What is BI-RADS grading in breast imaging? Many patients often ask about mammography grading in the clinic, and many grade III patients think they have a malignancy. BI-RADS is a system called the Breast Imaging Reporting and Data System (BI-RADS) recommended by the American College of Radiology to standardize the reporting of mammograms, ultrasounds and MRIs. There are seven levels. The meaning of each grade is as follows: Grade 0: Needs to be recalled and evaluated in conjunction with other tests. It means that the information obtained from the examination may not be complete. Grade I: No abnormality is seen. Grade II: benign changes are considered and regular follow-up is recommended (e.g., once a year). Grade III: Benign disease is possible, but a shorter follow-up period (e.g., once every 3-6 months) is required. The percentage of malignancy at this level is less than 2%. Grade IV: Malignant lesion is considered possible and requires biopsy for clarification. Grade V: High suspicion of malignant lesion (almost identified as malignant disease), requiring surgical excisional biopsy. Grade VI: Malignant lesion has been confirmed by pathology. Of course, the above grading is only to determine the degree of breast disease from the images, the specific situation should be combined with the clinician’s judgment to comprehensive analysis.