Use of Breast Imaging-Reporting and Data System (BI-RADS) Ultrasound Classification in Pediatric and Adolescent Patients Overestimates Likelihood of Malignancy

Multicenter study of 283 pediatric patients demonstrates that adult BI-RADS ultrasound classification significantly overestimates malignancy risk in children and adolescents, with all BI-RADS 4 lesions proving benign on pathology. Authors recommend against applying BI-RADS scoring to pediatric breast masses and call for development of age-appropriate diagnostic criteria.