The American College of Radiology (ACR) has issued guidance advising clinicians against using Breast Imaging Reporting and Data System (BI-RADS) assessment categories to manage breast masses in children and adolescents.
The categories and their associated malignancy probabilities were developed primarily for adult screening and have not been validated in pediatric patients, according to the guidance. BI-RADS ultrasound descriptors may help describe a pediatric breast mass, but the assessment categories were not meant for diagnostic workup of palpable masses in these patients, according to the authors, led by Stamatia Destounis, MD, of Elizabeth Wende Breast Care in Rochester, NY.
The ACR recommends basing management on pediatric-specific clinical findings and imaging features. Ultrasound is the preferred imaging tool for these patients, the college noted, while mammography is generally not used because of developing breast tissue and its limited benefit.
