Sadia Choudhery MD, Presenter: Nothing to Disclose

Stephen Jacob Seiler MD, Abstract Co-Author: Nothing to Disclose

1) Provide an overview of the changes recently implemented in the 5th edition of the Breast Imaging-Reporting and Data System (BI-RADS). 2) Present a variety of cases to highlight the changes in the reporting of mammography, breast ultrasound, & magnetic resonance imaging.  

1)  Mammography: • Removal of percentages from breast composition • A lobular mass is now oval • Isodensity re-termed equal density • Developing asymmetry added • Calcifications are benign or suspicious, without “intermediate” or “high” probability of malignancy • Eggshell calcifications encompassed by rim calcifications • Clustered calcifications re-termed grouped 2) Ultrasound: • Inclusion of tissue composition • A lobular mass is now oval • Re-categorization of margins to circumscribed & not circumscribed • Description of breast elasticity 3) MRI: • Non-mass-like enhancement re-termed non-mass enhancement (NME) • A lobular mass is now oval • Mass margins reclassified into circumscribed & not circumscribed • Internal enhancement of a mass no longer includes enhancing septations & central enhancement • Ductal enhancement now incorporated into linear distribution of NME • Internal enhancement of NME no longer includes reticular/dendritic & stippled/punctate but clustered ring has been added 4) Uncoupling of assessment & management recommendation.  

http://abstract.rsna.org/uploads/2014/14012210/14012210_ppbc.pdf

Choudhery, S, Seiler, S, Tilting the Atlas: A Discussion of the Changes between the 4th and 5th Editions of BI-RADS.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012210.html