Incomplete / Needs Additional Imaging
What is an assessment of "Needs Additional Imaging"?
An assessment of "Needs Additional Imaging" means that the provider wants additional imaging to be completed before the case can be assigned a final evaluation for breast cancer. The interpreting physician believes this case is incomplete without further imaging and/or a comparison to the patient's past imaging.
What are some of the additional imaging procedures that may be done if an individual is assessed as "Needs Additional Imaging"?
According to the Breast Imaging Reporting and Database System (BI-RADS), "a recommendation for additional imaging evaluation includes the use of spot-compression (with or without magnification), special mammographic views, and US. Category O should not be used for diagnostic breast imaging findings that warrant further evaluation with MRI" (Sickles et al.).
When would an evaluation of "Needs Additional Imaging" be given to women who receive screening or diagnostic mammograms?
According to the BI-RAD classification system, the evaluation of "Needs Additional Imaging" is used for women who undergo screening mammograms and need further imaging to receive a diagnosis. The evaluation of "Needs Additional Imaging" can also be given to women who undergo diagnostic mammograms, but only in certain cases, such as the woman being unable to receive ultrasound imaging the day of the exam or if the woman is unable/unwilling to forgo a full diagnostic exam after the initial imaging.
How else may the "Needs Additional Imaging" assessment appear on a chart?
The assessment of "Needs Additional Imaging" may appear as a BI-RADS category 0, "Incomplete - Need Prior Mammograms for Comparison," or "Incomplete - Need Additional Imaging Evaluation" (Sickles et al.).
Who gives an individual the evaluation of "Needs Additional Imaging"?
The interpreting physician for the woman's case will assign the evaluation of "Needs Additional Imaging." If needed, the physician will bring on second and third readers to the case if the imaging is ambiguous in its findings.
Sources:
Sickles, EA, D'Orsi CJ, Bassett LW, et al. (2013). ACR Bl-RADS Mammography. In: ACR Bl-RADS Atlas, Breast Imaging Reporting and Data System. American College of Radiology. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Bi-Rads#Mammography