Reporting and Data System. Reston, VA: American College of Radiology. 2013.
  • Sedgwick EL, Ebuoma L, Hamame A, et al. BI-RADS update for breast cancer caregivers. Breast Cancer Res Treat. 2015;150:243-254.

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