What does it mean that breast color Doppler ultrasound is BI-RADS grade 3?

BI-RADS 3 refers to the need for follow-up according to the standards of the American Radiological Society.

CDFI stands for color Doppler performance.

According to Adler's method, the CDFI blood flow signal was classified as grade 0, and no blood flow signal was found in the mass. Grade I, little blood flow, 1 ~ 2 punctate or thin rod tumor vessels; Grade ⅱ, moderate blood flow, 3 ~ 4 punctate blood vessels or a long blood vessel penetrating into the lesion, the length of which can approach or exceed the radius of the mass; Grade ⅲ, massive blood flow, with ≥5 punctate blood vessels or 2 long blood vessels. Grades 0 ~ I were judged as benign lesions, and grades II ~ III were judged as malignant lesions. The velocity curve was observed by pulse Doppler, and the peak velocity (Vp) and resistance index (RI) were measured. Then switch to RTE mode, use special probe to carry out pressurization and decompression operations, and obtain elastic images for discussion. The elastography score is 5 [1] for evaluation. Scoring criteria: purple (1), blue (2), green (3), yellow (4) and red (5). Malignant lesions were diagnosed above 4 o'clock, and benign lesions were diagnosed below 3 o'clock.

Prompt for follow-up. Considering your situation, it is 6×7×8mm, which is not very big. It is recommended to follow up further.

(Solemnly remind: I can't fully understand the condition because I can't see the patient face to face. The above suggestions are for reference only. Please go to the hospital for specific diagnosis and treatment under the guidance of a doctor! )

BI-RADS classification of reference breast:

Double rads level

Ultrasound examination can not comprehensively evaluate the lesions, and further imaging examination is needed to diagnose them.

Clinical signs, ultrasound examination showed no signs.

Breast examination has clinical signs.

L 1。 Clinically palpable mass or mass

L2。 There is no lump or nipple discharge in clinic.

L3。 Asymmetric thickening

L4。 Skin and nipple changes

☆ Breast pain is a conscious symptom, and those who are not included in the clinical signs are screened according to the screening process without clinical signs.

Double RADS 1 class

No abnormal manifestations were found by ultrasound, such as no mass, no structural disorder, no skin thickening, no microcalcification, etc.

L★ Regular ultrasound review every year.

The diagnosis of polyglandular type is reliable.

Double rads level

Benign signs can basically exclude malignancy.

① Simple cyst

② Intramammary lymph nodes (possibly 1 grade)

③ Breast prosthesis implantation

④ Age

⑤ Fat lobule (pay attention to differentiate it from fibroadenoma)

★6- 12 months ultrasound regular review.

Double rads level

Possible benign signs

① age

② Multiple complex cysts or small cluster cysts.

③ Tumor-like proliferative nodules (amorphous)

★ 3-6 months ultrasonic regular inspection and other further inspections.

Double rads level

The first ultrasound examination of l 35-39 years old was grade 3:

* Family history * Patient's anxiety * Unwilling to check regularly * Solid mass * Unclear cystic-solid mass * Clustered small cyst.

★ suggested biopsy

Although multi-center data confirmed that this level of ultrasound short-term follow-up is safe, but the treatment strategies or methods are increasing, and some patients at this level also need biopsy.

For example: 35-39Y, ultrasound may consider fibroadenoma, patients are anxious and unwilling to follow up, and biopsy may be considered.

Evaluation after Bi-RADS Level 3 review

From 35 to 39, the initial ultrasound examination of solid mass was grade 3, and there was no family history. The ultrasound review was 3-6 months.

L 1。 The mass shrank and disappeared → grade 2.

L2。 The quality has not changed. After 3-6 months, there is still no change → Grade 2.

L3。 The mass enlarged and became malignant → grade 4 (biopsy).

Double rads level

Suspicious anomalies have a malignant risk of 3-94%.

① Benign lesions such as fibroadenoma that do not conform to all ultrasound images (malignant manifestations in the benign and malignant differential table are 1-3).

② Solid mass lesions with ultrasound benign signs over 40 years old. This lesion may not have the characteristic breast cancer morphology, but it belongs to the high incidence age and may become malignant. 4A

★ Suggested biopsy: needle aspiration cytology, hollow needle biopsy, surgical biopsy, etc.

Double rads level

Most likely malignant.

Ultrasound has characteristic abnormal signs (malignant signs in the differential table of benign and malignant solid masses >); Item 3), the risk of malignant tumor is more than 95%.

Clear treatment should be started. When sentinel lymph node imaging and neoadjuvant chemotherapy are considered, hollow needle biopsy should be performed.

Double rads 6 level

It was confirmed to be malignant by biopsy.

When the biopsy proves malignant, it is used for image evaluation before treatment.

L mainly evaluate the image changes after previous biopsy, or monitor the image changes before surgical resection and before and after neoadjuvant chemotherapy.

Problems needing attention in double RADS classification (4)

Mainly according to the presence or absence of breast exploration and mass to divide.

1. undiscovered quality: level 0; 1 level; Level 6

2. Those who can touch the mass: Grade 2; Level 3; Level 4; Level 5; Level 6

Grades 3.2-5 are mainly divided by the main points of differentiating benign and malignant breast masses.

Problems needing attention in double RADS classification (5)

Class l0 means that the evaluation of ultrasound is incomplete and other imaging methods are needed, but pathological examination is not included. If there are clinical symptoms and ultrasound has no abnormal signs.

Grade l6 refers to those who are proved to be malignant by pathology.

Ultrasonic Color Blood Flow of Breast Masses (Adler Classification)

There is no blood vessel in grade 0 lesions.

The blood flow of grade I was less, with 1-2 punctate and rod-shaped vessels.

Grade II moderate blood flow, 3-4 spots or a blood vessel.

Grade ⅲ is rich in blood flow, with more than 5 punctate or 2 long blood vessels.