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BIRADS Reference Card
BIRADS Reference Card
QUICK REFERENCE
ULTRASOUND MAMMOGRAPHY
Tissue a. Homogeneous background echotexture – fat Breast a. The breasts are almost entirely fatty
composition composition
b. Homogeneous background echotexture – fibroglandular b. There are scattered areas of fibroglandular density
(screening
only) c. Heterogeneous background echotexture c. The breasts are heterogeneously dense, which
may obscure small masses
d. The breasts are extremely dense, which lowers
the sensitivity of mammography
Masses Shape Oval Masses Shape Oval
Round Round
Irregular Irregular
Orientation Parallel Margin Circumscribed
Not parallel Obscured
Margin Circumscribed Microlobulated
Not circumscribed Indistinct
- Indistinct Spiculated
- Angular Density High density
- Microlobulated Equal density
- Spiculated Low density
Echo pattern Anechoic Fat-containing
Hyperechoic Calcifications Typically Skin
Complex cystic and solid benign Vascular
Hypoechoic Coarse or “popcorn-like”
Isoechoic Large rod-like
Heterogeneous Round
Posterior features No posterior features Rim
Enhancement Dystrophic
Shadowing Milk of calcium
Combined pattern Suture
Calcifications Calcifications in a mass Suspicious Amorphous
Calcifications outside of a mass morphology Coarse heterogeneous
Intraductal calcifications Fine pleomorphic
Associated Architectural distortion Fine linear or fine-linear branching
features Duct changes Distribution Diffuse
Skin changes Skin thickening Regional
Skin retraction Grouped
Edema Linear
Vascularity Absent Segmental
Internal vascularity Architectural distortion
Vessels in rim Asymmetries Asymmetry
Elasticity Soft Global asymmetry
assessment Intermediate Focal asymmetry
Hard Developing asymmetry
Special cases Simple cyst Intramammary lymph node
Clustered microcysts Skin lesion
Complicated cyst Solitary dilated duct
Mass in or on skin Associated Skin retraction
features
Foreign body including implants Nipple retraction
Lymph nodes – intramammary Skin thickening
Lymph nodes – axillary Trabecular thickening
Vascular AVMs (arteriovenous malformations/ Axillary adenopathy
abnormalities pseudoaneurysms) Architectural distortion
Mondor disease Calcifications
Postsurgical fluid collection Location of Laterality
Fat necrosis lesion Quadrant and clock face
Depth
Distance from the nipple