By Dr Amaresh Hombal

Consultant Radiologist, The Breast and the Imaging Centers

When you get your yearly Mammogram reports, many of you must have noticed BI-RADS mentioned at the end. Have you ever wondered what that stands for? And what are those numbers that follow, represent? Let Us try and understand these terminologies and assessment categories better.

BI-RADS is an acronym for Breast Imaging-Reporting And Data System developed by the American College of Radiology (ACR), a quality assurance tool originally designed for use with mammography. In day-to-day practice, BI-RADS refer to the mammography assessment categories. These are standardized numerical codes typically assigned by a radiologist after interpreting a mammogram. This allows for concise and unambiguous understanding of patient records between multiple doctors and medical institutions.

In BI-RADS system, the results are sorted into categories numbered 0 through 6. BI-RADS 0 is assigned to a mammogram study that is not yet complete. You need to make sure that further evaluation is completed, like extra mammography views or an ultrasound or even a MRI. Once that extra evaluation is completed, you will be assigned a different category.

BI-RADS 1 means that the mammogram was negative (ie, no cancer) and that you should continue your routine annual screening. Negative mammogram does not mean that it is the end of screening.

BI-RADS 2 is assigned to those mammograms which have findings other than cancer (ie, benign). Nothing needs to be done. However, you should still continue your routine annual screening.

BI-RADS 3 means that your mammogram is probably normal but interval follow-up is needed and a repeat mammogram should be completed in 6 months. The chance of breast cancer is approximately 2% in this category. You should make sure that these follow-up mammograms are completed as requested.

BI-RADS 4 is assigned to those mammograms which have suspicious findings. This category is largely indeterminate and highly variable in outcome. There is 3% to 94% chance that this will be breast cancer. You will need a biopsy to get a small tissue sample to make a diagnosis. Talk to your doctor about any questions.

BI-RADS 5 means that your mammogram results are highly suspicious with over 95% chance of breast cancer. This calls for appropriate action. Talk to your doctor immediately about the course of action to be taken.

BI-RADS 6 means that you have already been diagnosed with breast cancer. Discuss your treatment plan with your doctor and assure that the treatment is completed.

Knowing your BI-RADS category can help to make sure that you get proper information and follow-up after your mammogram. You can keep track along with your doctor and actively participate in your medical care.

Remember, regular screening mammograms can save lives. Get yours done on time.