Breast imaging-reporting and data system (BI-RADS) assessment category 3
BI-RADS 3 is an intermediate category in the breast imaging reporting and data system. A finding placed in this category is considered probably benign, with a risk of malignancy between 0% and 2%.
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Terminology
BI-RADS 3 should not be utilized in the screening setting. It should be reserved for the diagnostic setting, such as when patients are recalled from screening for additional views (ie, following BI-RADS 0) or when patients present with a palpable lump.
Radiographic features
Mammography
The BI-RADS Atlas, fifth edition, contains three mammographic findings that should be categorized as BI-RADS 3 4,6:
- grouped round calcifications
- circumscribed, round or oval mass without calcification
- focal asymmetry without calcification or architectural distortion
Ultrasound
The following sonographic findings may be categorized as BI-RADS 3 6:
- complicated cyst with uniform low-level echoes
- microlobulated or oval mass composed of clustered microcysts (although BI-RADS 2 may be appropriate if the appearance is classic 7)
- hypoechoic mass, circumscribed, oval, parallel, without posterior features or with minimal posterior enhancement
- hyperechoic mass with central hypoechoic to anechoic components and surrounding edema consistent with, but not diagnostic of, fat necrosis
- refraction shadowing without an associated mass
- architectural distortion thought to be due to postsurgical scar
Radiology report
BI-RADS 3 carries a management recommendation of short-term follow-up. The recommendation should be for the modality or modalities that best demonstrated the initial finding. While follow-up protocols differ across practices, a common schedule is at 6, 12, and 24 months. Once stability is documented for at least two, and at most three, years, the finding can be downgraded to BI-RADS 2 (benign). If the finding develops suspicious features, such as growth, non-circumscribed margins, or suspicious calcification morphology, then it should be upgraded to BI-RADS 4 or 5.
Related Radiopaedia articles
Breast imaging and pathology
- breast screening
-
mammography
- breast imaging and the technologist
- forbidden (check) areas in mammography
-
mammography views
- craniocaudal view
- mediolateral oblique view
- additional (supplementary) views
- true lateral view
- lateromedial oblique view
- late mediolateral view
- step oblique views
- spot view
- double spot compression view
- magnification view
- exaggerated craniocaudal (axillary) view
- cleavage view
- tangential views
- caudocranial view
- bullseye CC view
- rolled CC view
- elevated craniocaudal projection
- caudal cranial projection
- 20° oblique projection
- inferomedial superolateral oblique projection
- Eklund technique
- normal breast imaging examples
- digital breast tomosynthesis
- breast ultrasound
- breast ductography
- breast MRI
- breast morphology
- breast intervention
- breast pathology
- malignant lesions
-
breast cancer
- breast adenocarcinoma
- ductal breast carcinoma
- ductal carcinoma in situ (DCIS)
- invasive ductal carcinoma
- lobular breast carcinoma
- ductal breast carcinoma
- adenoid cystic carcinoma of the breast
- apocrine carcinoma of the breast
- breast cancer metastases
- breast lymphoma
- breast sarcoma
- inflammatory carcinoma of breast
- intracystic breast cancer
- male breast cancer
- malignant phyllodes tumor
- metastases to the breast
- metaplastic carcinoma the breast
- gamuts
- breast adenocarcinoma
-
breast cancer
- borderline breast disease / high risk breast lesion
- benign lesions
- adenosis of the breast
- benign papillary lesions of the breast
- breast cyst
- breast hematoma
- breast hamartoma
- breast lipoma
- ductal adenoma of the breast
- epidermal inclusion cysts of the breast
- fat necrosis of the breast
- fibroadenoma
- granular cell tumor of the breast
- gynecomastia
- lymphocytic mastitis
- mammary fibromatosis
- oil cyst
- phyllodes tumor
- post-surgical breast scar
- post-radiation breast changes
- post-traumatic fibrosis
- pseudoangiomatous stromal hyperplasia (PASH)
- pseudogynecomastia
- tubular adenoma
-
breast calcifications (approach)
- morphology
- distribution
- location
- lobular calcification within breast tissue
- intraductal calcification within breast tissue
- milk of calcium within a breast cyst
- vascular calcification in breast tissue
- skin (dermal) calcification in / around breast tissue
- suture calcification within breast tissue
- stromal calcification within breast tissue
- artifactual calcification from outside the breast
- suspicious breast calcifications
- infection/inflammation
- vascular lesions
- systemic disease
- gamuts
- classification systems
- malignant lesions
- breast cancer staging