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Mammogram Interpretation

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Mammogram Interpretation, Mammography Interpretation, BI-RADS, Breast Imaging Reporting and Data System

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Grading
BI-RADS (Breast Imaging Reporting and Data System) for Mammograms and Breast Ultrasound

Category 0: Incomplete Imaging (additional imaging recommended)
Category 1: Negative findings (no Breast lesions identified)
Category 2: Benign findings
Category 3: Indeterminate, probably benign findings (<2% cancer risk)
Category 4: Suspicious for malignancy
Category 5: Highly suggestive of malignancy
Category 6: Biopsy proven malignancy

Interpretation
Benign Mammogram Findings

Intramammary Lymph Node
1. Smooth walled mass within the Breast tissue
2. Lucent center
3. Usually Mammogram repeated in 6 months
Smooth walled mass
1. Associated with cyst or fibroadenoma
2. Evaluate with breast Ultrasound
Scattered Microcalcifications
1. Bilateral shot-gun like appearance
2. Usually smooth, round with little density variation
3. Not clustered
4. Associated with:
  1. Benign fibrocystic change
  2. Sclerosing adenosis

Interpretation
Worrisome Mammogram findings suggesting Breast Cancer

Mass with irregular borders
1. Highly suggestive of carcinoma
Clustered Microcalcifications
1. Five calcifications in 1 cm area needs evaluation
Spiculated Density
1. Highly suggestive of Breast Cancer

Management
Initial Work-Up of Mammographic Abnormality

Studies
1. Diagnostic Mammogram
  1. Cone Compression View
  2. Magnification View
2. Breast Ultrasound
3. Stereotactic Breast Biopsy
Algorithm based on Findings
1. Simple Cyst
  1. Reassure
2. Solid or atypical
  1. See Breast Mass
  2. Category 2 (Benign)
    1. Re-image with Mammogram in 6 months
  3. Category 3 (Indeterminate)
    1. Image guided Breast biopsy
      1. Ultrasound guided Breast biopsy
      2. Stereotactic Breast biopsy
    2. Surgical Breast Biopsy
      1. Needle Localization