The ACR BI-RADS Atlas 2013 (4) is the updated version of the 2003 Atlas. BI-RADS® is designed to standardize breast imaging reporting and to reduce confusion in. ![]() ![]() RAPS helped establish the regulatory profession and continues to. RAPS is the largest global organization of and for those involved with the regulation of healthcare and related products, including medical. Earlier this month, Atlus warned streamers to not broadcast beyond an early point in the game, seemingly threatening content claims and strikes for anyone who defied. The 5th Edition of the ACR BI-RADS® is a richly illustrated work with information on breast imaging. BI-RADS is an acronym for Breast Imaging-Reporting and Data System, a quality assurance tool originally designed for use with mammography. Breast density BI- RADS classification - Moose and Doc. Breast density is thought to be a factor of increased risk for breast cancer. The idea was originally met with skepticism but consensus now is that it is indeed a true risk element, and of interest to screening mammography. Essentially, breast density is a comparison of the relative amounts of fat versus fibroglandular tissues in the breast. These are: Breast Density: BI- RADS type 1. Glandular tissue is less than 2. Breast Density: BI- RADS type 2. In type 2 breast density, there are scattered fibroglandular tissues, ranging from 2. Breast Density: BI- RADS type 3. The breast tissue in type 3 may be termed . With respect to breast density it implies that the fibrous tissue is prevalent throughout the breast, but not clustered together. Breast Density: BI- RADS type 4. The highest category of breast density, . At this level the sensitivity of the mammogram might even be reduced. With breast cancer development we often speak of malignant cells originating in duct . Fibroglandular parenchyma, what density of breast tissue is made of. Inside breasts there are . Within the breast the main glandular tissues are, obviously, those that produce milk, and also those that secrete sweat. Connecting and joining tissues between different elements are also . Amounts of fibrous and glandular tissues also tend to be quite proportionate, like a . High breast density is like a tree with many branches and lots of bushy leaves, as compared to a . It is an old Greek term which means . In the case of a breast, parenchymal tissues would include both glandular and fibrous tissues, but an overabundance; more than are normally found to support breast function in all women. The four categories of increasing breast density were adopted and modified by the American College of Radiology as part of an . It is difficult to isolate breast density in terms of an odds or risk ratio because, in order to be reliable, so many other variables need to be controlled or eliminated. However, even an inconclusive study can give general trends that can still help gauge cancer threat and plan for follow- up and treatment. This page is getting a little old, and while the above information is good, the statistics here about risks and odds, are out- of- date. Probably they are still OK, but new published articles on the subject exist, but I haven’t had time to add them here. When comparing the least- dense breast tissue categories with the most- dense, studies suggest the chances of developing breast cancer ranges from an odds ratio of 1. That is quite a bit of variability, but the majority of research still shows an odds ratio of 4 or higher. Firstly, the development of premalignant lesions such as atypical ductal hyperplasia is more likely in an . Secondly, a woman may have naturally overactive aromatase, which increases estrogen production within the breast, and may stimulate the growth of latent tumor cells. The effect of hormone levels on breast density It is a known fact that hormone levels can effect breast density in women. Predicting the influence of both natural hormones and supplemental hormone therapies is always a bit of a guessing game. After menopause, women’s breasts become fattier, in other words, . In terms of the breast cancer risk associated with breast density, this ought to be positive thing. Some hormone treatments work against this, however. Women who take estrogen to counter the effects of menopause run the risk of both increased breast density, and faster breast cancer growth if a tumor is already developing. Aromatase is an enzyme that synthesizes estrogen, and the biosynthesis of aromatase can stimulate the growth of fibro- glandular cells in the breast. To counter these processes, . Unlike obesity, breast density has been proven to actually increase the chance of developing cancer, whereas obesity is in almost all cases a concurrent and unrelated observation. The question remains, however, is high breast density something a woman can influence through her behavior, or is it simply genetic? Although results are still inconclusive, there is some evidence to support a genetic predisposition towards dense breasts, and some researchers even claim to have found one or two specific genes responsible. It is far too early to say what percentage of women may be genetically predisposed, but it could be over 5. Obesity would seem to have an inverse effect on breast density, as women with a high body- mass- index tend to have an overabundance of fat in their breast tissue (hence a very low breast density) So, conclusions as to the genetic effects on high breast density would have to be correlated somehow with genetic predisposition towards obesity. The one cancels the other out, so to speak. In terms of a women’s voluntary behavior, aside from taking hormones as discussed above, there is some speculation that diet and alcohol intake can influence breast density. While there may be minimal evidence to support these suppositions, the differences in density between those restrict their diet or alcohol intake versus those who do not is so very small, it is not statisically relevant. There has also been some speculation that women who live in urban areas may, in general, have a higher breast density than women who live in rural areas. Again, the tendency towards an increased breast density is genetically pre- determined. It may be the case that women living in urban centres are generally more inclined to take hormone supplementation than women in rural areas and this could possibly lead to the suggestion of average increased breast density in some studies. It is worth noting, however, that the elevated risk of breast cancer risk remains high for at least 5–1. In order to measure any presumed effects of . If a report describes a breast as . If it uses words like . A type 2 breast density might be desribed as . If the report uses words like . The radiologist might even say . I think they might now be required to, in the USA, but not in all countries. With the advent of computer processing, more specific ways of calculating and classifying breast density are constantly being developed. In addition to the basic mammogram X- ray, experiments are underway which calculate density based on the overall two- dimensional area of fibro- grandular tissue in the image, and also . Essentially, these more- detailed analyses create many sub- categories within the four basic . It is not immediately clear as to what purpose is served by attempting to sub- classify, or more precicely, to . However, over time, following the outcomes of highly specific breast density measures may lead to statistically meaningful trends, and to earlier, more focused breast cancer treatments. References. American College of Radiology. Breast Imaging and Reporting Data System. Reston V A, American College of Radiology 2. Obenauer S, Hermann KP, Grabbe E. Applications and Literature Review of the BI- RADS Classification. Eur Radiol (2. 00. Halls, Steven. B., Mammographic density of mammograms; categories affecting risk. International Conference IEEE Engineering in Medicine and Biology Society, volume 1, pages 7. K. S., Classification of mammographic breast density using a combined classifier paradigm.; Proc. Medical Image Understanding and Analysis, pages 1. Wolfe, J. N., Risk for breast cancer development determined by mammographic parenchymal pattern. Cancer, 3. 7: 2. 48. Harvey, J., and Bovbjerb, V., Quantitative Assessment of Mammographic Breast Density: Relationship with Breast Cancer Risk. January 2. 00. 4 Radiology, 2. Pankow JS, Vachon CM, Kuni CC, et al. Genetic analysis of mammographic breast density in adult women: evidence of a gene effect. J Natl Cancer Inst 1. Int J Clin Oncol 7 (5): 2. Maskarinec, G., Takata, Y., Pagano, I., Lurie, G., Wilkens, L. R., Kolonel, L. N.; Epidemiology: Alcohol consumption and mammographic density in a multiethnic population. International Journal of Cancer (Dec. Volume 1. 18 Issue 1. Pages 2. 57. 9 – 2. Perry, NM. City- Dwelling Women at Greater Risk for Breast Cancer. Scientific Assembly and Annual Meeting November 2. Chicago. Back to breast cancer screening list.
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