For many women who go in for a mammogram, the experience can make them nervous, which can produce even greater anxiety when results come back that don’t give the women a clean bill of health. However, in many cases, whatever shows up during the mammogram screening generally is nothing to worry about.
In order to help establish some uniformity in how radiologists read and interpret mammograms, the American College of Radiology set up a system of standards called the Breast Imaging Reporting and Data System (BIRADS). Within BIRADS, seven different mammogram results, ranging from a Category 0 to a Category 5, are possible:
Category 0: A Category 0 mammogram means that the assessment is not complete and additional imaging is required. By itself, a Category 0 result means that the radiologist may not have been able to see an abnormality completely, or that the abnormality was not completely defined. Additional imaging, including the use of spot compression, magnification, ultrasound, and special mammographic views may be used to help make a more complete evaluation.
A Category 0/Level 4 classification tends to be more urgent, because it means the radiologist thinks there may be an abnormality, but was not able to see the abnormality completely. A second mammogram appointment needs to be scheduled as soon as possible.
Category 1: A Category I mammogram means that the radiologist found nothing abnormal in the breasts. Usually, this rating means that the results were “negative.”
Category 2: A Category 2 mammogram signifies that the breasts are normal, but that the radiologist has viewed benign conditions, such as calcifications, calcified fibroadenomas or intramammary lymph nodes. Just as it is important for a woman to become familiar with the normal lumps and bumps of her breasts, any benign conditions which can be documented, based on a mammogram, are helpful in establishing a roadmap of a woman’s breasts. All of this information helps to rule out potentially suspicious finding in the future, which is particularly useful if a woman later chooses a new doctor or mammogram facility.
Category 3: A Category 3 mammogram indicates that there is an abnormality in the breast that is probably benign, but which the doctor nonetheless believes needs to be monitored. Follow-up mammograms usually are repeated every 6 months for a year, and then annually for 2 years. By keeping a watchful eye on following mammograms, a doctor can track the abnormality for any changes which could indicate cancer. A Category 3 requires diligent monitoring, without having to subject a patient to biopsy.
Category 4: A Category 4 mammogram means that the radiologist recommends that a biopsy be performed. Although this classification does not necessarily mean that there is a malignancy, the result does imply that there is significant suspicion.
Category 5: A Category 5 mammogram means that the radiologist viewing the film sees abnormalities that have the characteristics of cancer. This evaluation only is assigned if there is a high probability of malignancy. Usually, immediate biopsy is recommended, followed by treatment of the lump or mass.
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