Risk assessment and quality assurance tool developed by American College of Radiology that provides a widely accepted lexicon and reporting schema for imaging of the breast. It applies to mammography, ultrasound, and MRI.

Score Category Likelihood of cancer Next course of action
0 Need additional imaging N/A Alternative imaging test
1 Negative 0% Routine screening after 1 year
2 Benign 0% Routine screening after 1 year
3 Probably benign 0-2% Screen after 6 months
4 Suspicious 4a (2-10%): Low suspicion
4b (10-50%): Moderate suspicion
4c (50-95%): High suspicion Biopsy
5 Highly suggestive of malignancy > 95% Biopsy
6 Biopsy proven malignancy -