What are the BIRADS-US classifications of lesions on breast ultrasonography?

Updated: Jan 24, 2017
  • Author: Durre Sabih, MBBS, MSc, FRCP(Edin); Chief Editor: Mahan Mathur, MD  more...
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Answer

Answer

Using ultrasound criteria a lesion can be classified into a BIRADS-US system developed by the ACR with the following interpretation:

  • BIRADS-0: Incomplete assessment needs additional evaluation

  • BIRADS-1: Normal

  • BIRADS-2: Benign

  • BIRADS-3: Probably benign (2% of less chances of malignancy)

  • BIRADS-4: Suspicious (2-95% chances of malignancy)

  • BIRADS-5: Malignant (>95% chances of malignancy)

  • BIRADS-6: Biopsy-proven malignancy

Table 1. Ultrasound BIRADS Categories and Management Guidelines. [11] (Open Table in a new window)

BIRADS category

Conditions that fall into the category

Management

BIRADS-1

Normal tissue, focal thickening causing “lump”

Routine screening

BIRADS-2

Simple cysts, ductal ectasia, intramammary nodes, lipomas

Early follow-up to document stability unless clinical indications suggest a more aggressive evaluation

BIRADS-3

Complex cysts, small intraductal papillomas, fibroadenomas

Short interval follow-up or biopsy

BIRADS-4

One feature of malignancy

Biopsy

BIRADS-5

More than one feature of malignancy

Biopsy


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