This case-insensitive code system http://hl7.org/fhir/us/breast-radiology/CodeSystem/RadLexCDE defines the following codes in a Is-A heirarchy:

Lvl	Code	Display	Definition
1	RDES241	Breast Calcification	Breast Calcification
1	RDES243	Breast Cyst	Breast Cyst
1	RDES245	BI-RADS	Breast Mass Detection on Mammography
1	RDES246	Breast Mass	Breast Mass
1	RDE1556	Presence	Abnormalcalcificationobservation
2	RDE1556_present	present	RDE1556_present
2	RDE1556_absent	absent	RDE1556_absent
2	RDE1556_indeterminate	indeterminate	RDE1556_indeterminate
2	RDE1556_unknown	unknown	RDE1556_unknown
1	RDE1557	Side	Breastlateralityofabnormalityobserved
2	RDE1557_right	right	RDE1557_right
2	RDE1557_left	left	RDE1557_left
2	RDE1557_bilateral	bilateral	RDE1557_bilateral
1	RDE1558	Location	Clockpositionsoftheabnormalityobserved
2	RDE1558_oneOclockPosition	oneo'clockposition	RDE1558_one o'clock position
2	RDE1558_twoOclockPosition	twoo'clockposition	RDE1558_two o'clock position
2	RDE1558_threeOclockPosition	threeo'clockposition	RDE1558_three o'clock position
2	RDE1558_fourOclockPosition	fouro'clockposition	RDE1558_four o'clock position
2	RDE1558_fiveOclockPosition	fiveo'clockposition	RDE1558_five o'clock position
2	RDE1558_sixOclockPosition	sixo'clockposition	RDE1558_six o'clock position
2	RDE1558_sevenOclockPosition	seveno'clockposition	RDE1558_seven o'clock position
2	RDE1558_eightOclockPosition	eighto'clockposition	RDE1558_eight o'clock position
2	RDE1558_nineOclockPosition	nineo'clockposition	RDE1558_nine o'clock position
2	RDE1558_tenOclockPosition	teno'clockposition	RDE1558_ten o'clock position
2	RDE1558_elevenOclockPosition	eleveno'clockposition	RDE1558_eleven o'clock position
2	RDE1558_twelveOclockPosition	twelveo'clockposition	RDE1558_twelve o'clock position
1	RDE1559	Depth	AnteriordepthistheoutermostdepthclosesttothenippleofthebreastMiddledepthinbetweentheanteriorandposteriorportionofthebreastPosteriordepthclosesttothechestwallofthebreast
2	RDE1559_anterior	anterior	RDE1559_anterior
2	RDE1559_middle	middle	RDE1559_middle
2	RDE1559_posterior	posterior	RDE1559_posterior
1	RDE1560	Breast body landmark	Breastlandmarkvalueset
2	RDE1560_nipple	nipple	RDE1560_nipple
2	RDE1560_chestWall	chestwall	RDE1560_chest wall
2	RDE1560_skinStructure	skinstructure	RDE1560_skin structure
1	RDE1561	Distance from landmark	Distancefrombodylandmarktobodylocationofabnormality
1	RDE1562	Laterality from landmark	RDE1562
2	RDE1562_rightAndLeft	rightandleft	RDE1562_right and left
2	RDE1562_midline	midline	RDE1562_midline
2	RDE1562_structureOfRightHalfOfBody	structureofrighthalfofbody	RDE1562_structure of right half of body
2	RDE1562_structureOfLeftHalfOfBody	structureoflefthalfofbody	RDE1562_structure of left half of body
1	RDE1563	Quadrant	Quadrant of breast
2	RDE1563_lowerInner	lowerinner	RDE1563_lower inner
2	RDE1563_lowerOuter	lowerouter	RDE1563_lower outer
2	RDE1563_upperInner	upperinner	RDE1563_upper inner
2	RDE1563_upperOuter	upperouter	RDE1563_upper outer
1	RDE1564	Region	Region of breast
2	RDE1564_axilla	axilla	The axilla (also, armpit, underarm or oxter) is the area on the human body directly under the joint where the arm connects to the shoulder. It also contains many sweat glands.
2	RDE1564_axillaryTail	axillarytail	RDE1564_axillary tail
2	RDE1564_axillaOne	axillaone	There are three levels of axillary lymph nodes (the nodes in the underarm or 'axilla' area): Level I is the bottom level, below the lower edge of the pectoralis minor muscle.
2	RDE1564_axillaTwo	axillatwo	There are three levels of axillary lymph nodes (the nodes in the underarm or 'axilla' area):Level II is lying underneath the pectoralis minor muscle.
2	RDE1564_axillaThree	axillathree	There are three levels of axillary lymph nodes (the nodes in the underarm or 'axilla' area): Level III is above the pectoralis minor muscle.
2	RDE1564_inframammaryFold	inframammaryfold	The mass/lesion is located in the inframammary crease where the lower boundary of the breast and the chest meet.
