Mammogram Results: Breast Imaging Reporting and Database System (BI-RADS)
Radiologists in the United States and some other countries use the Breast Imaging Reporting and Database System, or BI-RADS, to report the findings of mammograms. The American College of Radiology (ACR) created this system to provide one way for all radiologists to categorize their findings and create a follow-up action plan. Talk to your doctor about what category your result falls into and what follow-up plan he or she recommends.
Breast Imaging Reporting and Database System (BI-RADS)
| Category | Assessment | Follow-up |
|---|---|---|
| 0 | Need additional imaging evaluation: means that more studies are necessary to gather more information. | Additional imaging needed before a category can be assigned. |
| 1 | Negative: means that there is no significant or noticeable abnormality to report. | Continue annual screening mammography (for women over age 40). |
| 2 | Benign (noncancerous) finding: means that there has been a finding, such as benign calcifications or fibroadenoma, which is not cancerous. | Continue annual screening mammography (for women over age 40). |
| 3 | Probably benign: means that there is a finding that is most likely benign, but should be followed in a shorter period of time to see if the area of concern changes. | Receive a 6-month follow-up mammogram. |
| 4 | Suspicious abnormality: means that there are suspicious findings that could turn out to be cancer. | May require biopsy. |
| 5 | Highly suggestive of malignancy (cancer): means that there are findings that look like and probably are cancer. | Requires biopsy. |
| 6 | Known biopsy-proven malignancy (cancer): means that any findings on the mammogram have already proven to be cancer through a biopsy. | Biopsy confirms presence of cancer before treatment begins. |
Mammogram reports also include an assessment of your breasts’ density. Dense breasts have less fatty tissue and more non-fatty tissue compared to breasts that aren’t dense. Dense breasts:
- can be twice as likely to develop cancer as nondense breasts
- can make it harder for mammograms to detect breast cancer; breast cancers (which look white like breast gland tissue) are easier to see on a mammogram when they’re surrounded by fatty tissue (which looks dark)
BI-RADS classifies breast density into four groups:
- Mostly fatty: The breasts are made up of mostly fat and contain little fibrous and glandular tissue. This means the mammogram would likely show anything that was abnormal.
- Scattered density: The breasts have quite a bit of fat, but there are a few areas of fibrous and glandular tissue.
- Consistent density: The breasts have many areas of fibrous and glandular tissue that are evenly distributed through the breasts. This can make it hard to see small masses in the breast.
- Extremely dense: The breasts have a lot of fibrous and glandular tissue. This may make it hard to see a cancer on a mammogram because the cancer can blend in with the normal tissue.
