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Abstract

Title: Concordance of breast imaging reporting and data system assessments and management recommendations in screening mammography.
Author: Taplin SH, Ichikawa LE, Kerlikowske K, Ernster VL, Rosenberg RD, Yankaskas BC, Carney PA, Geller BM, Urban N, Dignan MB, Barlow WE, Ballard-Barbash R, Sickles EA
Journal: Radiology 222(2):529-535
Year: 2002

Abstract: PURPOSE: To examine how frequently Breast Imaging Reporting and Data System (BI-RADS) mammographic screening assessments were associated with expected clinical management recommendations. MATERIALS AND METHODS: Seven Breast Cancer Surveillance Consortium mammography registries recorded screening assessments and recommendations in 1997 to identify the proportion of women in each BI-RADS category. The first screening assessment for a woman without cancer or a prior mammogram within 9 months was associated with its independently recorded recommendation. RESULTS: Among 292,795 women, screening assessments included 269,022 (91.9%) with a 'negative' or 'benign finding,' and 267,103 (99.3%) of these women were recommended for normal interval follow-up. Among 11,861 (4.1%) women with screening assessments of 'probably benign finding,' 4,782 (40.3%) were recommended for short interval follow-up as expected on the basis of the BI-RADS, but a high proportion (36.9%) were recommended for additional imaging. Among 1,625 (0.6%) women with 'suspicious abnormality,' most were recommended for biopsy (48.7%) or clinical examination and/or surgical consult (9.0%), but many were recommended for additional imaging (38.7%). Among 243 (0.1%) women with screening assessments 'highly suggestive of malignancy,' a majority were recommended for biopsy (73.3%) or clinical examination and/or surgical consult (18.1%) consistent with BI-RADS, but some were recommended for additional imaging (6.6%). CONCLUSION: BI-RADS assessments and management recommendations are consistent for negative and benign assessments, but inconsistencies were found in assessments and recommendations for mammographic abnormalities.