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BI-RADS5QuickReferenceCard
Tissue composition (screening only)
ULTRASOUND
a. Homogeneous background echotexture – fat b. Homogeneous background echotexture – fibroglandular c. Heterogeneous background echotexture
Masses
Calcifications Associated features Special cases
Shape
Oval Round
Irregular
Orientation
Parallel
Not parallel
Margin
Circumscribed Not circumscribed
- Indistinct
- Angular
- Microlobulated
Echo pattern
- Spiculated Anechoic
Hyperechoic
Complex cystic and solid Hypoechoic Isoechoic Heterogeneous Posterior features No posterior features
Enhancement
Shadowing
Combined pattern Calcifications in a mass Calcifications outside of a mass
Intraductal calcifications
Architectural distortion
Duct changes Skin changes
Skin thickening
Skin retraction
Edema Vascularity
Absent
Internal vascularity
Elasticity assessment
Vessels in rim Soft Intermediate
Hard
Simple cyst
Clustered microcysts
Complicated cyst
Mass in or on skin
Foreign body including implants
Lymph nodes – intramammary
Lymph nodes – axillary
Vascular abnormalities
AVMs (arteriovenous malformations/ pseudoaneurysms)
Mondor disease Postsurgical fluid collection Fat necrosis
ACR BI-RADS? Atlas Fifth Edition
QUICK REFERENCE
MAMMOGRAPHY
Breast composition
a. The breasts are almost entirely fatty b. There are scattered areas of fibroglandular density
c. The breasts are heterogeneously dense, which may obscure small masses
d. The breasts are extremely dense, which lowers the sensitivity of mammography
Masses
Shape
Oval
Round
Irregular
Margin Circumscribed
Obscured
Microlobulated Indistinct
Spiculated
Density High density
Equal density
Low density
Fat-containing
Calcifications Typically benign
Skin Vascular
Coarse or “popcorn-like” Large rod-like
Round
Rim
Dystrophic
Milk of calcium
Suture
Suspicious Amorphous morphology Coarse heterogeneous
Fine pleomorphic
Fine linear or fine-linear branching
Distribution Diffuse
Regional
Grouped
Linear
Segmental
Architectural distortion Asymmetries Asymmetry
Global asymmetry
Focal asymmetry
Dev
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