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Johns Hopkins Health Alert

Mammograms: Know Your BIRADS Score

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A mammogram is a specialized X-ray of the breast. It can be used to evaluate a breast lump or other abnormality that has been detected by a breast self-exam (BSE) or a clinical breast examination. Mammography is also important as a screening tool because it can detect breast cancer at an early stage, before it can be felt on a physical exam. Mammogram interpretation is performed by a radiologist.

When a radiologist interprets a mammogram, he or she assigns a score to it that indicates the radiologist's opinion as to the likelihood of cancer being present. The score is used to communicate with doctors about how concerned the radiologist is about the findings.

The American College of Radiologists has developed national standards for rating mammograms. Your mammogram report may include a BIRADS (Breast Imaging Reporting and Data System) assessment. There are seven categories. If you achieve a score of 3, 4 or 5, you will require a follow-up study. Knowing your BIRADS score will help ensure that you get the proper follow-up after your mammogram. It is part of what you need to know to actively participate in your medical care.

BIRADS 0Diagnosis: Incomplete, typically because more information is needed. Next steps: The mammogram or ultrasound didn't give the radiologist enough information to make a clear diagnosis; follow-up imaging is necessary.

BIRADS 1Diagnosis: Negative (N). Next steps: There is nothing to comment on. Breasts are normal and routine screening is recommended. 

BIRADS 2Diagnosis: Benign Finding-Negative (N). Next steps: A definite negative mammogram; radiologist may describe benign finding, such as a lymph node within the breast, breast implants or a fibroadenoma (solid lump comprised of benign cells); routine screening recommended.

BIRADS 3Diagnosis: Probably Benign Finding (P). Next steps: A finding is present that is most likely benign (>98%), but another evaluation should be made shortly. You'll be asked to follow-up with a repeat mammogram in six months. If you have a family or personal history of breast cancer, the radiologist may opt to do more tests now rather than wait.

BIRADS 4Diagnosis: Suspicious Abnormality (S). Next steps: Lesions are present that don't have characteristics of breast cancer, but there is a reasonable probability of malignancy (20% to 35%); a biopsy should be considered.

BIRADS 5Diagnosis: Highly Suspicious of Malignancy (M). Next steps: Lesion has a high probability of being cancer (>= 95%). Appropriate action should be taken. You will need to have a biopsy for diagnosis. Talk to your doctors about what course of action to take.

BIRADS 6Diagnosis: Known Biopsy-Proven Malignancy. Next steps: Biopsy-detected malignancy is present but additional information is necessary.

 

Posted in Healthy Living on July 20, 2011


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer


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