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BIRADS – How Does Your Mammogram Score?

Understanding the Numbers


Updated June 03, 2014

After your mammogram or breast ultrasound, a radiologist will read the image and write a report, giving an opinion on your breast health. The American College of Radiologists set up standards for rating mammograms, which is called BIRADS (Breast Imaging Reporting and Data System).

Any score of three, four, or five will require follow-up studies.

BIRADS Classifications:

Category 0 -- Incomplete
Your mammogram or ultrasound didn't give the radiologist enough information to make a clear diagnosis. Don't worry, this may mean that scar tissue from a previous surgery or biopsy may have shown up, or that a breast lump that is big enough to be easily felt isn't imaging clearly. You will need to have a follow-up image done.

Category 1 -- Normal
There are no suspicious masses or calcifications to report; tissue looks healthy.

Category 2 -- Benign or Negative
Breasts are same size and shape and tissue looks normal. Any cysts, fibroadenomas, or other masses appear benign.

Category 3 -- Probably Benign
There are no suspicious lesions, masses, or calcifications to report, but follow-up to confirm that no cancer exists is recommended. This may be needed if your radiologist does not have your baseline or previous mammogram for comparison.

Category 4 -- Possibly Malignant
There are some suspicious lesions, masses, or calcifications to report; a breast biopsy is recommended to check the suspicious area.

Category 5 -- Malignant
There are masses with an appearance of cancer. A biopsy is recommended to make an accurate diagnosis.

Category 6 -- Malignant Tissue from a biopsy has been examined and found to be cancerous, and treatment such as surgery, chemotherapy, and/or radiation is required.

Here is a table of the BIRAD scores.

American College of Radiology. BI-RADS US (PDF document) Copyright 2004. BI-RADS US.
breastscore.com. Breast Ultrasound Computer-Aided Scoring For Level Of Suspicion To Cancer. Copyright 2004. Breast Ultrasound Computer-Aided Scoring Overview.
Christopher Comstock MD, Associate Clinical Professor, Director of Breast Imaging, UCSD Dept of Radiology, La Jolla CA. 8/31/07 interview.
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