5th edition, 2013 reporting system was introduced to standardize reporting of breast lesions. The original ACR reporting document can be downloaded here.
Categories
Category 0 – Incomplete
- need additional imaging for evaluation / prior images for comparison
- recall the patient for the above information
Category 1 – Negative
- needs only routine mammographic screening
- no likelihood of cancer
Category 2 – Benign
- needs only routine mammographic screening
- no likelihood of cancer
Category 3 – Probably benign
- 6-month follow up or continued mammography surveillance
- <2% likelihood of malignancy
Category 4 – Suspicious
Category 4a
- low suspicion
- 2-10% likelihood of malignancy
- needs tissue diagnosis
Category 4b
- moderate suspicion
- 10-50% likelihood of malignancy
- needs tissue diagnosis
Category 4c
- high suspicion
- 50-95% likelihood of malignancy
- needs tissue diagnosis
Category 5 – Highly suggestive of malignancy
- >95% likelihood of malignancy
- needs tissue diagnosis
Category 6 – Known biopsy-proven malignancy
- surgical excision when clinically appropriate