The Mammography Tab uses the BI-RADS classification to add images, DICOMS and define the mammography findings for a case.  This tab will only display for cases with a subspecialty of “breast” and is only available at this time in the RCMS Advanced Edit area.

Navigate to the Mammography Tab

Log in to RCMS using your ACR login information.


Select either [Create New Case] or select an existing case using View Case List. If using an existing case, select [Edit] to access the case edit functionality and check out the case.


Select the Mammography tab by either clicking on the tab named Mammography or using the drop down menu on the Properties tab.



The Mammography Tab:




Entering the Case Information: Creating a “Normal” Case or Case with No Findings

For a case designated as “normal” or no findings on the case, select the breast density and BI -RADS 1 classification. Select [Save] located on the bottom of the screen.



Entering the Case Information: Creating a Case with Findings

Breast Density, BI-RADS Classification, Case Laterality

Before any images or findings can be entered for the case, the Breast Density, BI-RADS Classification and Laterality must first be selected. These selections define the case.


  • Select the Breast Density by clicking on the appropriate breast composition. Once selected, the selected option will be highlighted. The option may be changed by clicking on a different breast composition.

  • Select the BI-RADS Classification by clicking on the appropriate assessment category. Once selected, the selected option will be highlighted. The option may be changed by clicking on a different BI-RADS classification.

  • Select the Laterality by clicking on the Left Breast, Right Breast or Both Breast depending upon where the finding(s) is located.



  • Once these three items have been selected, an [Add Findings] button will appear.



Select the [Add Findings] button to enter the findings for the case. Once selected, various buttons and options will be displayed.  The finding area will be created and numbered along the top.



Add Image or DICOM

NOTE: Images and DICOMs are selected from the case Image tab. Images and DICOMS must be added to the case on the Images Tab prior to selecting them for the Mammography Tab.

Adding an Image:

Select the [Add Image] button to add a JPEG image to the case.Selecting the [Add Image] button will open the Image Instance pop-up box. Select the appropriate image(s) using the checkboxes and then select [Insert]. Multiple images may be added.



Images will then be displayed on the Mammography Tab page.



  • Hover the mouse over an image to display a larger pop-up of the image.
  • Select the red X to remove the image from the page.
  • Select the pencil icon to open the IMAPP functionality to map and annotate the image. Refer to the attached document or select the link IMAPP instructions for mapping and annotating an image instructions. To close the IMAPP box, select the red X located in the top right corner.



Adding a DICOM study:

Selecting the [Add DICOM] button will open the Image instance box for DICOM studies.



Select the appropriate DICOMS(s) using the checkboxes and then select [Insert]. Multiple DICOMS may be added.

The DICOM(s) will now be displayed on the Mammography Tab page.


  • Click on the DICOM box to display a larger pop-up of the DICOM study.

  • Select the red X to remove the DICOM from the page.



Once the image(s) or DICOM(s) are added, the finding will be classified.

Adding Finding Information:

Select the finding category from the list by clicking on the appropriate category button:

  • A. Masses
  • B. Calcifications
  • C. Architectural Distortion
  • D. Asymmetries
  • E. Intramammary lymph node
  • F. Skin lesion
  • G. Solitary dilated duct
  • H. Other – refer to section on use of Other category for more information

To change the selected category, click on the (X) next to the category text and choose a new category. Any red X will be used as a delete/remove for the Mammography tab.



 Once the category is selected, the system will display the various options for that particular category. Each category has required choices as indicated with a red *. A selection must be made for those items. Items without the red *are optional.

As selections are made for the finding, the selections will be highlighted and displayed in text above. Selections may be changed by either clicking on a new selection or clicking on the red (X) to delete the selection.



Associated Features are not required but may be added to a finding to identify other features for a case. Associated features are not available for all categories of findings. Multiple associated features may be selected for a finding. Select the associated feature by clicking on the selection in the list. The selections will be highlighted and displayed in text above. To remove a selection, click on the red (X).

