BACKGROUND: The American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) lexicon for ultrasound is a standardized evaluation tool, developed to improve on accuracy of diagnosing breast masses. Studies on breast cancer in Uganda report late diagnosis, high rates of disease recurrence and poor survival; however utilization of BIRADS ultrasound lexicon can improve on such poor outcomes. Clinical utility of BIRADS ultrasound lexicon in Uganda is not known. This study evaluated the utilization of BIRADS ultrasound lexicon among ultrasound practitioners and clinicians at Mulago Hospital, Uganda. GENERAL OBJECTIVE: To assess the utilization of BIRADS ultrasound lexicon among ultrasound practitioners and clinicians at Mulago Hospital. METHOD: A cross sectional descriptive study was conducted in the breast surgical outpatient clinic of Mulago hospital . Copies of breast ultrasound scan reports and Medical records that belong to patients who had been reviewed by a doctor, were consecutively collected. The proportions of breast ultrasound scan findings reported using BIRADS were computed. Concordance rates and percentage agreements of BIRADS descriptors versus BIRADS classification category as well as clinician’s management plan versus BIRADS recommendation respectively, were calculated using Cohen’s kappa. The bivariate data analysis was reported using lins concordance correlation coefficients. RESULTS: There was 54.4% ((68/125) 95% Confidence interval (CI) 45.5-63.0) utilization of BIRADS US lexicon among Ultrasound practitioners. The concordance of BIRADS descriptors with BIRADS classification was poor (Concordance Correlation Coefficient (CCC) of 0.883, 95% CI: 0.834-0.932, p value < 0.001) while the percentage agreement was moderate (62.2%, kappa-0.5158 and p value <0.001). The concordance of clinicians’ management with BIRADS recommendation was substantial (CCC- 0.986, 95% CI: 0.979-0.994, p value < 0.001) with a moderate percentage agreement (63.5% kappa-0.5816, and p value <0.001). CONCLUSION: Utilization of BIRADS US lexicon among ultrasound practitioners at Mulago hospital was just slightly above average. The poor concordance of BIRADS descriptors with classification categories, and moderate percentage agreements seen in this study, suggest need for further training of both ultrasound practitioners and clinicians at Mulago hospital.

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