RadEssentialReading-room reference
BI-RADS assessment categories
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Final assessment categories with likelihood of malignancy and management.
| Category | Assessment | Malignancy | Management |
|---|---|---|---|
| 0 | Incomplete: need additional imaging or prior comparison | N/A | Recall |
| 1 | Negative | Essentially 0% | Routine screening |
| 2 | Benign | Essentially 0% | Routine screening |
| 3 | Probably benign | >0% to ≤2% | Short-interval follow-up (6 mo) |
| 4A | Low suspicion | >2% to ≤10% | Tissue diagnosis |
| 4B | Moderate suspicion | >10% to ≤50% | Tissue diagnosis |
| 4C | High suspicion | >50% to <95% | Tissue diagnosis |
| 5 | Highly suggestive of malignancy | ≥95% | Tissue diagnosis |
| 6 | Known biopsy-proven malignancy | N/A | Surgical excision when appropriate |
Breast composition (mammography)
| Code | Description |
|---|---|
| a | Almost entirely fatty |
| b | Scattered areas of fibroglandular density |
| c | Heterogeneously dense, may obscure small masses |
| d | Extremely dense, lowers sensitivity |
Subcategories 4A/4B/4C are used for mammography and US; not for MRI. Category 3 follow-up: 6, 12, 24 months (± 36) before downgrading to 2.
Sources
- D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA, et al. ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. 5th ed. Reston, VA: American College of Radiology; 2013.
Radessential summarizes published classification systems for practicing radiologists. Summaries are condensed; confirm details against the cited source before relying on them for patient care.