Location of Finding
Breast MRI finding locations should be reported in a standardized order: laterality, location in breast, depth, distance from nipple.
Reporting Order
- Laterality — right, left, or bilateral
- Location in breast — clock face (preferred), quadrant, or other anatomic location
- Depth — anterior, middle, or posterior third
- Distance from nipple — whole centimeters from base of nipple to center of finding
Example: Right breast, 10:00, anterior depth, 3 cm from nipple
Clock Face Convention
- Preferred method — most specific
- Report in whole hour numbers only (e.g., “2 o’clock” not “2:30”)
- Oriented based on patient facing observer: 3:00 = lateral left breast = medial right breast
- If between whole hours, use the closest whole number
Quadrant Reporting
- Use when most appropriate (e.g., large findings spanning multiple clock positions)
- Upper outer, upper inner, lower outer, lower inner
Other Anatomic Locations
| Term | Definition |
|---|---|
| Retroareolar | Behind nipple, anterior depth |
| Central | Behind nipple, middle or posterior depth |
| Axillary tail | Upper outer quadrant adjacent to axilla |
| Axilla | Axillary region |
Depth
Report as anterior third, middle third, or posterior third of the breast.
Distance from Nipple
- Measure from base of nipple to center of finding in whole cm
- Use same 2D image when possible, or MIP if not
- For findings close to nipple: also describe distance from anterior extent to nipple (surgical planning)
- For large findings: include distance to anterior and posterior extents
- Note distances to skin, pectoralis, or chest wall when relevant
Board Pearl
Do NOT use half-hour clock positions (e.g., “2:30”) or subcentimeter distance measurements (e.g., “2.3 cm”). These imply a precision that is not reproducible across readers and modalities. Use whole numbers only.
Tissue Zone (Optional)
Describing premammary, mammary, or post-mammary zone can help correlate findings across modalities (e.g., facilitating targeted ultrasound).