BI-RADS

Question 1

Can BI-RADS 6 be used for a pt with treated cancer?

Answer 1

NO!! BI-RADS 6 can only be used for pt with known biopsy proven cancer that has not been treated yet

Question 2

The term “circumscribed” is BEST defined by ?

Answer 2

At least 75% of the margin is well defined

Question 3

multiple bilateral circumscribed masses on screening mammograph

Answer 3

BI-RADS 2

Question 4

Descriptions for mass shape:

Answer 4

only 3: - oval - round - irregular

Question 5

Descriptors for echogenicity:

Answer 5

• anechoic - hypoechoic - isoechoic - hyperechoic - complex

Question 6

BI-RADS category with 2-95% probabililty of malignancy

Answer 6

BI-RADS 4; suspicious abnormality

Question 7

BI-RADS 4 probability of malignancy

Answer 7

2-95%

Question 8

BI-RADS ultrasound lexicon for mass margin

Answer 8

-circumscribed - indistinct - angular - microlobulated - spiculated

Question 9

BI-RADS definition of a mass:

Answer 9

“a 3D structure demonstrating convex outward borders, usually evident on 2 orthogonal views.” No size definition for mass

Question 10

Baseline screening mammogram in a 43-year-old woman showed a solitary mass. Ultrasound image from the diagnostic imaging is provided. What is the most appropriate BI-RADS assessment?

Answer 10

Ultrasound shows a circumscribed, oval, isoechoic mass . This would normally be considered probably benign (BI-RADS 3), with recommendation for surveillance at 6, 12, and 24 months if stable at each examination.

Question 11

Which organization created and maintains the BI-RADS lexicon?

Answer 11

ACR

BI-RADS is an acronym for Breast Imaging-Reporting and Data System, a quality assurance tool originally designed for use with mammography. The system is a collaborative effort of many health groups but is published and trademarked by the American College of Radiology (ACR).

Question 12

A finding lacking convex borders is only seen on 1 view. This would be BEST characterized by:

Answer 12

Asymmetry

Question 13

Breast density is assessed with the following categories according to the fifth edition BI-RADS atlas published in 2014:

Answer 13

(a) “The breasts are almost entirely fatty”; (b) “There are scattered areas of fibroglandular densitiy”; (c) “The breasts are heterogeneously dense, which may obscure small masses”; and (d) “The breasts are extremely dense, which lowers the sensitivity of mammography”

Question 14

How many follow-up visits are suggested for a BI-RADS 3 (probably benign) lesion if stable at each follow-up?

Answer 14

Surveillance is usually performed at 6 months, 12 months, and 24 months, with the option to extend the surveillance period to 36 months if stable at each follow-up (total of 3-4 visits)

Question 15

BI-RADS category denoting <2% chance of malignancy

Answer 15

BI-RADS 3

A BI-RADS 3 finding should have less than a 2% risk of malignancy and is not expected to change over the follow-up interval. For example, a nonpalpable, circumscribed mass on a baseline mammogram is considered BI-RADS 3, unless it can be shown to be a cyst. Other examples of BI-RADS 3 include a focal asymmetry which becomes less dense on spot compression views, or a cluster of punctuate calcifications.

Question 16

BI-RADS assessment category 2 indicates:

Answer 16

BI-RADS 2 is used when the radiologist chooses to describe a characteristically benign finding. Examples of possible BI-RADS 2 findings include calcified involuting fibroadenoma, secretory calcifications, fat-containing lesion, simple cyst, intramammary lymph node, or architectural distortion related to known prior surgery.

Question 17

> 95% likelihood of malignancy

Answer 17

BI-RADS 5

Question 18

What does the term BI-RADS stand for?

Answer 18

Breast Imaging Reporting and Data System (BI-RADS) is a lexicon of terminology developed through the American College of Radiology to standardize terms to describe breast density, mammographic findings, and assessment and management recommendations. There are modality-specific terminologies for each of the principle diagnostic modalities including mammography, ultrasound, and MRI. These lexicons are updated periodically as knowledge increases.

Question 19

A 40-year-old woman has a smooth, oval, nonpalpable mass measuring 8 mm on her baseline mammogram. What is the likelihood of malignancy?

Answer 19

<2%

These features suggest a “probably benign” (BI-RADS 3) mass. The < 2% likelihood of malignancy is based on retrospective studies of masses with these features (i.e., not growing, not palpable, no irregular features).