The ACR BI-RADS® Experience: Learning From History

Burnside, Elizabeth S.; Sickles, Edward A.; Bassett, Lawrence W.; Rubin, Daniel L.; Lee, Carol H.; Ikeda, Debra M.; Mendelson, Ellen B.; Wilcox, Pamela A.; Butler, Priscilla F.; D'Orsi, Carl J.

doi:10.1016/j.jacr.2009.07.023

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Volume 6, Issue 12 , Pages 851-860, December 2009

The ACR BI-RADS^® Experience: Learning From History

Elizabeth S. Burnside, MD, MPH, MS
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Corresponding author and reprints: Elizabeth S. Burnside, MD, MPH, MS, University of Wisconsin Medical School, Department of Radiology, E3/311 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792-3252
Edward A. Sickles, MD
- Department of Radiology, University of California, San Francisco, Medical Center, San Francisco, California
Lawrence W. Bassett, MD
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
Daniel L. Rubin, MD, MS
- Department of Radiology, Stanford University School of Medicine, Stanford, California
Carol H. Lee, MD
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York
Debra M. Ikeda, MD
- Department of Radiology, Stanford University School of Medicine, Stanford, California
Ellen B. Mendelson, MD
- Department of Radiology, Northwestern Memorial Hospital, Chicago, Illinois
Pamela A. Wilcox
- Department of Quality and Safety, American College of Radiology, Reston, Virginia
Priscilla F. Butler
- Department of Quality and Safety, American College of Radiology, Reston, Virginia
Carl J. D'Orsi, MD
- Breast Imaging Center, Department of Radiology, Emory University Hospital, Atlanta, Georgia

The Breast Imaging Reporting and Data System^® (BI-RADS^®) initiative, instituted by the ACR, was begun in the late 1980s to address a lack of standardization and uniformity in mammography practice reporting. An important component of the BI-RADS initiative is the lexicon, a dictionary of descriptors of specific imaging features. The BI-RADS lexicon has always been data driven, using descriptors that previously had been shown in the literature to be predictive of benign and malignant disease. Once established, the BI-RADS lexicon provided new opportunities for quality assurance, communication, research, and improved patient care. The history of this lexicon illustrates a series of challenges and instructive successes that provide a valuable guide for other groups that aspire to develop similar lexicons in the future.

Key Words: BI-RADS, breast cancer, breast imaging, diagnosis, informatics lexicon, mammography, screening, structured reporting