What does BIRADS on your mammography/ ultrasound report mean?

Lot of times in my Breast Clinic at CK Birla Hospital, Gurgaon, I get patients who come and tell me that they are suffering from stage III breast cancer. When I ask them how do they know about that, the answer which I usually hear is that “my mammogram/ ultrasound report shows BIRADS III.” Not only patients but I have also seen some doctors getting confused with the BIRADS reporting.

BIRADS (Breast Imaging Reporting and Data Systems) is a standardized way of reporting breast radiology reports.  This helps radiologists categorize patients from a score of 0-6 and it helps breast cancer surgeons in taking decisions based on this score. Having a uniform reporting system is useful because patients might get their radiology and breast disease treatment done at different places.

The score doesn’t imply the stage of cancer and patients should be aware of this to avoid unnecessary anxiety after seeing the radiology report.

  • BIRADS 0 means an incomplete investigation – This usually occurs when a mammogram is done in a patient with a dense breast and it does not yield any meaningful information. In such a case, usually an ultrasound or MRI Breast is done

 

  • BIRADS 1 is a negative scan, which basically implies that there is no lesion in the breast and everything is normal. In these patients we advise them to follow up after 1 year

 

  • BIRADS 2 is suggestive of a benign lesion, which has essentially a 0% risk of cancer and these lumps don’t require a biopsy. They can be followed up in a year’s time. Simple cysts, most typical fibroadenomas fall under this category.

 

  • BIRADS 3 lesions are probably benign and these breast lesions/ lumps should be followed up every 6 months (short term follow-up). These lumps do not require a biopsy/ FNAC but if you have a family history of breast cancer, then the clinician might be inclined to do more tests/ biopsy at this stage rather than wait for 6 months.  Fibroadenomas, duct ectasias can fall under this category of lesions.

 

  • BIRADS 4 breast lumps/ lesions are suspicious lesions and they need to be biopsied to confirm the diagnosis. They are further sub-divided into 4a, 4b, 4c which implies low, medium and high risk for cancer. These patients should be counselled accordingly and a tru-cut/ core needle biopsy should be scheduled as soon as possible. Atypical fibroadenomas, suspicious microcalcifications, duct papillomas usually fall under this category of lesions

 

  • BIRADS 5 lesions are highly suggestive of malignancy and the risk of cancer in these breast lumps is more than 95%. All patients with these breast lumps should be subjected to the tru-cut biopsy, which is preferred over a FNAC (fine needle aspiration cytology)

 

  • BIARDS 6 lesions are when a radiological test is done after confirming the diagnosis of breast cancer.

 

The table below summarizes the BIRADS score and the action which needs to be taken in each category.

The Radiology Assistant : Bi-RADS for Mammography and Ultrasound 2013

 

So the next time you receive your mammography / breast ultrasound report, don’t be surprised to see the BIRADS score. Discuss the report with your radiologist and breast cancer surgeon and take action accordingly. Remember, that all breast lumps are not cancerous and all of them don’t even require a biopsy/ FNAC test.

 

This information has been provided by

Dr. Rohan Khandelwal

Principal Consultant,

The Breast Centre

CK Birla Hospital, Gurugram

Breast Cancer – Facts & Figures (Hindi Video)

Breast Cancer is now the most common cancer amongst Indian women. Approximately 1 in 22 Indian women suffer from this disease during their lifetime. A high incidence has also been noticed in parts of North India like Gurgaon, Delhi NCR, Punjab.

Breast cancer is curable if defected early. If breast cancer is detected at an early stage, another advantage is that mastectomy or full removal of the breast might not be required.

In this patient education video, Dr. Rohan Khandelwal (Breast Cancer Surgeon in Delhi NCR) talks about some common facts and figures regarding Breast cancer in India. In this Hindi video, he talks in detail about the risk factors and the best way to detect this disease at an early stage.

It is important to realise that the most common presentation of breast cancer is in the form of a painless lump in the breast (not painful).

If you have any further queries regarding breast cancer, please reach out to

Dr. Rohan Khandelwal

Breast Cancer Surgeon, CK Birla Hospital for Women

+91 79-88252759

Mastectomy for Breast Cancer Treatment – Things to Know

Mastectomy is one of the most common surgical approaches for breast cancer management.

Over the years, the technique of mastectomy has undergone a lot of change. This patient education video summarises the current role of mastectomy in treating breast cancer, along with the post- surgery care required by the patient.

