UMMS Affiliation

School of Medicine; Department of Medicine; Department of Radiology

Publication Date


Document Type



Diagnosis | Health Services Administration | Health Services Research | Neoplasms | Radiology | Skin and Connective Tissue Diseases | Women's Health


Objectives: BI-RADS 3 is an established assessment category in which the probability of malignancy is equal to or less than 2%. However, monitoring adherence to imaging criteria can be challenging and there are few established benchmarks for auditing BI-RADS 3 assignments. In this study, we explore some parameters that could serve as useful tools for quality control and clinical practice management.

Materials and Methods: This retrospective study covered a 4-year period (Jan 2014-Dec 2017) and included all women over 40 years who were recalled from a screening exam and had an initial assignment of BI-RADS 3 (probably benign) category after diagnostic workup. A follow-up period of 2 years following the assignment of BI-RADS 3 was used for quantitative quality control metrics.

Results: Among 135,765 screening exams, 13,453 were recalled and 1,037 BI-RADS 3 cases met inclusion criteria. The follow-up rate at 24 months was 86.7%. The upgrade rate was 7.4% (77/1,037) [CI: 5.9-9.2%] and the PPV3 was 33.8% (26/77) [CI: 23.4-45.5%]. The cancer yield was 2.51% (26/1,037) [CI: 1.64-3.65%] and did not differ (p=0. 243) from the 2% probability of malignancy. The initial BI-RADS3 per screening exam and per recall from screening were 0.76% (1,037/135,765) [CI: 0.72-0.81%] and 7.7% (1,037/13,453) [CI: 7.26-8.17%], respectively.

Conclusion: Regular audit of BIRADS 3 metrics has the potential to provide additional insights for clinical practice management. Data from varied clinical settings with input from an expert committee could help establish benchmarks for these metrics.


BI-RADS 3, BI-RADS criteria, breast cancer, mammography, radiology, screening

Rights and Permissions

Copyright @ Srinivasan Vedantham. This work is licensed under Creative Commons Attribution 4.0 License.

DOI of Published Version



Roychowdhury P, Vijayaraghavan GR, Roubil J, Williams IM, Siddiqui E, Vedantham S. Value of BI-RADS 3 Audits. Biomed J Sci Tech Res. 2022 Feb;41(5):33086-33092. doi: 10.26717/BJSTR.2022.41.006668. Epub 2022 Feb 14. PMID: 35392255; PMCID: PMC8983005. Link to article on publisher's site

Journal/Book/Conference Title

Biomedical journal of scientific and technical research

Related Resources

Link to Article in PubMed

PubMed ID


Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.