What is the BIRADS system and what is its role in breast evaluation?
The BIRADS system (Breast Imaging Reporting and Data System) is an internationally recognized classification used in breast imaging, like the mammography, το breast ultrasound and breast MRI. Developed by American College of Radiology to clearly guide the management of findings and improve communication between experts: breast surgeon, radiologist, pathologist, cytologist and oncologist.
The use of BIRADS helps in the accurate assessment of breast imaging findings and determines the next steps — whether it's follow-up or further investigation with a biopsy.
The classification is based on ACR BI-RADS® Atlas 5th Edition (2013), which is the official model of American College of Radiology.
BIRADS Categories
The BIRADS scale ranges from 0 to 6, with each category providing specific information about the finding and the likelihood of malignancy:
- BIRADS 0 - Incomplete: Additional imaging needed for a definitive assessment.
- BIRADS 1 - Negative: No suspicious findings detected.
- BIRADS 2 - Benign findings: No suspicion of malignancy (e.g., cyst, lipoma).
- BIRADS 3 - Probably benign: Less than 2% chance of malignancy. Short-interval follow-up (usually 6 months) is recommended, or biopsy in some cases.
- BIRADS 4 - Suspicious abnormality: 3–95% likelihood of malignancy. Biopsy is necessary.
- BIRADS 5 - Highly suggestive of malignancy: Greater than 95% probability of cancer. Biopsy is urgent.
- BIRADS 6 - Known biopsy-proven malignancy: Diagnosis confirmed by biopsy; imaging confirms extent of disease.
Why is it important to understand BIRADS?
Understanding classification of the BIRADS helps women actively participate in their breast care, better understand test results, and feel more confident in planning their next move, in collaboration with the medical team.
For more information on breast health, visit breastaware.gr - the trusted Greek resource for prevention, early diagnosis, and education.
Bιβλιογραφία
- D'Orsi CJ, et al. ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. 5th ed. Reston, VA: American College of Radiology; 2013.
- Spak DA, et al.. BI-RADS® fifth edition: A summary of changes. Diagn Interv Imaging. 2017 Mar;98(3):179-190.
- American College of Radiology. Breast Imaging Reporting and Data System (BI-RADS®) https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Bi-Rads
- Burnside ES, et al. The ACR BI-RADS® Experience: Learning From History. J Am Coll Radiol. 2009 Dec;6(12):851-860.
- Grimm LJ, et al. Assessment of BI-RADS Category 4 Subcategorization in Diagnostic Mammography. AJR Am J Roentgenol. 2015 Jun;204(6):1345-1350
