Taking Cases with the Experts: BI-RADS Multimodality

D. David Dershaw, M.D. Stamatia V. Destounis, M.D.

Jessica W.T. Leung, M.D. Linda Moy, M.D.

Edward A. Sickles, M.D., moderator

1

51-year-old asymptomatic woman;

routine screening mammography.

MLO

CC

CC MLO

CC MLO

MLO 100% CC 100%

A. Negative (1)

B. Benign (2)

C. Probably benign (3)

D. Incomplete – awaiting prior exam(s) (0)

E. Incomplete – need additional imaging (0)

What is Your BI-RADS Assessment ?

MLO

Current 1 yr ago 2 yrs ago 3 yrs ago

Current 1 yr ago

CC

2 yrs ago 3 yrs ago

A. Negative (1)

B. Benign (2)

C. Probably benign (3)

D. Incomplete – need additional imaging (0)

What is Your BI-RADS Assessment ?

How is the screening exam audited,

since a final assessment was made

before recall took place?

How is the screening exam audited,

if the patient had been recalled and

underwent diagnostic imaging prior

to comparison with prior exams?

64-year-old woman with palpable

right breast mass; radiopaque

marker placed over palpable mass

at diagnostic mammography.

2

MLO CC

MLO 100% CC 100%

ML SCM 100% CC SCM 100%

Right 12:00 4cmFN Rad Right 12:00 4cmFN Arad

A. Probably benign (3)

B. Suspicious – low suspicion (4A)

C. Suspicious – moderate suspicion (4B)

D. Suspicious – high suspicion (4C)

E. Highly suggestive of malignancy (5)

What is Your BI-RADS Assessment ?

Biopsy diagnosis:

invasive ductal carcinoma

Index Cancer

8.7 cm Inferior to Index Cancer

9.3 cm Inferior to Index Cancer

A. Incomplete – targeted ultrasound (0)

B. Suspicious – moderate suspicion (4B)

C. Suspicious – high suspicion (4C)

D. Highly suggestive of malignancy (5)

E. Known biopsy proven malignancy (6)

What is Your BI-RADS Assessment ?

Right 4:00 9 cm FN Rad Right 4:00 9 cm FN Arad

US-guided biopsy diagnosis:

invasive ductal carcinoma

67-year-old asymptomatic woman;

previous left mastectomy for carcinoma

8 years ago; routine screening

mammography.

3