Fact-sheet: Invasive breast cancer
Updated on 09/17/2021 at 12:16 PM
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Classification
ACR BI-RADS classification
ACR 0: Further work-up is needed: comparison with prior studies, additional views, spot compression views, magnification of microcalcifications, ultrasound, ...
ACR 1: Normal Mammography.
ACR 2: Benign finding requiring neither follow-up nor further investigation:
- Round opacity with macrocalcifications (fibroadenoma or cyst)
- Intramammary lymph node
- Round opacity corresponding to a typical cyst on ultrasound
- Fat-density or mixed-density lesion (lipoma, hamartoma, Galactocele, oil cyst)
- Known scar and calcification on suture material
- Macrocalcifications without an associated opacity (fibroadenoma, cyst, fat necrosis, secretory duct ectasia, vascular calcifications, etc.)
- Ring-like or arciform, semilunar, sedimented, rhomboid microcalcifications
- Skin calcifications and diffuse regular punctate calcifications
ACR 3: Probably benign finding for which short-term follow-up is recommended:
- Round or regular punctate or powdery microcalcifications, few in number, in a small isolated round cluster
- Small round or oval cluster of amorphous calcifications, few in number, suggestive of early fibroadenoma calcification
- Well-circumscribed opacity, round, oval, or slightly polycyclic without microlobulation, noncalcified, not cystic on ultrasound
- Focal asymmetry of density with concave margins and/or intermixed with fat
ACR 4: Indeterminate or suspicious finding warranting histologic verification:
- Numerous regular punctate microcalcifications and/or clustered with margins that are neither round nor oval
- Numerous clustered powdery microcalcifications
- Irregular, pleomorphic, or granular microcalcifications, few in number
- Spiculated lesion without a dense center
- Noncystic round or oval opacity with lobulated or obscured margins, or increasing in size
- Architectural distortion other than a known and stable scar
- Localized asymmetry or increased density with convex margins or evolving over time
ACR 5: Finding highly suggestive of malignancy:
- Vermicular, branching, or irregular, pleomorphic, or granular microcalcifications, numerous and clustered
- Clustered microcalcifications of any morphology with a ductal distribution
- Microcalcifications associated with an architectural abnormality or an opacity
- Clustered microcalcifications that have increased in number or whose morphology and distribution have become more suspicious
- Ill-defined opacity with blurred and irregular margins
- Spiculated opacity with a dense center