Location of lesion is a required item for all categories. Click on the Location of lesion button to access the options for this item. Laterality is the only required item for Location of lesion and will be pre-selected based on the Laterality selected previously. Optional items for location are Quadrant, Clock-Face, Depth and Distance from Nipple. When selected, these items will be highlighted or displayed and displayed in text above. To remove a selection, click on the red (X).

  • A. Quadrant – click on the desired option.

  • B. Clock-Face – click on the  to display the desired option.

  • C. Depth – click on the desired option.

  • D. Distance from the nipple – enter a value in the free text field.

  • E. Criticality – this is an optional field and may be used to rate the importance of the finding when there are multiple findings for the case. Click on the   to display the desired option.

Once all of the required selections are completed for the finding, select the [Save] button to save the finding information to the case. If required items have not been selected, the system will display an alert to the user at the bottom of the list by the Save



Move and Copy Finding Information

When adding finding information to a case, it may be necessary to either move or copy the information from one laterality to a new laterality. This can be performed in several ways. Refer to the attached document for detailed instructions with additional screen shots.

>Option #1 - Move Finding Information – Changing the Laterality

In the Location of lesion area, the default laterality will be the laterality selected when defining the case information or the Case Laterality.

By selecting the opposite laterality, either on the case Laterality or the Location of lesion area, the system will ask if the user wants the finding term information moved from one breast laterality to the opposite breast laterality. Moving the information will remove the finding information from the current laterality and place it under the opposite laterality. NOTE: Image map/annotation and Location of lesion may need to be edited if the findings are moved to a new laterality.

The system will verify the move with a pop-up confirmation box.

>Option # 2 - Move Finding Information – Select the [Move] button

The same functionality is also available by selecting the [Move] button located on the bottom of the screen. Moving the information will remove the finding information from the current laterality and place it under the opposite laterality. NOTE: Image map/annotation and Location of lesion may need to be edited if the findings are moved to a new laterality.

The system will verify the move with a pop-up confirmation box.

Option # 3 - Copy Finding Information – Changing the Laterality

In some instances, there may be similar findings on both breasts. There is copy functionality available to copy finding information from one breast laterality to the opposite breast laterality.

If finding information has been started for either the Left Breast or Right Breast laterality, to copy the information, select Both Breasts for the Case Laterality. The system will ask the user if the finding terms are to be copied to the opposite breast laterality. Copy will retain the information on the original laterality and place the same information on the opposite laterality.

NOTE: Although possible, the finding terms for both breasts will not be exactly the same. Edit any finding information, especially the Location of lesion and any Image map/annotation as applicable for each breast laterality.

Option # 4 - Copy Finding Information – Select the [Copy] Button

If the case is known to have similar findings on both breasts, select Both Breast as the Case Laterality. The system will default to the Left Breast. Define the finding information for the Left Breast and then select the [Copy] button located at the bottom.

The system will ask the user if the finding terms are to be copied to the opposite breast laterality. Copy will retain the information on the original laterality and place the same information on the opposite laterality.

NOTE: Although possible, the finding terms for both breasts will not be exactly the same. Edit any finding information, especially the Location of lesion and any Image map/annotation as applicable for each breast laterality.

Option # 5 - Copy Saved Finding Information – Select the [Copy] Icon

There may be cases where you want to copy a saved finding. Select the “copy” icon by the saved and the system will create a new finding using the same information in the saved finding.

Use of Other Category

Listed on the Findings area of the Mammography tab is an option for [Other]. This feature is not a BI-RADS finding but allows the user to designate some feature or observation on an image.

Add an image to the finding and map/annotate the image for the feature/observation. An explanation can be added to identify the feature or observation on the IMAPP box. Select the checkmark for “There is no abnormality present on the image.

On the Findings area, select the [Other] option. Location of lesion may also be defined. Select [Save] to save the feature.