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BI-RADS Categorization As a Predictor of Malignancy¹

¹ From the Department of Radiology, University of Pennsylvania Medical Center, 3400 Spruce St, Philadelphia, PA 19104 (S.G.O., N.K.); the Division of Anatomic Pathology, Mayo Clinic, Rochester, Minn (C.R.); and the National Cancer Institute, Rockville, Md (D.C.S.). From the 1997 RSNA scientific assembly. Received May 13, 1998; revision requested July 10; revision received August 17; accepted November 5. Address reprint requests to S.G.O.

View larger version (154K): [in a new window]   Figure 1. Calcifications had been identified on an outside a screening mammogram in a 40-year-old woman, and follow-up diagnostic mammography was performed. Spot magnification mammogram obtained in the craniocaudal projection reveals a cluster of calcifications (arrow). The interpretation was punctate, questionably new calcifications, and a 6-month follow-up examination was recommended. Needle localization was performed, and solid-type DCIS measuring 0.8 cm was found. Repeat excision revealed residual DCIS measuring 1.2 cm, with negative margins of resection.

View larger version (152K): [in a new window]   Figure 2. New calcifications had been identified on a screening mammogram in a 68-year-old woman, and follow-up diagnostic mammography was performed. Spot magnification image reveals a cluster of calcifications (arrow). The interpretation was new but coarse calcifications. There were other coarse benign calcifications elsewhere in the breast. A 6-month follow-up examination was recommended. Needle localization was performed, and solid-type DCIS measuring 0.5 cm was found, with negative margins of resection.

View larger version (148K): [in a new window]   Figure 3. Outside 90° lateral spot magnification mammogram demonstrates calcifications (arrow) in a 47-year-old woman who had undergone left mastectomy and right reduction mammoplasty and who had outside images, including this image, at presentation. Review of several mammograms demonstrated coarsening of the calcifications, and the interpretation was probable fat necrosis following reduction mammoplasty. Needle localization revealed solid-type DCIS measuring 0.8 cm, with negative margins of resection.