Birads classification of breast.pptx

BIRADS cassification is done for the breast patients to classify their risks of breast cancer.

1. Birads classification of breast Presented by Dr kanta dey

2. The standardized system of reporting breast cancer risk is called the Breast Imaging Reporting and Data System (BI-RADS). It was developed by the American College of Radiology and is a numerical scale ranging from 0 to 6 that is used in  mammogram , breast ultrasound, and breast magnetic resonance imaging (MRI) reports. These screening and diagnostic tests help determine BI-RADS score.

3. Classification Breast imaging studies are assigned one of seven assessment categories: BIRADS 0 BIRADS 1 BIRADS 2 BIRADS 3 BIRADS 4 BIRADS 5 BIRADS 6

4. Birads 0 Incomplete need additional imaging evaluation (additional  mammographic views  or ultrasound) for mammography, obtaining previous images not available at the time of reading CATAGORY MANAGEMENT LIKELIHOOD OF CANCER Need additional imaging or Prior examination Recall for additional imaging and /or await Prior examination N/A

5. This patient presented with a mass on the mammogram at screening, which was assigned as BI-RADS 0 (needs additional imaging evaluation).

6. Birads 1 Negative symmetrical no masses, architectural distortion, or suspicious calcifications CATAGORY MANAGEMENT LIKELIHOOD OF CANCER Negative Routine screening 0%

7. The breasts are symmetric and no masses, architectural distortion or suspicious calcifications are present

8. Image showing usg of a normal breast where fibro us connective tissue (Cooper ligaments) arranged in a honeycomb-like structure surrounding the breast ducts and fat 

9. Image shows Fatty replaced breast,no tissue lympgadenopathy is seen.Normal breast on MRI.

10. Birads 2 Benign 0% probability of malignancy CATAGORY MANAGEMENT LIKELIHOOD OF CANCER Benign Conservative or surgical 0%

11. BI-RADS Category 2: Mass seen on mammogram proved to be a cyst.

12. A well-defined, anechoic, ovoid lesion with posterior acoustic enhancement Shown in ultrasonogram s uggestive of simple breast cyst

13. This MRI image shows well circumscribed lesions suggestive of simple breast cyst,BIRADS grade 2

14. Birads 3 probably benign <2% probability of malignancy short interval follow-up suggested CATAGORY MANAGEMENT LIKELIHOOD OF CANCER Probably benign Short interval follow up (less than 6 months) or regular surveillance More than 0% but less than or equal to 2 %

15. (A) image shows a circumscribed mass at baseline screening mammography in a 40-year-old woman due to a biopsy-confirmed fibroadenoma . (B) Targeted transverse ultrasound image shows a circumscribed hypoechoic mass, a BI-RADS 3 finding.

16. BI-RADS 3 Lesion With Malignant Biopsy Results on Follow-up. Forty-one-year-old Woman Undergoing Baseline High Risk sc reening Breast MRI. (A) MRI of Right Breast including MIP (Top Left), T2 STIR (Top Right), T1 Fat-Saturated Post contrast 3 Assessment Assigned. At 6-Month Follow-up MRI Examination, mass was Stable; However, (B) 12-Month Follow-up MRI Reveals Increased Size, Irregular Shape, and Spiculated Margins of Posterior Right Breast mass in Addition to Anterior Right diagnosed as inflitrated ductal carcinoma

17. BIRADS 4 suspicious for malignancy2-94% probability of malignancy for mammography and ultrasound, these can be further divided: BI-RADS 4A: low suspicion for malignancy (2-9%) BI-RADS 4B: moderate suspicion for malignancy (10-49%) BI-RADS 4C: high suspicion for malignancy (50-94%) biopsy should be considered Management :tissue diagnosis

18. Adenosis classified as BI-RADS 4A A. Ultrasound revealed a solid irregular hypoechoic mass.  B.Image contoured manually

19. A rounded mass with irregular & spiculated margin and several internal micro-calcifications is noted at upper outer quadrant of left breast which is suspicious for cancer ( BI-RADS category 4c ). 

20. Image showing Invasive ductal cancer in a 46-year-old woman in the lateral right breast. A-E, There is an asymmetric segmental clumped nonmass enhancement (arrows) classified correctly as suspicious (BI-RADS 4) in DCE-MRI. 

21. BIRADS 5 highly suggestive of malignancy >95% probability of malignancy Management: Tissue diagnosis and appropriate action should be taken

22. Mammogram shows pleomorphic microcalcifications in a regional distribution compromising the outer -superior quadrant of the left breast. There is also thickening of the skin and nipple retraction. The imaging findings are highly suggestive of malignancy: BI-RADS 5.

23. Ultrasound correlation revealed a spiculated poorly marginated fixed hypoechoic lesion measuring 2.3x1.7cm in the 10-11 clock position 4.8cm from nipple, 2mm skin deep. The lesion shows marked intra lesional vascularity. 

24. A 33×28 mm mass with irregular and spiculated margin and type III curve on post contrast kinetic analysis is noted at the upper central portion of the left breast compatible with  BI-RADS assessment category 5 .

25. BIRADS 6 known biopsy-proven malignancy  Use after incomplete excision Use for monitoring after neo adjuvant chemotherapy CATAGORY MANAGEMENT Biopsy proven malignancy Surgical excision When clinically appropriate

26. Here images of a biopsy proven malignancy. On the initial mammogram a marker is placed in the palpable tumor . Due to the dense fibroglandular tissue the tumor is not well seen. Ultrasound demonstrated a 37 mm mass with indistinct and angular margins and shadowing. After chemotherapy the tumor is not visible on the mammogram. Ultrasound showed shrinkage of the tumor to a 18 mm mass, which was categorized as BI-RADS 6

27. Breast density BI-RADS reports also score breast density, which assesses how much fatty, glandular, and fibrous tissue have in your breasts. Dense breast tissue can make it harder to spot tumors on mammogram. BI-RADS scoring uses four levels of density LEVEL 1:Almost all fatty tissue (easiest to see anomalies or tumors ) LEVEL 2:Scattered areas of dense (fibrous and glandular) tissue, but mostly fatty tissue LEVEL 3:Mix of dense and fatty tissue LEVEL 4:Mostly dense tissue (hardest to see tumors )

28. LIMITATIONS OF BIRADS For younger women, children, and adolescents, the BI-RADS score may not be reliable. It's also important to note that your BI-RADS score doesn't replace the opinion and insight of healthcare provider or  radiologist  regarding imaging tests. The number is not a substitute for a clinical exam.

29. THANK YOU