1. To provide an overview of the salient features of the updated 5th edition of BI-RADS 2. To highlight the key modifications made to the BI-RADS 5th edition in comparison with its predecessor. 3. To determine the clinical relevance of these changes and their impact on patient management.

The American College of Radiology first introduced Breast Imaging Reporting and Data System (BI-RADS) lexicon in 1993 in an attempt to standardize breast imaging reports, and improve communica­tion with referring physicians. The latest update of the BI-RADS lexicon was released in the year 2013, with the aim of improving reproducibility of assessment and further reducing ambiguity so as to aid better risk stratification. [1] The updated BI-RADS significantly expands the lexicon for breast ultrasonography (US), and breast magnetic resonance (MR) imaging and provides clear recommendations...

- Salient updates in the 5th edition of BI-RADS pertaining to mammography, ultrasonography (US), and magnetic resonance (MR) imaging will be outlined. - Relevant features that require consideration during image interpretation and reporting as per the 5th edition of BI-RADS, will be highlighted. - The implications of these modifications on patient management will be emphasized. Updates pertaining to Mammography MASSES - 'The term ‘lobular’ in the 4th edition of BIRADS was intended to be applied to masses with an ‘undulating’ contour. In clinical practice, confusion...

Overall, the changes made in the new BI-RADS give improved uniformity of terminology across the mammography, ultrasound, and MRI lexicons; add compatibility across the lexicons; and promote usage of the same descriptors across all 3 modalities, permitting a holistic assessment, ultimately leading to improved patient diagnosis and patient care. The revised BI-RADS seeks to improve clarification in image interpretation, maintain reporting standardization, and provide a more universal lexicon across all imaging modalities used for assessment of breast pathologies. Awareness of these updates is of utmost...

1. D’Orsi CJ, Mendelson EB, Ikeda DM, et al. Breast imaging reporting and data system: ACR BIRADS – breast imaging atlas. Reston (VA): American College of Radiology; 2003. 2. Rominger M, Wisgickl C, Timmesfeld N. Breast microcal­cifications as type descriptors to stratify risk of malignancy: a systematic review and meta-analysis of 10 665 cases with special focus on round/punctate microcalcifications. Rofo 2012;184(12):1144–1152. 3. Leung JW, Sickles EA (2007) Developing asymmetry identified on mammography: correlation with imaging outcome and pathologic findings. Am J Roentgenol 188:667–675 4....