Table 2 A summary of key changes in the BI-RADS MRI lexicon
From: How I report breast magnetic resonance imaging studies for breast cancer staging and screening
Feature | 2013 BI-RADS Atlas |
|---|---|
Breast composition | a (fatty)through to d (extreme FGT) |
BPE level | Minimal, mild, moderate, marked |
BPE distribution | Symmetric or asymmetric |
Focus | Removed from BPE section |
Mass shape | ‘lobular’ removed: oval, round or irregular only |
Mass margin | ‘smooth’ removed: circumscribed, irregular or spiculated only |
Mass internal enhancement | ‘Enhancing internal septations’ and ‘central enhancement’ removed |
Non-mass enhancement (nme) | Non-mass like removed |
Nme distribution | ‘ductal’ removed |
Nme internal enhancement characteristics | ‘Stippled/punctate’ removed (a normal pattern of BPE) |
|  | ‘reticular/dendritic’ removed |
|  | ‘clustered ring’ added |
Intramammary lymph node | New addition as separate feature |
Skin lesion | New addition as separate feature |
Associated findings | Skin invasion: new descriptors (‘direct invasion’, ‘inflammatory cancer’) |
| Â | Oedema: removed |
|  | ‘Lymphadenopathy’: removed. Now termed ‘axillary adenopathy’ |
|  | ‘Chest wall invasion’ added; separate from pectoral muscle invasion |
|  | ‘Nipple retraction’ removed |
Non-enhancing findings | Ductal precontrast high signal on T1W added |
| Â | Cyst added |
| Â | Postoperative collections (haematoma/seroma) added |
| Â | Post therapy skin/trabecular thickening added |
| Â | Architectural distortion added |
Fat containing lesions | New section (includes fat necrosis, lymph nodes, hamartomas etc.) |
Kinetic curve assessment | New section: initial phase (slow, medium, fast), delayed phase (persistent, plateau, washout) |
Implants | New section: includes material and type, location, evidence of rupture, abnormal implant contour, signs of intracapsular rupture; extracapsular silicone (breast or lymph nodes), water droplets or peri-implant fluid |