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5-tier ACR system of radiologic breast findings

The 5-tier ACR system was a previously used system for classification of radiologic breast findings, proposed by the American College of Radiology (ACR). It is no longer in widespread use, having been gradually superseded by the 6-tier BI-RADS classification system first published in 1992.  5: ...


BI-RADS 0 is one of six categories from the breast imaging reporting and data system and is used when imaging is incomplete such as: when further imaging or information is required, e.g. compression, magnification, special mammographic views, ultrasound when requesting previous images not avai...


A BI-RADS 1 category under the breast imaging reporting and data system is when no finding is present in an imaging modality (not even a benign finding).


BI-RADS 2 is a benign category in the breast imaging reporting and data system. A finding placed in this category should have essentially a 100% chance of being benign.  Examples of such lesions include: calcified fibroadenomas multiple secretory calcifications fat-containing lesions such as...


BI-RADS 3 is an intermediate category in the breast imaging reporting and data system. A finding placed in this category is considered probably benign, with a risk of malignancy between 0% and 2%. Terminology BI-RADS 3 should not be utilized in the screening setting. It should be reserved for ...


A BI-RADS 4 lesion under the breast imaging reporting and data system refers to a suspicious abnormality. BI-RADS 4 lesions may not have the characteristic morphology of breast cancer but have a definite probability of being malignant. A biopsy is recommended for these lesions. If possible, the ...


BI-RADS 5 lesions under the BI-RADS (breast imaging reporting and data system) refer to breast lesions that are highly suspicious for malignancy, requiring appropriate action to be taken (i.e. biopsy and management as appropriate). BI-RADS 5 lesions have the characteristic morphology of breast c...


BI-RADS 6 is an assessment category of the ACR (American College of Radiology) BI-RADS system. Patients with biopsy-proven cancer prior to definitive therapy would be category 6.

Breast imaging-reporting and data system (BI-RADS)

BI-RADS (Breast Imaging-Reporting and Data System) is a risk assessment and quality assurance tool developed by American College of Radiology that provides a widely accepted lexicon and reporting schema for imaging of the breast. It applies to mammography, ultrasound, and MRI. This article refle...

Classification of ductal carcinoma in situ (DCIS)

The new pathological classification of DCIS is based on cytonuclear atypia, degree of necrosis, size, and distance from margin/architecture. Low and intermediate grades DCIS require cytologic, architectural and size criteria to be met but high-grade DCIS requires only cytologic criteria; this is...

Kaiser score: breast MRI classification flowchart

The Kaiser score is an evidence-based clinical decision rule to distinguish benign from malignant lesions in breast MRI. It incorporates five BI-RADS descriptors: spiculations suspicious protrusion from the lesion surface that has concave lateral aspects this includes classical spiculations, ...

Nottingham classification

The Nottingham classification is used at the end of work up of a breast lesion to help guide management. A = malignant lesion needs surgical excision regardless of biopsy result B = indeterminate will accept a benign biopsy result, but only if it is congruent with imaging, i.e. a well circum...

Parenchymal patterns in breast imaging

Parenchymal patterns in breast imaging influence mammographic screening sensitivity and is related to the risk of breast cancer. This article describes the historical classifications of breast density. See the main article on breast density for the currently accepted BI-RADS descriptors. Classi...

PGMI evaluation system

PGMI (Perfect, Good, Moderate, Inadequate) is a method of evaluation of clinical image quality in mammography developed by the United Kingdom Mammography Trainers Group with the support of the Royal College of Radiographers, aimed to ensure the maintenance of a high standard of mammography in Br...

RCR breast imaging classification system

work in progress - Fran/Derek   UK interpretation/system to guide investigation (2008) Classification Mammography   Ultrasound   MRI    

Tabar 5-tier grading system

The Tabar 5-tier grading system is used to classify mammographic lesions. This should not be confused with the Tabar classification of parenchymal patterns in breast imaging. It is a separate but translatable system to the BI-RADS classification system (please note that Tabar grade 3 ≠ BI-RADS 3...

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