2	RDE1564_inSkin	inskin	Located within skin.
2	RDE1564_centralToNipple	centraltonipple	Central to the nipple (central portion of the breast-behind the nipple).
1	RDE1565	Type	RDE1565
2	RDE1565_amorphous	amorphous	RDE1565_amorphous
2	RDE1565_coarse	coarse	RDE1565_coarse
2	RDE1565_dystrophic	dystrophic	RDE1565_dystrophic
2	RDE1565_eggshell	eggshell	RDE1565_eggshell
2	RDE1565_fine	fine	RDE1565_fine
2	RDE1565_generic	generic	RDE1565_generic
2	RDE1565_coarseHeterogeneous	coarseheterogeneous	RDE1565_coarse heterogeneous
2	RDE1565_indistinct	indistinct	RDE1565_indistinct
2	RDE1565_largeRoadlike	largeroadlike	RDE1565_large roadlike
2	RDE1565_layering	layering	RDE1565_layering
2	RDE1565_fineLinear	finelinear	RDE1565_fine linear
2	RDE1565_lucentCentered	lucentcentered	RDE1565_lucent centered
2	RDE1565_milkOfCalcium	milkofcalcium	RDE1565_milk of calcium
2	RDE1565_finePleomorphic	finepleomorphic	RDE1565_fine pleomorphic
2	RDE1565_punctate	punctate	RDE1565_punctate
2	RDE1565_rim	rim	RDE1565_rim
2	RDE1565_round	round	RDE1565_round
2	RDE1565_skin	skin	RDE1565_skin
2	RDE1565_spherical	spherical	RDE1565_spherical
2	RDE1565_sature	sature	RDE1565_sature
2	RDE1565_vascular	vascular	RDE1565_vascular
1	RDE1567	Count	RDE1567
1	RDE1568	Distribution	RDE1568
2	RDE1568_fineLinearBranching	finelinearbranching	RDE1568_fine, linear, branching
2	RDE1568_clustered	clustered	RDE1568_clustered
2	RDE1568_diffuse	diffuse	RDE1568_diffuse
2	RDE1568_grouped	grouped	RDE1568_grouped
2	RDE1568_linear	linear	RDE1568_linear
2	RDE1568_regional	regional	RDE1568_regional
2	RDE1568_segmental	segmental	RDE1568_segmental
1	RDE1569	Distribution width	Sizeoftheentireregionaffectedbyabnormalityinmm
1	RDE1570	Size	Sizeofasinglefindingobservedinmm
1	RDE1571	Associated features	RDE1571
2	RDE1571_architecturalDistortion	architecturaldistortion	f the mass blurs a tissue plane between fat and fibroglandular tissue or if the mass produces distortion of the ducts, these findings may be termed architectural distortion.
2	RDE1571_axillaryAdenopathy	axillaryadenopathy	Enlarged axillary (under the armpit) lymph nodes. Additional evaluation is needed to determine the cause.
2	RDE1571_biopsyClip	biopsyclip	Tissue marker placement after image-guided breast biopsy has become a routine component of clinical practice. Marker placement distinguishes multiple biopsied lesions within the same breast, prevents re-biopsy of benign lesions, enables multi-modality correlation, guides pre-operative localization and helps confirm surgical target removal.
2	RDE1571_brachytherapyTube	brachytherapytube	Brachytherapy may be temporary or permanent. Temporary brachytherapy places radioactive material inside a catheter for a specific amount of time and then it is removed. It is given at a low-dose rate (LDR) or high-dose rate (HDR). Permanent brachytherapy is also called seed implantation. It puts radioactive seeds (about the size of a grain of rice) in or near the tumor permanently. After several months, the seeds lose their radioactivity.
2	RDE1571_chestWallInvasion	chestwallinvasion	A tumor of the lung that has invaded the chest wall.
2	RDE1571_cooperDistorted	cooperdistorted	Cooper's ligaments support the breasts on the chest wall, maintain their contour, and keep them in position. Breasts become distorted if cancerous tumors grow on the ligaments.
2	RDE1571_cooperThickened	cooperthickened	Cooper's ligaments support the breasts on the chest wall, maintain their contour, and keep them in position. These support breast tissue; and can become contracted in cancer of breast, producing dimples in overlying skin. Thickening occurs when there are skin changes usually associated with the presence of a mass, benign or malignant, that causes shortening in the Coopers ligaments due to fibrosis.
2	RDE1571_edema	edema	Edema (swelling of the breasts) may be due to blockage of subdermal lymphatics by tumor cells or an inflammatory process within the breast or axilla.
2	RDE1571_edemaAdj	edemaadj	This is swelling of one or both breasts. A mammographic pattern of skin thickening, increased parenchymal density, and interstitial marking.
