🎀 Breast Nodule Smart Manager · Assessment, Follow-up & Treatment Decision
This tool maps the BI-RADS category to malignancy probability and follow-up/biopsy triage, then after diagnosis gives surgery, axillary management, and subtype-based systemic and radiotherapy principles.
Breast Nodule Smart Manager · Assessment, Follow-up & Treatment Decision
BI-RADS category (ultrasound/mammography)
Maximum nodule diameter (mm)
Molecular subtype (if diagnosed)
Tumor stage cT (if diagnosed)
Regional nodes cN (if diagnosed)
When to use
Use to triage imaging findings (1–2 routine, 3 short-term follow-up, 4–5 biopsy, 6 diagnosed) and, once a subtype is known, to outline treatment principles.
How it works
BI-RADS category → malignancy probability and biopsy decision. Diagnosed → breast-conserving + RT vs mastectomy, SLNB (Z0011/AMAROS) vs dissection, and subtype-driven systemic therapy (endocrine/anti-HER2/chemo ± immunotherapy).
Key points
- Breast conservation with whole-breast radiotherapy is survival-equivalent to mastectomy when eligibility criteria are met. (original synthesis · not guideline verbatim)
- Larger HER2+ or triple-negative tumors, or node-positive disease, favor neoadjuvant therapy before surgery.
- BI-RADS is an imaging probability, not a diagnosis — biopsy pathology remains the gold standard.
References
- Sickles EA, et al. ACR BI-RADS Atlas, 5th edition. American College of Radiology.
- Schmid P, et al. Pembrolizumab for Early Triple-Negative Breast Cancer (KEYNOTE-522). N Engl J Med 2020.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.