🎀 Breast Ultrasound BI-RADS Structured Read
Enter 5th-edition breast-ultrasound lexicon features and get a suggested BI-RADS category by 'most suspicious feature decides the category'. Instant, browser-side.
Clinical takeaway
BI-RADS has no official point algorithm — the category is set by the most suspicious feature.
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When to use
Structured assistance in assigning a breast-ultrasound BI-RADS category from descriptors.
How it works
Simple-cyst pattern → 2; all benign-leaning features → 3; any suspicious feature (irregular shape, not parallel, non-circumscribed margin, complex, posterior shadowing, suspicious calcifications, associated features) → 4–5 by number/severity.
Key points
- BI-RADS has no official point algorithm — the category is set by the most suspicious feature.
- Spiculation or skin/nipple retraction lean toward category 5.
- A simple-cyst pattern (anechoic, circumscribed, posterior enhancement) is category 2.
- The 4A/4B/4C sub-division is the physician's integrated malignancy estimate.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Internal echogenicity | Anechoic (simple-cyst-like) |
|---|---|
| Shape | Oval |
| Orientation | Parallel (aspect ratio < 1) |
| Margin | Circumscribed |
| Posterior features | No change |
| Calcifications | None |
| Associated features | None |
→Suggested categoryBI-RADS 2 (benign)
- Read：Meets simple-cyst criteria (anechoic, circumscribed, posterior enhancement/no change, no suspicious features)
- Management：BI-RADS 2 benign: routine screening, no biopsy or short-interval follow-up
- Note：BI-RADS has no official point algorithm; the category is set by the most suspicious feature, and the final category needs the physician's integrated judgement
| Internal echogenicity | Heterogeneous |
|---|---|
| Shape | Irregular |
| Orientation | Not parallel (taller-than-wide, ratio > 1) |
| Margin | Spiculated |
| Posterior features | Combined |
| Calcifications | Suspicious calcifications (micro/amorphous/fine pleomorphic) |
| Associated features | Skin/nipple retraction, architectural distortion, skin thickening, etc. |
→Suggested categoryLeaning BI-RADS 4C–5
- Suspicious features：irregular shape, not parallel (taller-than-wide), margin spiculated, suspicious calcifications, suspicious associated features (retraction/distortion) (5 total)
- Suggested category：Leaning BI-RADS 4C–5 — any suspicious feature places it in category 4 needing biopsy; more/more typical features raise the category
- Management：High suspicion / highly suggestive of malignancy: biopsy (image-guided); spiculation or skin/nipple retraction and architectural distortion are classic malignant features, leaning 5; a benign pathology discordant with imaging still needs surgical consultation
Frequently asked questions
- What is Breast Ultrasound BI-RADS Structured Read?
- Enter 5th-edition breast-ultrasound lexicon features and get a suggested BI-RADS category by 'most suspicious feature decides the category'. Instant, browser-side.
- How is Breast Ultrasound BI-RADS Structured Read calculated? What is the core formula?
- Simple-cyst pattern → 2; all benign-leaning features → 3; any suspicious feature (irregular shape, not parallel, non-circumscribed margin, complex, posterior shadowing, suspicious calcifications, associated features) → 4–5 by number/severity.
- When is Breast Ultrasound BI-RADS Structured Read used?
- Structured assistance in assigning a breast-ultrasound BI-RADS category from descriptors.
- What are the key clinical points for Breast Ultrasound BI-RADS Structured Read?
- BI-RADS has no official point algorithm — the category is set by the most suspicious feature. Spiculation or skin/nipple retraction lean toward category 5. A simple-cyst pattern (anechoic, circumscribed, posterior enhancement) is category 2. The 4A/4B/4C sub-division is the physician's integrated malignancy estimate.
- What are the limits and cautions when using Breast Ultrasound BI-RADS Structured Read?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Breast Ultrasound BI-RADS Structured Read calculated in practice? Can you show a worked example?
- Inputs: Internal echogenicity Anechoic (simple-cyst-like), Shape Oval, Orientation Parallel (aspect ratio < 1), Margin Circumscribed, Posterior features No change, Calcifications None, Associated features None → Result: Suggested category BI-RADS 2 (benign)（Read: Meets simple-cyst criteria (anechoic, circumscribed, posterior enhancement/no change, no suspicious features), Management: BI-RADS 2 benign: routine screening, no biopsy or short-interval follow-up, Note: BI-RADS has no official point algorithm; the category is set by the most suspicious feature, and the final category needs the physician's integrated judgement） Inputs: Internal echogenicity Heterogeneous, Shape Irregular, Orientation Not parallel (taller-than-wide, ratio > 1), Margin Spiculated, Posterior features Combined, Calcifications Suspicious calcifications (micro/amorphous/fine pleomorphic), Associated features Skin/nipple retraction, architectural distortion, skin thickening, etc. → Result: Suggested category Leaning BI-RADS 4C–5（Suspicious features: irregular shape, not parallel (taller-than-wide), margin spiculated, suspicious calcifications, suspicious associated features (retraction/distortion) (5 total), Suggested category: Leaning BI-RADS 4C–5 — any suspicious feature places it in category 4 needing biopsy; more/more typical features raise the category, Management: High suspicion / highly suggestive of malignancy: biopsy (image-guided); spiculation or skin/nipple retraction and architectural distortion are classic malignant features, leaning 5; a benign pathology discordant with imaging still needs surgical consultation）