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Introduction to Breast MRI Basics – BI-RADS and Approach to Interpretation

Overview and Rationale for Breast MRI

Indications for Breast MRI

Breast Anatomy

Positioning, Technique, Protocol for Breast MRI

Protocol – 43 yo woman – High Risk Screening

Protocol – 31 yo woman – Family History

MRI BI-RADS Lexicon – Amount of Fibroglandular Tissue

Background Parenchymal Enhancement (BPE)

Changing BPE Over 3 Time Points

Enhancing MRI Findings

New Focus of Enhancement – Benign

New Focus of Enhancement – Malignant

Masses – Overview

Non-Mass Enhancement (NME) – Overview

Clustered Ring NME – Benign

Clumped and Clustered Ring NME – DCIS

Kinetic Curve Assessment

Location of Lesion & How to Report It

Interpretation and Reporting

Interpretation and Report – 4mm Focus Right Breast

Report Organization and Examples

BI-RADS Assessment Categories – Overview

BI-RADS 1

BI-RADS 2 – Left Lumpectomy

BI-RADS 2 – Right Lumpectomy, Right Non-Enhancing Mass

BI-RADS 2 – Left Post Excisional Biopsy Change

BI-RADS 2 – Marked BPE, Stable

BI-RADS 2 – Bilateral Stable Findings

New focus of enhancement on a high risk patient (BI-RADS 4)

BI-RADS 3 – Changing Pattern of Background

BI-RADS 4 – Linear NME, Left Breast

BI-RADS 4 – Right Extensive DCIS, Left Dominant Focus

BI-RADS 4 – New Diagnosis Left Cancer, Focal NME left

BI-RADS 4 – New Diagnosis Right Breast Cancer, Nodes on Right

BI-RADS 4 – Left Axillary Node Metastasis, Evaluate for Breast Cancer

BI-RADS 5 – Suspicious Mass in Left Breast, Not Biopsied Yet

BI-RADS 5 – Left Breast Cancer, MRI Shows Right Cancer

BI-RADS 5 – New Diagnosis Right Cancer, Suspicious Masses in Right Breast

BI-RADS 5 – Right Inflammatory Cancer, Bilateral Nodes

BI-RADS 6 – Right Breast Cancer, No Other Findings

BI-RADS 6 – Left Breast Cancer, No Other Findings

BI-RADS 6 – Left Breast Cancer, Index Mass

BI-RADS 6 – Pre and Post Neoadjuvant Chemotherapy (NAC) for Left Breast Cancer