BIRADS

Question 1

Describe the BIRADS categories

Answer 1

0: incomplete
1: Negative
2: Benign
3: Probable benign <2%
4: Suspicious abn : 2-95% chance of Ca
4A low 4B intermediate 4C moderate
5. Highly suggestive of malignancy 95% chance of cancer
6. Known biopsy –> proven malignancy

Question 2

BIRADS 0

Answer 2

Either suspicious finding that needs diagnostic workup or technical error that requires repeat study

Question 3

BIRADS 2

Answer 3

1. cysts, secretory calcifications, fat containing lesions like oil cysts, lipomas, galactoceles, mixed density hamartomas
2. Redemonstration of an UNCHANGED previously worked up lesion

Question 4

What BIRADS is multiple BL well circumscribed similar appearing masses

What if one mass is growing or different than the rest

What BIRADS is multiple foci on an MRI

Answer 4

2, US if one is palpable

Not BR-2.

BR-2

Question 5

BIRADS 3

Answer 5

BR 3 means < 2 % chance of ca

Can only be used on a baseline lesion, CANNOT be used to describe something new
- “if grouped round calcifications are on the first mammo you can BR-3 them * pg 474

Typical lesions:

1. Fibroadenoma
2. Focal asymmetry that looks like breast tissue (becomes less dense on compression)
3. Grouped round calcifications

Question 6

Is a palpable lesions like a fibradenoma BIRADS 3?

Answer 6

Classic teaching says a palpable lesion cannot be BIRADS 3; however a palpable lesion cs with fibroadenoma has < 2% risk of cancer. The new BIRADS might change this rule. There is too much controversy for them to ask this

Question 7

BIRADS 4: chance of malignancy and what management

Answer 7

2-95% chance of malignancy. Should be biopsied and if benign you would be ok accepting it as benign

Question 8

BIRADS 5

BIRADS 6

Answer 8

> 95% chance of malignancy, if you biopsy and it’s benign , you will still proceed with surgical biopsy because you are CONVINCED it’s cancer

Path proven cancer