In recent years, the BI-RADS classification has been frequently described in reports in the breast imaging literature and in clinical diagnostic reports. The BI-RADS (Breast imaging reporting and data system) was proposed and recommended by the American College of Radiology (ACR) in 1992 and has been revised three times since then, and by 2003 it has been used not only to guide It has been revised three times since then, and by 2003 was used not only to guide the diagnosis of mammography (4th edition), but also to expand the use of breast ultrasound and MRI. The purpose is to standardize the diagnostic reporting of all imaging normal and abnormal conditions of the breast as a whole organ, using uniform terminology, standard diagnostic categorization and examination procedures. Xu Qing, Department of Ultrasound, Yueqing People’s Hospital BI-RADS staging includes grades 0-6: Grade 0: means that the lesion cannot be fully evaluated using ultrasound examination and requires further other imaging examinations for diagnosis. For example, those with clinical manifestations of nipple overflow, asymmetric thickening, skin and nipple changes, etc., with no signs on ultrasound. A clinically detected lump, age >20 years, with suspicious signs on preferred ultrasound or without features, requires a mammogram. MRI is recommended for those with no features on ultrasound or X-ray and need to differentiate between scarring and recurrent lesions after breast-conserving surgery for breast cancer. Those who need final evaluation before determining treatment. Grade 1: Breast imaging shows clear breast structures without lesions showing, and can be confidently judged as not abnormal or normal. The so-called cystic hyperplasia, lobular hyperplasia, and adenopathy (collectively referred to as fibrocystic changes or structural dysplasia), which are commonly diagnosed in our country, are considered normal lymph nodes according to the BI-RADS description of intramammary lymph nodes, anterior axillary lymph nodes showing hypodense lymph nodes or central hypodensity. A clinically detected mass with limited asymmetric changes, despite the final diagnosis of sclerosing adenopathy, cannot be classified as such and may be classified as grade 3 or 4a. Grade 2: Definite benign breast masses (fibrolipid adenoma, lipoma, simple cyst, cumulus cyst, cumulus oilus cyst), definite benign calcifications (e.g., annular calcifications, short streaks of well-defined calcifications, coarse speckled calcifications, sparse, more homogeneous dotted calcifications of a single size, crescent-shaped sedimentary calcifications, etc.), breast nodules with little change in the image on multiple repeat ultrasound examinations, age <40 years Fibroadenomas or fibroadenomas at the age of <25 years on first ultrasound, irregular structures after surgery with no change in the images on multiple reviews, and breast prostheses are all in this category. Annual follow-up observation is recommended. Grade 3: Almost certainly benign. It must be emphasized that this is not an indeterminate type, but for mammography it has less than 2% chance of malignancy (i.e. almost always benign). For example: a solid oval-shaped mass with clear borders and an aspect ratio <1 at age <40 years is benign and has a <2% risk of malignancy. Consider fibroids with high likelihood: solid masses with oval shape, clear borders and aspect ratio <1. The original grade 3 (probably benign) can be changed to grade 2 (benign) after 2 to 3 consecutive years of review. Multiple complex cysts or clusters of small cysts. Verrucous hyperplastic nodules (in the indeterminate category). Short-term follow-up (3-6 months) and other investigations are recommended for cases in this grade. Grade 4: used to express lesions that require interventional management but are less malignant, with a risk of malignancy of 3 to 94%. 4a: Solid masses with non-benign ultrasound presentation (1-2 items) that require pathology. Their pathology report is not expected to be malignant, and routine follow-up for 6 months after benign biopsy or cytology findings is appropriate. This category includes some solid masses with palpable, partially well-defined margins, such as ultrasound suggestive of fibroadenoma, palpable complex cysts, or suspicious abscesses. 4b: Includes lesions that are moderately suggestive of malignancy. The correlation between radiological diagnosis and pathological findings is close to unanimous. In this scenario, benign follow-up depends on this concordance. A partially well-defined, partially indistinct mass that may be a fibroadenoma or fatty necrosis is acceptable; however, papilloma requires excisional biopsy. 4c: indicates a moderately strong malignant lesion that does not yet have the typical malignant features of grade V. This category includes, for example, solid masses with indistinct borders, irregular shapes, or new microscopic, pleomorphic clusters of calcifications. Such pathological findings are often malignant. Grade 5: Used to describe lesions that are almost certainly breast cancer. There is a 95% probability of malignancy. Irregularly shaped masses with burrs, thin strips of calcifications in a segmental or linear pattern, or irregularly shaped masses with burrs accompanied by irregular and polymorphic calcifications are classified as grade 5. Surgical biopsy is recommended. A standard biopsy without typical malignant lesions is classified as grade IV. Grade 6: This is a new type of grading that is used for the imaging evaluation of pathologic biopsies that have been confirmed as malignant but have not been treated. It is primarily used to evaluate imaging changes after prior biopsy or to monitor the effect of preoperative neoadjuvant chemotherapy. Unlike BI-RADS grade IV and V, cases at this level do not require intervention to determine if the lesion is malignant. The use of breast ultrasound and mammography is now a commonly used method to diagnose breast diseases, and the medical community at home and abroad is gradually applying the BI-RADS grading criteria to standardize the imaging diagnosis of breast diseases, especially for the diagnosis of breast cancer screening. In some teaching hospitals in East China and South China, the imaging departments are gradually adopting the BI-RADS classification criteria for breast diagnosis.