This video also covers points to prevent lymphedema (swelling of the arm) following breast cancer surgery.

This information has been provided by Dr. Rohan Khandelwal, who is a Breast Cancer Surgeon with more than 8 years of experience. He is currently heading the department at CK Birla Hospital for Women, Gurugram.

CME on Best Practices in the management of Breast Cancer

The Breast Cancer Department of CK Birla headed by Dr. Rohan Khandelwal recently organised a CME on best practices in the management of Breast Cancer and Breast Lumps.

Dr. Rohan Khandelwal and his team discussed the latest surgeries in the management of breast cancer including breast Onco-plastic surgery and skin/ nipple sparing mastectomies with reconstruction.

Dr. Rohan Khandelwal

Breast Cancer/ Lump Surgeon is available at CK Birla Hospital, Gurugram everyday.

Lifestyle changes to manage cyclical breast pain (Mastalgia)

Breast pain is a common symptom with which patients come to the Breast Clinic. Although there are various causes of breast pain, the most common is fibrocystic diseases or fibroadenosis.

Fibroadenosis or fibrocystic disease leads to cyclical breast pain, which means that pain is maximum before the menstrual periods but reduces when the periods start. The intensity of pain can vary from patient to patient. In some patients the pain is so severe, that they need to take pain killers.

There are certain lifestyle changes and natural therapies which ladies can use to reduce their cyclical breast pain but they should only be tried once the doctor has confirmed the diagnosis and ruled out more serious conditions like inflammation and breast cancer. One should also maintain a pain diary to evaluate if the pain is reducing or increasing with time.

1. Weight reduction – this is specially useful for patients who have a high body mass index (BMI). A reduction or even 2-3 kg’s can lead to a dramatic improvement in breast pain

2. Cutting down on tea/ coffee – There is anecdotal evidence that reduction in caffeine intake, specially before the periods helps in the management of cyclical Mastalgia

3. Adequate breast support – wearing a well supported sports bra helps in reducing the pain, specially during walking/ running/ exercising. Underwired bra’s can sometimes aggravate the pain

4. Turmeric/ curcumin – many of my patients have benefitted with curcumin/ haldi/ turmeric for a period for 30-40 days. Patients have reported a 30-35% reduction in pain.

If your breast pain doesn’t settle down with these methods, please consult your doctor for further evaluation and treatment.

For further advise, please contact

Dr. Rohan Khandelwal

Breast Surgeon (Benign and Cancerous Breast Conditions)

Gurgaon

+91 79-88252759

The Breast Centre at CK Birla Hospital for Women

After successfully running a Breast Cancer unit for the last 5 years at Gurgaon, me and my team have taken up the challenge to set up another Breast Cancer unit at CK Birla Hospital for Women, Gurugram.

At the Breast Centre, we would be providing comprehensive breast services ranging from non cancerous to cancerous disorders. Everything from state of the art surgical facilities to an aesthetically designed chemotherapy lounge will be available under one roof.

For appointments, you can contact –

Shantanu – +91 79-88252759

or contact Dr. Rohan Khandelwal, Breast Cancer Surgeon in Gurgaon – rohankhandelwal@gmail.com

World Cancer Day 2018

On the occasion of #worldcancerday, I would like to share the picture of the youngest #breastcancer patient I have treated till now.

She is a 25 year old, mother of a 2 year old who came to me with a small breast lump which she picked up after reading a Hindi article on breast cancer.

Few things which I would like to highlight through this case:

1. Age at diagnosis is reducing. This was my third patient in the 20’s over the last 3 months. Majority of my breast cancer patients are in their 30’s.

So, if anyone you know is suffering from a breast lump, please get it checked.

2. Awareness is increasing, which is an excellent thing. I am seeing a lot of patients with stage 1 and 2 disease, which leads to better survival.

To help create more awareness, each one reading this post should tell one more person about breast cancer and it’s symptoms (painless breast lump, recent change in shape of the breast, bloody discharge from the nipple)

3. Another heartening point is the change in the society’s attitude towards these patients. Friends and family members are becoming more accommodating towards the needs of cancer patients.

Please share this message to create more awareness.

This message has been shared in public interest by Dr Rohan Khandelwal, who is a Breast Cancer Surgeon at Gurgaon / Delhi NCR