Ukrainian Journal Health of Woman. 2025. 4(179): 104-114. doi: 10.15574/HW.2025.4(179).104114
Karlova O. O.¹, Kozarenko Т. M.¹, Zelenkevych L. O.^2
1Shupyk National Healthcare University of Ukraine, Kyiv
²Specialized Mammology Center of the "First Private Clinic", Kyiv, Ukraine

For citation: Karlova OO, Kozarenko ТM, Zelenkevych LO. (2025). Ultrasound descriptors of pathological changes in the breast. Ukrainian Journal Health of Woman. 4(179): 104-114. doi: 10.15574/HW.2025.4(179).104114
Article received: Jul 07, 2025. Accepted for publication: Sep 16, 2025.

The article provides a detailed analysis and practical aspects of implementing the BI-RADS (Breast Imaging Reporting and Data System), developed by the American College of Radiology (ACR).
Aim – to standardize the description and stratification of pathological changes in the breast during ultrasound (US) examination to ensure unambiguous communication between medical specialists, including radiologists, oncologists, and gynecologists.
It has been established that the implementation of the standardized BI-RADS lexicon eliminates ambiguity in result interpretation and minimizes the need for histological interpretation by diagnostic physicians. The paper thoroughly examines the algorithm for analyzing masses based on five key descriptors: shape, orientation relative to the skin, margins (contours), echogenicity, and posterior acoustic features. Particular attention is paid to the differential diagnosis between solid masses and non-mass findings, as well as the assessment of tissue architecture and the state of the ductal system. The study analyzes additional evaluation criteria that increase the specificity of the method: the presence of micro- and macrocalcifications, vascularization patterns in color Doppler and power Doppler modes, and the use of shear-wave elastography to determine tissue stiffness. A list of the most suspicious ultrasound signs of malignancy has been compiled, including vertical orientation ("higher-than-wide"), spiculated margins, marked hypoechogenicity, and intranodular vascularization.
Conclusions. The use of the BI-RADS system in daily clinical practice increases the sensitivity of ultrasound diagnostics, allows for a justified reduction in the number of unnecessary invasive procedures (biopsies), and provides a clear algorithm for choosing patient management tactics — ranging from dynamic monitoring to urgent surgical intervention.
The authors declare no conflict of interest.
Keywords: breast, lexicon, cancer screening, elastography, Doppler sonography, cancer diagnosis, mass, echogenicity, structure, women.

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