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Clinicians’ Perceptions of Breast Ultrasound Reporting for Women Using the BI-RADS Lexicon at a Tertiary Hospital in Uganda: An Exploratory Qualitative Study

In the era of breast cancer which still remains a high cause of mortality among women in many parts of the world, the BI-RADS breast ultrasound reporting system has been recommended to standardize communication of breast findings and improve on the management of women with suspected breast cancer. This study aimed at exploring the perceptions of clinicians on the use of the BI-RADS system to report breast ultrasound findings. It was an exploratory qualitative study conducted at Mulago National Referral hospital, a tertiary hospital treating women with breast cancer in Uganda. Individual interviews were conducted with the clinicians (doctors) working in the breast clinic of the hospital. The responses were audio-recorded and transcribed. Thematic analysis was employed to develop the themes from the responses. Overall, the clinicians interviewed expressed a positive perception towards use of the BI-RADS system when reporting breast ultrasound findings. They reported that BI-RADS has positively influenced the management of women with breast masses who are identified quickly. Three key themes emerged from the responses namely: 1) Ease of interpretation of reports; 2) Positive impact on patient management and 3) Limited knowledge of BI-RADS. The study has demonstrated that the BI-RADS system eases the work of clinicians when making management decisions for women with suspected breast masses. Continued training on use of BI-RADS involving clinicians and radiologists is thus recommended.

BI-RADS, Ultrasound, Clinicians, Uganda

Aloysius Gonzaga Mubuuke, Francis Businge, Eric Murachi. (2023). Clinicians’ Perceptions of Breast Ultrasound Reporting for Women Using the BI-RADS Lexicon at a Tertiary Hospital in Uganda: An Exploratory Qualitative Study. International Journal of Medical Imaging, 11(2), 25-29.

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Giaquinto AN, Sung H, Miller KD, Kramer JL, Newman LA, Minihan A, Jemal A, Siegel RL. Breast Cancer Statistics 2022. CA A Cancer J Clin 2022; 72: 524-541.
2. Berg WA. BI-RADS 3 on Screening Breast Ultrasound: What Is It and What Is the Appropriate Management? J Breast Imaging 2021; 3 (5): 527-538.
3. Kadys A, Gremke N, Schnetter L et al. Intercontinental comparison of women with breast cancer treated by oncologists in Europe, Asia, and Latin America: a retrospective study of 99,571 patients. J Cancer Res Clin Oncol (2023).
4. Onono A, Mubuuke AG. Uptake of the BI-RADS Ultrasound characterization of breast masses: Perceptions among staff at Mulago National Referral Hospital, Uganda. Radiology Open Journal 2019; 3 (2): 28-33. doi: 10.17140/ROJ-3-123.
5. Joko-Fru WY, Jedy-Agba E, Korir A, et al. The evolving epidemic of breast cancer in sub-Saharan Africa: Results from the African Cancer Registry Network. Int. J. Cancer. 2020; 147: 2131-2141.
6. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA A Cancer J Clin. 2021; 71: 209-249.
7. Lee JM, Arao RF, Sprague BL, et al. Performance of screening ultrasonography as an adjunct to screening mammography in women across the spectrum of breast cancer risk. JAMA Intern Med 2019; 179: 658-67.
8. Buchberger W, Geiger-Gritsch S, Knapp R, Gautsch K, Oberaigner W. Combined screening with mammography and ultrasound in a population-based screening program. Eur J Radiol 2018; 101: 24-9.
9. Berg WA, Berg JM, Sickles EA, et al.. Cancer yield and patterns of follow-up for BI-RADS category 3 after screening mammography recall in the national mammography database. Radiology 2020; 296 (1): 32–41.
10. Lee CS, Berg JM, Berg WA. Cancer yield exceeds 2% for BI-RADS 3 probably benign findings in women older than 60 years in the national mammography database. Radiology 2021; 299 (3): 550–558.
11. Tagliafico AS, Calabrese M, Mariscotti G, et al. Adjunct screening with tomosynthesis or ultrasound in women with mammography-negative dense breasts: interim report of a prospective comparative trial. J Clin Oncol 2016; 34: 1882-8.
12. Okello J, Kisembo H, Bugeza S, Galukande M. Breast cancer detection using sonography in women with mammographically dense breasts. BMC Medical Imaging 2014; 14, 41.
13. Hille H, Vetter M, Hackelöer B. The accuracy of BI-RADS classification of breast ultrasound as a first-line imaging method. Ultraschall Med 2012; 33: 160-3.
14. Lazarus E, Mainiero MB, Schepps B, et al. BI-RADS lexicon for US and mammography: interobserver variability and positive predictive value. Radiology 2006; 239: 385–391.
15. Elverici E, Barça AN, Aktaş H, et al. Nonpalpable BI-RADS 4 breast lesions: sonographic findings and pathology correlation. Diagn Interv Radiol 2015; 21: 189.