The BIRADS Bible: Changing Terminology, Improving Communications

The BIRADS Bible: Changing Terminology, Improving Communications

Doctors speak with a careful language to ensure accurate diagnosis and treatment of patients. What seems like obscure jargon to a patient may in fact be precision in action. This is something that everyone can appreciate.


We as radiologists rely on our written reports to translate the findings of your imaging exams to your doctor.  In mammography we use specific wording to summarize the findings of breast studies. The BIRADS (Breast Imaging Reporting and Data System) atlas and recommendations have been updated. The atlas in which terms are defined has been revised to make our reports more effective at communicating to our referring doctors and to reflect changes in knowledge in breast imaging in the last few years.


We’ve covered BIRADS in the past (here) but just to review, it is a way of summarizing findings on a mammogram as well as a quality assurance tool. The system is used so your referring physician, your radiologist and anyone else involved in your breast health (like the doctor who performs a biopsy) can readily understand the results and recommended management. It is also a means of following patients, so that your biopsy results are connected to and reviewed by the doctor who interpreted your breast images, an important way we as radiologists track our work and improve our abilities.


The revised edition has changed the look of our breast imaging reports. The final BIRADS category which ends the report has been modified. There is now an assessment category from 0-6, similar to the categories we have described before with the majority of breast imaging reports falling into either category 1 negative or category 2 benign. There is now a separate statement at the end of the report specifically addressing management. For the majority, this management statement will say “routine annual mammography”. If your breast imaging test indicates a need for further follow-up or biopsy, this will be specified in the management section.


BIRADS is an important tool which has helped strengthen the practice of breast imaging. These changes are intended for better clarity in our breast imaging reports. Together we, your team of healthcare professionals, can make a difference – even better than before.  




Image credit: Bible paper by Dave Bullock via Wikimedia Commons Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0)

Originally published 4/25/14 on