Breast Imaging Reporting and Data System (BI-RADS): Practical Approach for Ultrasound Interpretation

This document provides a practical overview of the Breast Imaging Reporting and Data System (BI-RADS) classification as applied to breast ultrasound. The BI-RADS system, developed by the American College of Radiology, standardizes the interpretation and reporting of breast imaging findings to improve communication between radiologists and clinicians and to guide clinical management. The document reviews the BI-RADS categories used in breast ultrasound, emphasizing the imaging characteristics that distinguish benign, probably benign, suspicious, and highly suggestive malignant lesions. Particular attention is given to the interpretation of sonographic features such as lesion shape, margins, orientation, echogenicity, posterior acoustic features, and associated findings. Additionally, this resource highlights common diagnostic pitfalls and practical considerations in the differentiation between complicated cysts, complex cystic and solid masses, fibroadenomas, and malignant lesions. The goal is to support clinicians, sonographers, and trainees in developing a structured approach to breast ultrasound interpretation and in applying BI-RADS categories consistently in clinical practice. This educational resource is intended for medical imaging professionals, physicians, and healthcare providers involved in breast imaging and breast cancer evaluation.