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Breast Imaging Reporting And Database System
Masses: seen on 2 views (if on one view only - density)
Shape: Round, Oval, Lobular, Irregular
Margin: Circumscribed, Microlobulated, Obscured, Indistinct (Ill-defined), Spiculated
Density: High Density, Equal Density (Isodense), Low density but no fat containing, Fat containing radiolucent (Oil cyst, Lipoma, Galactocele, Hamartoma)
Calcifications:
Typically Benign:
Skin calcs, Vascular calcs, Coarse or Popcorn-like (Involuting Fbroadenoma), Large Rod-like calcs, Round calcs, Punctate calcs, Lucent-Centered calcs, Rim or Eggshell calcs (fat necrosis), Milk of Calcium calcs (teacups, 90 sec compression prior exposure), Suture calcs, Dystrophic calcs (irradiated breast or following trauma)
Higher probability Malignancy:
Amorphous or Indistinct Calcs: small hazy roundish calcs - bx
Coarse heterogeneous Calcifications:
Fine Pleomorphic Calcifications: many shapes, <0.5mm
Fine Linear Branching Calcifications: calcs filling the duct, DCIS
Distribution:
Diffuse/Scattered: if no other worrisome characteristics, usually benign
Regional: not usually worrisome unless other worrisome characteristics (pleomorphic calcs)
Grouped: calcs in 2cm, may be worrisome
Linear: worrisome, DCIS
Segmental: worrisome, suggestive of multifocal DCIS confined to a single lobe of the breast
Architectural Distortion: change from the normal crisscrossing arcs without vissible mass
Intrammary Lymph node
Focal asymmetry
Global asymmetry
PNL: Posterior Nipple Line