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Learn More About The BI-RADS System

Published on | Eric Brown

Mammogram and MRI

Breast Imaging Reporting and Data System (BI-RADS)

The American College of Radiology (ACR) came up with a standard way to describe mammogram findings and results. In this system, the results are sorted into categories numbered 0 through 6. This system is called the Breast Imaging Reporting and Data System (BI-RADS). Having a standard way of reporting mammogram results lets doctors use the same words and terms, which can help ensure better follow up of suspicious findings.  By law, when breast imaging is performed, the imaging center, will send a letter to patients, describing the findings.  These letters are typically quite vague, but, will commonly correspond to the specific BI-RADS category.

In some states, the BI-RADS system is being used to describe a women’s breast density.  These states require the radiologist, to define the level of density (which is proportion of breast vs. fatty tissue found in a women’s breast).  This law came to be, as data has begun to emerge, relating the density of a women’s breast, with her risk of developing breast cancer.  Here is an example of this law:


Where applicable, such report shall include the following notice: “If your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary screening tests, which can include a breast ultrasound screening or a breast MRI examination, or both, depending on your individual risk factors. …You should contact your physician if you have any questions or concerns about this report.”

Quite a bit of controversy has surrounded mammography lately.  Many questions have come up:  What age should a women start having routine mammography?  How often should screening mammography be performed?  What is the risk of the mammogram itself?  Ultimately, screening will be based on a particular women’s risk, rather than follow the same guidelines for all.  Here is a nice chart, to understand the risks and benefits of screening mammography by age.  In the end, a thorough discussion about risk and screening should take place.



Mammogram Risk Model


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