Breaking Down the New BI-RADS® Update

In this episode of the SBI podcast, hosts Dr. Karla Sepulveda and Dr. Alyssa Cubbison welcome Dr. Jessica Leung, professor of diagnostic radiology at the University of Texas MD Anderson Cancer Center, for a deep dive into the newly released BI-RADS® (Breast Imaging Reporting and Data System) update. Drawing on years of committee work and international collaboration, the conversation explores how BI-RADS continues to shape the standardization of breast imaging reporting and clinical decision-making. Dr. Leung highlights key updates, including the removal of the term “developing asymmetry” in mammography while reinforcing its clinical relevance, and the addition of “non-mass lesion” in ultrasound to better align with MRI and contrast-enhanced mammography. The group also discusses evolving MRI terminology, auditing changes that now classify pleomorphic florid LCIS as cancer, and expanded guidance around lymph node assessment. They close with insights on what was intentionally left out—such as AI integration and risk stratification—and how trainees and clinicians alike can use the updated, image-rich manual as both a reference and a learning tool.   The SBI Podcast is produced by Association Briefings.