Clinical Application of the BI-RADS Final Assessment to Breast Sonography in Conjunction with Mammography
Eun-Kyung Kim1,
Kyung Hee Ko1,
Ki Keun Oh1,
Jin Young Kwak1,
Jai Kyung You1,
Min Jung Kim1 and
Byoung-Woo Park2
1 Department of Radiology, Research Institute of Radiological Science, Yonsei
University College of Medicine, 134, Shinchon-dong, Seodaemun-gu, Seoul
120-752, South Korea.
2 Department of Surgery, Yonsei University College of Medicine, Seoul, South
Korea.
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Fig. 1 —32-year-old woman with palpable breast mass. Transverse
sonography image shows wellcircumscribed hypoechoic, oval-shaped mass without
any suspicious characteristics, suggesting probably benign lesion (BI-RADS
category 3). It was confirmed as fibroadenoma on sonography-guided core
biopsy.
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Fig. 2 —43-year-old woman with screening sonography of
mammographically dense breast. Transverse sonography image shows hypoechoic
mass with nonparallel orientation and angular margin, suggesting malignancy
(BI-RADS category 4). It was confirmed as fibrocystic change on
sonography-guided core biopsy and surgical excision.
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Fig. 3 —57-year-old woman with palpable breast mass. Transverse
sonography image shows irregular-shaped mass with spiculated margin, highly
suggestive of malignancy (BI-RADS category 5). It was confirmed as
infiltrating ductal carcinoma on sonography-guided core biopsy and surgical
excision.
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Fig. 4A —43-year-old woman with sonography screening of
mammographically dense breast. She had undergone right mastectomy due to
breast carcinoma 2 years previously. Left mammogram (not shown) showed
homogeneous dense parenchyma without abnormalities. Sonography image at time
of screening mammography shows 4-mm hypoechoic mass with noncircumscribed
mass, classified as BI-RADS category 4.
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Fig. 4B —43-year-old woman with sonography screening of
mammographically dense breast. She had undergone right mastectomy due to
breast carcinoma 2 years previously. Left mammogram (not shown) showed
homogeneous dense parenchyma without abnormalities. Sonography image obtained
at 6-month follow-up shows lesion is slightly larger and shows lobulations.
Sonography-guided core biopsy was performed, and invasive ductal carcinoma was
diagnosed at histologic analysis.
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Fig. 5 —42-year-old woman with palpable breast mass. Mammogram (not
shown) showed focal asymmetric density. Sonography image was interpreted as
showing BI-RADS category 3 lesion, but margin was found to be microlobulated
in retrospective review. Invasive ductal carcinoma was diagnosed by
sonography-guided core biopsy.
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Fig. 6 —47-year-old woman with palpable breast mass. Mammogram (not
shown) showed homogeneous dense parenchyma without abnormalities. Sonogram of
palpable area shows prominent parenchymal tissue without mass lesion. Ductal
carcinoma in situ was diagnosed by surgical excision.
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Copyright © 2008 by the American Roentgen Ray Society.
