For the first time, ultrasound BI-RADS included descriptors for elasticity , allowing sonographers to characterize the stiffness of a lesion—a key indicator of potential malignancy.
Proper gain settings, depth adjustment (to see the pectoralis muscle ), and firm transducer pressure are vital to reducing artifacts and getting a "crisp" image. Why It Matters Today Sonography 2014 - Breast Ultrasound
The update allowed for diagnosis-based descriptors, such as "post-surgical change," rather than requiring a painstaking description of every shape and margin when a cause was already known. For the first time, ultrasound BI-RADS included descriptors
The 2014 update didn't just tweak existing terms; it introduced critical new tools for clinical practice: The 2014 update didn't just tweak existing terms;
Terms were standardized across all imaging modalities, ensuring that a "spiculated margin" meant the same thing to a radiologist whether they were looking at a mammogram or an ultrasound. The Role of Ultrasound in Dense Breast Tissue
Research highlighted in 2014 continued to emphasize ultrasound’s role as an indispensable adjunct to mammography . In women with dense breast tissue, mammography sensitivity can be as low as 30–48%, but adding high-resolution ultrasound can increase cancer detection by 3–4 additional cancers per 1,000 women . Optimization and Technology
Breast US - American Institute of Ultrasound in Medicine (AIUM)