Guide to mammography reports: BI-RADS terminology.

Mammography reports use specific terminology from the Breast Imaging Reporting and Data System (BI-RADS)1 to describe findings and to assign a final assessment category (see accompanying table1, 2). At times, there may be a question about why a particular category has been selected for a certain patient’s examination, and what subsequent management is needed. This editorial addresses questions that commonly arise when primary care physicians interpret mammography reports. The same standard terminology (e.g., mass, asymmetry, calcifications) may be used to describe benign or suspicious findings. A mass, for example, can be benign (with a smooth, well-circumscribed margin) or suspicious (with a spiculated margin) in appearance. As a result, the term “mass” could be included in BI-RADS categories 2 (benign findings) through 6 (known malignancy). BI-RADS category 0 indicates insufficient imaging information to allow for complete evaluation. One example is an abnormal finding on screening mammography that requires further imaging or comparison with previous mammography to verify stability of the finding. After such additional evaluation or comparison, an amended report with a final assessment category (BI-RADS 1 through 6) will be issued. Results categorized as BI-RADS 1 or 2 are negative or benign; routine screening mammography is typically recommended. However, there are exceptions. For example, if a patient with a palpable lump has been