🎀 Mammography BI-RADS Structured Read
UseStructured assistance in assigning a mammography BI-RADS category from descriptors.
SourceDestounis SV, Friedewald SM, Grimm LJ, Poplack SP, Sung JS. Mammography. In: ACR BI-RADS® v2025 Man…
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
BI-RADS has no official scoring — the category is set by the most suspicious feature.
When to use
Structured assistance in assigning a mammography BI-RADS category from descriptors.
How it works
Most suspicious feature drives the level: spiculated mass or fine-linear branching calcifications (segmental/linear) or suspicious feature + retraction → 4C–5; → 4; circumscribed mass / focal asymmetry → 3; benign calcifications / fat-containing mass → 2.
Key points
- BI-RADS has no official scoring — the category is set by the most suspicious feature.
- Associated features (skin/nipple retraction) can upgrade a suspicious finding to 5.
- v2025 splits category 0 into 'needs additional imaging' and 'needs prior comparison'.
- The final category must integrate bilateral comparison, prior films and clinical context.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Mass margin | Obscured |
|---|---|
| Mass shape/density | Oval or round, not high density |
| Calcification morphology | Coarse heterogeneous |
| Calcification distribution | Regional |
| Asymmetry | Global asymmetry |
| Architectural distortion | None |
| Suspicious associated features (skin/nipple retraction, skin thickening, axillary adenopathy) | None |
→Suggested categoryBI-RADS 4 (4A–4B)
- Suggested category：BI-RADS 4 (4A–4B): Suspicious (malignancy ~ 2–50%)
- Deciding feature：most suspicious feature → coarse heterogeneous calcifications (also: obscured mass margin, oval/round, not high-density mass)
- Management：Biopsy (image-guided); require imaging-pathology concordance — only then is it benign
| Mass margin | No mass |
|---|---|
| Mass shape/density | Not applicable (no mass) |
| Calcification morphology | No calcifications |
| Calcification distribution | Not applicable (no calcifications) |
| Asymmetry | None |
| Architectural distortion | None |
| Suspicious associated features (skin/nipple retraction, skin thickening, axillary adenopathy) | None |
→Suggested categoryBI-RADS 1
- Suggested category：BI-RADS 1: Negative
- Deciding feature：No abnormal feature entered (negative)
- Management：No abnormal finding: routine screening
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Mammography BI-RADS Structured Read?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Mammography BI-RADS Structured Read upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Mammography BI-RADS Structured Read calculated in practice? Can you show a worked example?
- Inputs: Mass margin Obscured, Mass shape/density Oval or round, not high density, Calcification morphology Coarse heterogeneous, Calcification distribution Regional, Asymmetry Global asymmetry, Architectural distortion None, Suspicious associated features (skin/nipple retraction, skin thickening, axillary adenopathy) None → Result: Suggested category BI-RADS 4 (4A–4B)（Suggested category: BI-RADS 4 (4A–4B): Suspicious (malignancy ~ 2–50%), Deciding feature: most suspicious feature → coarse heterogeneous calcifications (also: obscured mass margin, oval/round, not high-density mass), Management: Biopsy (image-guided); require imaging-pathology concordance — only then is it benign） Inputs: Mass margin No mass, Mass shape/density Not applicable (no mass), Calcification morphology No calcifications, Calcification distribution Not applicable (no calcifications), Asymmetry None, Architectural distortion None, Suspicious associated features (skin/nipple retraction, skin thickening, axillary adenopathy) None → Result: Suggested category BI-RADS 1（Suggested category: BI-RADS 1: Negative, Deciding feature: No abnormal feature entered (negative), Management: No abnormal finding: routine screening）