Breast Imaging Reporting and Data System
The Breast Imaging Reporting and Data System (BI-RADS) is a standard of the American College of Radiology (ACR) for performing and diagnosing mammograms , which was published in 1997 and has been updated several times since then. It consists of a lexicon for the diagnostic terms such as “compression”, “focus” etc. with exact definitions, and a classification for the final assessment. Each finding should also contain a standardized assessment of the radiopacity of the breast in four stages. BI-RADS was intended to objectify and standardize the radiologist's findings . The descriptors are chosen in such a way that they enable as precise a distinction as possible between benign and malignant findings. In the USA, the FDA has included BI-RADS in its binding guidelines for mammography.
After initial resistance, the standard was accepted and translated worldwide. It is now part of all relevant recommendations and guidelines. The European mammography screening programs also make the use of the BI-RADS standard mandatory.
Since the third edition, BI-RADS has included an atlas with drawn examples. Since the fourth edition (2003) of the standard also definitions and classifications includes for breast ultrasound (ultrasound of the breast) and those for magnetic resonance imaging of the breast ( BI-RADS-MRI ). German translations of the fourth edition are available in bookshops; the fifth edition (Feb. 2014) can so far only be purchased in English from the ACR (see web link below).
BI-RADS categories
According to the definition of the 4th edition 2003, the BI-RADS categories have the following meanings:
| BI-RADS category | meaning |
|---|---|
| 0 | The mammographic examination is incomplete. Further imaging or comparative mammograms are needed. |
| 1 | negative |
| 2 | Benign finding, e.g. B. calcified fibroadenomas , calcified secretions, oil cysts , lipomas , galactoceles, hamartomas , lymph nodes or implants . |
| 3 | Probably benign finding. Less than 2% chance of malignancy. Check-up recommended in 6 months. |
| 4th | Suspicious findings. A biopsy should be considered. Level 4 can be optionally divided into 4a-c (screening mammography: only 4a-b) with increasing probability of malignancy. |
| 5 | Highly suspect for malignancy . More than 95% chance of malignancy. Histological confirmation necessary. |
| 6th | Biopsy performed, malignancy proven, documentation prior to definitive therapy . |
The German S3 guideline for breast cancer early detection requires a histological confirmation by means of vacuum or punch biopsy for all BI-RADS 4 or 5 classified findings . BI-RADS-3 findings are also biopsied under certain conditions, e.g. B. in the case of incongruity between the clinic and imaging, if the patient is afraid of cancer or has a corresponding risk profile.
literature
- Uwe Fischer (Hrsg./Übers.): ACR BI-RADS: Illustrated instructions for uniform diagnosis of mammography, breast sonography, MR mammography. Edition 2. Georg Thieme, 2006. ISBN 3131369728 , 9783131369727
Web links
- BI-RADS on the ACR website
- BI-RADS version 3, German translation without illustration (PDF) on the website of the Austrian X-ray Society
Individual evidence
- ↑ ES Burnside, EA Sickles et al. a .: The ACR BI-RADS experience: learning from history. In: Journal of the American College of Radiology: JACR. Volume 6, Number 12, December 2009, pp. 851-860, ISSN 1558-349X . doi : 10.1016 / j.jacr.2009.07.023 . PMID 19945040 . PMC 3099247 (free full text).
- ↑ FDA: Mammography Quality Standards Act - Mammography Reports (accessed February 20, 2014)
- ↑ a b S3 guideline breast cancer early detection, 2008 (PDF)
- ↑ S3 guideline "Mammakarzinom", 2012 (PDF) ( Memento of the original from October 8, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ American College of Radiology (2003): BI-RADS Mammography, Fourth Edition ( Memento from April 26, 2012 in the Internet Archive )
