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Taking Cases with the Experts: BI-RADS Multimodality
D. David Dershaw, M.D. Stamatia V. Destounis, M.D.
Jessica W.T. Leung, M.D. Linda Moy, M.D.
Edward A. Sickles, M.D., moderator
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51-year-old asymptomatic woman;
routine screening mammography.
MLO
CC
CC MLO
CC MLO
MLO 100% CC 100%
A. Negative (1)
B. Benign (2)
C. Probably benign (3)
D. Incomplete – awaiting prior exam(s) (0)
E. Incomplete – need additional imaging (0)
What is Your BI-RADS Assessment ?
MLO
Current 1 yr ago 2 yrs ago 3 yrs ago
Current 1 yr ago
CC
2 yrs ago 3 yrs ago
A. Negative (1)
B. Benign (2)
C. Probably benign (3)
D. Incomplete – need additional imaging (0)
What is Your BI-RADS Assessment ?
How is the screening exam audited,
since a final assessment was made
before recall took place?
How is the screening exam audited,
if the patient had been recalled and
underwent diagnostic imaging prior
to comparison with prior exams?
64-year-old woman with palpable
right breast mass; radiopaque
marker placed over palpable mass
at diagnostic mammography.
2
MLO CC
MLO 100% CC 100%
ML SCM 100% CC SCM 100%
Right 12:00 4cmFN Rad Right 12:00 4cmFN Arad
A. Probably benign (3)
B. Suspicious – low suspicion (4A)
C. Suspicious – moderate suspicion (4B)
D. Suspicious – high suspicion (4C)
E. Highly suggestive of malignancy (5)
What is Your BI-RADS Assessment ?
Biopsy diagnosis:
invasive ductal carcinoma
Index Cancer
8.7 cm Inferior to Index Cancer
9.3 cm Inferior to Index Cancer
A. Incomplete – targeted ultrasound (0)
B. Suspicious – moderate suspicion (4B)
C. Suspicious – high suspicion (4C)
D. Highly suggestive of malignancy (5)
E. Known biopsy proven malignancy (6)
What is Your BI-RADS Assessment ?
Right 4:00 9 cm FN Rad Right 4:00 9 cm FN Arad
US-guided biopsy diagnosis:
invasive ductal carcinoma
67-year-old asymptomatic woman;
previous left mastectomy for carcinoma
8 years ago; routine screening
mammography.
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