DOI:10.2214/AJR.06.5090
AJR 2006; 187:W557
© American Roentgen Ray Society
BI-RADS Lexicon Reemphasized
Carl J. D'Orsi and
Ferris M. Hall
Emory Healthcare Emory University Medical Center Atlanta,
GA
Beth Israel Deaconess Medical Center and Harvard Medical School
Boston, MA
WEB—This is a Web exclusive article.
We enjoyed the article by Alexander et al.
[1] titled "Association
of Stellate Mammographic Pattern with Survival in Small Invasive Breast
Tumors." However, we have some concern about the authors' use of
terminology that does not conform to the terminology outlined in the BI-RADS
lexicon [2]: specifically,
their terms "stellate" rather than "spiculated" in
describing masses and "crushed stone" rather than
"pleomorphic" in describing calcifications. Indeed, both these
terms were specifically discussed and finally rejected by the initial
multidisciplinary BI-RADS committees when a consensus lexicon was first
developed in the early 1990s.
Since the first edition of the BI-RADS lexicon was published in 1992, it
has been accepted by all official breast cancer organizations and by virtually
all radiologists in the United States. Today, most radiologists throughout the
world use BI-RADS or some close variation. The lexicon is currently in its 4th
edition [2], and the current
BI-RADS committee is chaired by one of us.
The benefits of standardized terminology apply equally to all of medicine
and science. They are particularly relevant to radiology because of the
increasing use of worldwide teleradiology and voice recognition. Because no
governing body can dictate our use of language, a major problem with teaching
or applying standard lexicons is having them widely accepted
[3]. BI-RADS has gained this
acceptance in large part through its use in journals, books, and even
examinations. However, the use of nonstandard terminology remains all too
common in imaging journals, even when, as in the case of the article by
Alexander et al. [1], the
authors refer to BI-RADS in their text.
BI-RADS for mammography has come a long way in 14 years, and we hope the
multiple other developing imaging terminologies, including the recently
created BI-RADS US and BI-RADS MRI lexicons, will benefit from some of its
lessons. We particularly encourage authors, editors, and journals to use these
standard lexicons.
References
- Alexander MC, Yankasas BC, Biesemier KW. Association of stellate
mammographic pattern with survival in small invasive breast tumors.
AJR 2006; 187:29
-37[Abstract/Free Full Text]
- American College of Radiology. Breast Imaging Reporting
and Data System (BI-RADS), 4th ed. Reston, VA: American College
of Radiology, 2003
- Hall FM. The language of the radiology report: primer for residents
and wayward radiologists. AJR 2000;175
: 1239-1240[Free Full Text]
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