Breast BIRADS classification: (Breast imaging reporting and data system) Criteria for the expression of breast changes adopted in the Breast Imaging Reporting and Data System (BIRADS) created and recommended by the American College of Radiology (ACR) in 1992. It has been revised three times since then, and in 2003, not only mammography (4th edition) but also ultrasound and MRI were added to the guidelines. It standardizes the diagnostic reports of all normal and abnormal imaging of the breast as a whole organ, using uniform terminology, standard diagnostic categories and examination procedures, so that radiologists’ diagnoses can be made in accordance with the rules and regulations, and at the same time, it also strengthens the coordination and tacit understanding between the radiology department and the other relevant clinical departments, so that the clinical therapists can know what they should do next when they look at the reports of the radiologists. Classification Interpretation Recommended Treatment 0 Imaging evaluation is incomplete and requires further evaluation. Follow-up is recommended in conjunction with clinical examination or if other imaging is negative. II Regular follow-up (e.g., annually) is recommended for consideration of benign changes. III Benign disease possible (about 2% malignant possible). However, shorter follow-up intervals (e.g., once every 3 to 6 months) are needed, and the percentage of malignancy at this level is less than 2%. IVA Low suspicion of malignancy Puncture biopsy is recommended, with benign results Follow-up is recommended. IVB Moderate suspicion of malignancy Puncture biopsy recommended, with excision recommended if papilloma. IVC Moderate concern (atypical signs of malignancy) Biopsy recommended, pathologist should be cautious in taking such tissues, short term follow up if benign. V Highly suspicious of malignant lesions (greater than or equal to 95% identified as malignant disease). Requires surgical excision biopsy and appropriate management of VI for biopsy and pathologic confirmation of malignant lesion.