BIRADS classification in mammary gland ultrasound

The article was consulted professionally by Specialist I Le Hong Lien – Obstetrics and Gynecology Department – Share99 Central Park International Health Hub.

BIRADS classification aims to standardize the diagnosis, the malignant risk pregnosm helps to have appropriate behavior. Combining ultrasound after mammograms is always necessary in hard-to-see lesions on a solid breast background that is easily missed.

BI-RADS (Breast Imaging Reporting and Data System) is a system that categorises mammogram results by a score of 0 to 5 as follows:

• 0 – Information is not enough to conclude.
• 1 – Nothing unusual. You should continue to check periodically.
• 2 – Detection of benign cysts (which are tumors but not cancers). You should continue to check periodically.
• 3 – Detect abnormalities but not necessarily cancer. Mammograms should be performed within the next 6 months.
• 4 – Detection of risk factors for cancer. Your doctor may perform a biopsy to determine.
• 5 – Detect a high risk of cancer. You need to have a biosy to determine.

The mammary glands are made up of multiple sub-lobes, each with a lobe tube, which divides gradually to the last point of milk glands. Each lobe has 3-100 milk glands. The gland lobes are not evenly distributed but are concentrated at 1⁄4 on the outer side of the breast. This is a region with more mammary gland organization so it is more prone to cancer.

Breast cancer is a form of malignant cancer. A medical block can be benign (non-carcinogenic) or malignant (carcinogenic). The majority of cancer starts from the milk ducting, a small part develops in milk bags or lobes.

3.1 Mammary fibroids

Mammary fibroids are a common form of benign breast tumors of the mammary glands. The tumor is round, smooth, easily mobile in breast tissue, usually located near the nipple but can also appear in many other places on the breast.

Women with mammary fibroids often feel pain, burning, swelling and sensitivity in the chest area. These symptoms increase during menstruation and gradually decrease as they get further away from menstruation. The patient only happens to detect when touching the chest that a tumor is painless, does not affect daily activities. The disease occurs more in young women, under the age of 50 years.

3.2 Mammary papillae

A mammary papillae is a breast tumor located in the organization of the mammary gland hemoma. Tumours are formed from paved parquetthoma cells in the heart of the main milk gland tube. The person presenting with discharge on one side of the breast when touched, colorless, bloody or blue-brown. Patients must take regular tests to make a diagnosis that distinguishes it from mammary gland cancer.

Tests for the diagnosis and pregnosing of a mammary papillae include nipple translation tests and mammograms. After diagnosis of the disease, the treatment is in dinhed as tumor removal.

3.3 Mammary fibrosis

Mammary fibrosis cyst disease is a disease that occurs in the glandular system of the lobe and the mammary gland lobe. The disease occurs mainly at the age of 35-45 years, with prominent clinical symptoms such as painful sensations, discomfort in the mammary glands, increased sensations during menstruation. In some cases, the patient feels so painful that he cannot wear a bra and does not dare to touch. Lesions appear on both sides of the breast. The cyst is formed from the lobe and lobe milk glands, inside each cyst contains secretion and the carel carthm cells are expanded.

Cystic fibrosis of the mammary glands may increase the risk of breast cancer, especially for people with a history of family breast cancer and a bio-test that finds there is atypical increase in reproduction.

3.4 Dilation of milk glands

Dilation of the milk glands is a disease that occurs in the main milk gland ducts of the mammary glands. The disease occurs mainly in women who give birth to many children and have a long time of child support. Accordingly, after many years of breastfeeding, the main milk gland ducties will be dilated, filled with milk fluid, which solides, the appearance of an inflammatory reaction around the dilated milk gland duct.

Patients often have symptoms of white or yellowish nipple discharge. Touching the breast, there are hard clouds forming wires just below the areola, radiating a few centimeters outside.

The standard of diagnosis of the disease is an ultrasound of the mammary glands that sees the tubes of milk dilated and provoking a mammogram that sees milky volume. On a mild level, the patient is prescribed infrared, hot compresses, combined with milk suction 1-2 times a day. If there is repeated bacterial infections, a dilated main milk gland cyclic system may be in order to be removed.

3.5 Cocooned milk follicles

Cocooned milk follicles are also a pathology that occurs in the main milk glands of the mammary glands. The disease is common in women of lactation age. The disease occurs because several main milk gland tubes are clogged to dilate and block the tube formation, forming inflammatory processes and fibrosis of the organizations around the lesion area. The cysts are of different sizes, the inside of which is filled with condensed milk.

The disease appears with palpation of the breast with a floating mass, mobile, painless, of different sizes. When the squeeze sees milk discharge at the top of the nipple. To cause breast anesthgram

The disease is diagnosed by ultrasound of a mammary gland cyst and a mammogram that sees milky volume. First, the patient is treated with suction pokes for the treatment of cocooned milk follicles. If the follicles are relapsed within 2 months, cyst removal surgery must be in place.

4.1 Classification of BIRADS in mammary gland ultrasound

BIRADS 1: No injuries found, more images needed for evaluation

BIRADS 2: Normal mammary gland organization to benign lesions (typical cysts, thick negative nodules)

BIRADS 3: Benign lesions (fibro gland tumors), only 0.8% malignant

BIRADS 4: Suspected malignant lesions (signs suggesting malignant tumors), additional biomass is required, there is a 31.1% likelihood of malignanity

BIRADS 5: Suspicion of malignant lesions is very high (there are 2 or more signs of malignant tumors), a biomarker is required, there is a 96.9% chance of malignanity

BIRADS 6: Malignant tumors have been tested for proven anatomy, patients continue treatment.

4.2 Some signs suggest benign tumors

Shape: Oval tumor (main sign)

Direction: Parallel (main sign)

Shoreline: Clearly separated shoreline (main sign)

Damage limitation: The face is clearly and thinly separated from the next benign tissue (secondary sign)

Response structure:

• Follicle drum response (main sign)
• Thick feedback (secondary signs)
• Rear sound gain (secondary sign)
• Coarse calcification (secondary signs)

4.3 Some signs suggest melanoma

Shape: Round or uneven

Direction: In a non-parallel direction (main sign)

Shoreline: Tentacles (main signs) or unknown, corner folding, small multi-arc (secondary signs)

Damage limit: With a thick recovery border (secondary sign)

Feedback structure: Very poor or mixed responses (secondary signs)

Calcification: There are micro calcifications (main signs)

Doppler Ultrasound: There is perfussing in the tumor, RI > 0.83, PI > 1.6

Meta meta metalysed lymphadenopathy:

• Diameter > 1cm
• 3mm thick > shell
• No more umbilical cords
• There is perfusion outside the umbilical cord
• Multi-arc

The Imaging Department at Share99 International Health Hub is equipped with ultrasound machines with specialized probes, high frequency for mammogram examination. Especially, Share99 has applied advanced automatic 3D ultrasound technology in the world to Vietnam. The system was manufactured by GE Heathcare (USA) as Invenia TM ABUS.

This is a device capable of screening, diagnosing, monitoring before and after the treatment of mammary gland diseases and together with the mammogram system to increase the detection of breast cancer at a very early stage without clinical manifestations.

Outstanding advantages of Invenia ABUS 3D breast ultrasound machine:

• Helps to accurately detect abnormalities or lesions in the breast. In women with thick breast tissue like Vietnamese, accuracy is up to 90%
• Do not use toxic chemicals, do not emit X-rays – X-rays
• Short ultrasound time: only about 15 minutes