MRI Report Organization
The breast MRI report should be concise and follow a standardized structure.
Eight Required Report Components
- Indication for examination — structured category (new in v2025)
- Comparison to previous examination(s) with dates
- Acquisition parameters — field strength, sequences, contrast details, artifacts
- Amount of fibroglandular tissue (FGT) — A, B, C, or D
- Level of BPE — minimal, mild, moderate, or marked
- Clear description of important findings — using lexicon terminology without embellishment
- Assessment — BI-RADS category number and wording
- Management recommendations — concordant with assessment
v2025: Structured Exam Indications (New)
Three major indication categories:
| Major Indication | Examples |
|---|---|
| Asymptomatic Screening | Elevated risk, gene mutation, dense breasts, prior breast cancer |
| Diagnostic: Work-Up | Clinical findings, imaging findings, follow-up category 3, implant assessment |
| Diagnostic: Current Breast Cancer | Extent of disease, response during/after NAC |
Board Pearl
“Asymptomatic Screening” should only be used for patients with no current clinical/imaging findings and no current breast cancer. This structured indication system facilitates outcome auditing by separating screening from diagnostic exams.
Report Wording
- Use lexicon terms without embellishment or definitions in narrative
- Assessment category number AND wording in impression: e.g., “Assessment category 4B, Suspicious. Intermediate Suspicion for Malignancy”
- Document any discussions between interpreting physician and referring clinician