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A suspicious area on mammography or ultrasound. [9] This may include: Microcalcifications on MRI. [10] BI-RADS score of 4 or 5 on mammography, ultrasound, or MRI. [11] A suspicious hard palpable lump [9] Skin changes like crusting, scaling, or dimpling of the breast, which may signal an underlying breast cancer [9] Abnormal nipple discharge [7] [9]
Breast ultrasound is also used to perform fine-needle aspiration biopsy and ultrasound-guided fine-needle aspiration of breast abscesses. [8] Women may prefer breast ultrasound over mammography because it is a painless procedure and does not involve the discomfort of breast compression present in mammograms.
The assessment categories were initially developed for mammography and later adapted for use with MRI and ultrasound findings. The summary of each category, given below, is nearly identical for all three modalities. Category 6 was added in the 4th edition of the BI-RADS. BI-RADS assessment categories are: [2] 0: Incomplete; 1: Negative; 2: Benign
Breast density is assessed by mammography and expressed as a percentage of the mammogram occupied by radiologically dense tissue (percent mammographic density or PMD). [23] About half of middle-aged women have dense breasts, and breasts generally become less dense as they age. Higher breast density is an independent risk factor for breast cancer.
Breast ultrasounds may be used with or without a mammogram. Breast ultrasound is the use of medical ultrasonography to perform imaging of the breast. It can be used as either a diagnostic or a screening procedure. [38] It may be used either with or without a mammogram. [39]
After describing the findings, the radiologist provides a final assessment ranging from 0 to 6: BI-RADS 0 indicates an incomplete assessment which needs additional imaging. BI-RADS 1 & 2 indicate a negative and benign screen mammogram respectively. BI-RADS 3 indicates probably benign. [53] BI-RADS 4 indicates suspicious for malignancy.
Inflammatory breast cancer [1] (IBC) is one of the most aggressive types of breast cancer. It can occur in women of any age (and, extremely rarely, in men, see male breast cancer [ 2 ] ). It is referred to as "inflammatory" due to its frequent presentation with symptoms resembling a skin inflammation, such as erysipelas .
A physical exam of the breast is one of the three tests that is scored that is a part of a triple test score. [12] A clinical breast examination (CBE) is different from a breast self-exam because a CBE is conducted by a physician during an appointment whereas a self-exam is recommend to be conducted monthly by patients at home.