2	RDE1571_goldSeed	goldseed	Tiny, gold seeds, about the size of a grain of rice, that are put in and/or around a tumor to show exactly where it is in the body. The tumor can then be directly targeted and be given higher doses of radiation with less harm to nearby healthy tissue. Also called gold fiducial marker seeds, gold fiducial markers, and gold-seed fiducial markers.
2	RDE1571_hematoma	hematoma	A hematoma is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillaries.
2	RDE1571_nippleRetraction	nippleretraction	Retracted nipples lie flat against the areola. The condition can be the result of inflammation or scarring of the tissue behind the nipple, and caused by numerous conditions, not just cancer. In the case of breast cancer, nipple retraction occurs when the tumor attacks the duct behind the nipple, pulling it in.
2	RDE1571_noChestWallInvasion	nochestwallinvasion	The mass has not attached itself to the chest wall.
2	RDE1571_pectoralisMuscleInvasion	pectoralismuscleinvasion	Pectoralis muscle invasion is when a tumor has become large enough to invade into the pectoralis muscle.
2	RDE1571_pectoralisMuscleInvolvement	pectoralismuscleinvolvement	Pectoralis muscle involvement of the tumor has been detected on the MRI by muscle enhancement with obliteration of the fat plane between the tumor and the muscle.
2	RDE1571_pectoralisMuscleTenting	pectoralismuscletenting	The tent sign is a term referring to a characteristic appearance of the posterior edge of the breast parenchyma when a mass (usually an infiltrating lesion) causes its retraction and forms an inverted 'V' that resembles the tip of a circus tent.
2	RDE1571_postSurgicalScar	postsurgicalscar	Post surgical scarring happens because of the incisions needed to surgically remove tumor, cells, etc. The amount of scarring is connected to the different stages of wound healing. Surgical scar care should be continued for a year.
2	RDE1571_seroma	seroma	A breast seroma is a collection (pocket) of serous fluid that can develop after trauma to the breast or following procedures such as breast surgery or radiation therapy. Serous fluid is a pale yellow, transparent fluid that contains protein, but no blood cells or pus.
2	RDE1571_skinInvolvement	skininvolvement	The mass or lesion has attached itself to the skin of the breast. There are several layers of skin that the mass or lesion can penetrate and that is what determines the level of skin invasion.
2	RDE1571_skinLesion	skinlesion	A skin lesion is a part of the skin that has an abnormal growth or appearance compared to the skin around it.In order to diagnose a skin lesion, a full physical exam is necessary.
2	RDE1571_skinRetraction	skinretraction	Skin retraction (or inversion) or Skin retraction. Breast cancers that are located near the skin or nipple may cause scarring within the breast that pulls at the nipple or nearby skin. Skin and nipple retraction are more obvious when a woman raises her arms above her head or leans forward.
2	RDE1571_skinThickening	skinthickening	The presence of skin thickening on mammography is variably defined, usually being more than 2 mm in thickness. It can result from a number of both benign and malignant causes.
2	RDE1571_surgicalClip	surgicalclip	Most surgical clips are currently made of titanium, and as many as 30 to 40 clips may be used during a single surgical procedure. Surgical clips may remain inside the patient's body after the wounds are healed.
2	RDE1571_trabecularThickening	trabecularthickening	Trabecular thickening-thickening of the Cooper's ligaments and fibrous stroma-is an imaging finding of breast edema, usually secondary to dilated lymphatics. Skin thickening and trabecular thickening often occur together, and they have similar differential diagnoses.
2	RDE1571_calcificationInMass	calcificationinmass	Calcifications usually can't be felt, but appear on a mammogram. Depending on how calcifications are clustered; shape, size, and number, further tests may be necessary. Larger 'macrocalcifications' are usually not associated with cancer.
2	RDE1571_calcificationNotOnMammogram	calcificationnotonmammogram	Calcifications usually can't be felt, but appear on a mammogram. Calcifications can be clustered and their shape, size, and number. Large 'macrocalcifications' are usually not associated with cancer.
2	RDE1571_calcificationOnMammogram	calcificationonmammogram	Calcifications are small deposits of calcium that show up on mammograms as bright white specks or dots on the soft tissue background of the breasts. The calcium readily absorbs the X-rays from mammograms
2	RDE1571_calcifications	calcifications	Calcifications are small deposits of calcium that show up on mammograms as bright white specks or dots on the soft tissue background of the breasts.
2	RDE1571_microCalcifications	microcalcifications	Micro-calcifications show up as fine, white specks in a mammogram, similar to grains of salt; usually noncancerous, but certain patterns can be an early sign of cancer.
2	RDE1571_milkOfCalcium	milkofcalcium	The term milk of calcium (MOC) is given to dependent, sedimented calcification within a cystic structure or hollow organ. This sort of colloidal calcium suspension layering can occur in various regions.
2	RDE1571_rimCalcifications	rimcalcifications	These are very thin benign calcifications that appear as calcium is deposited on the surface of a sphere. Although fat necrosis can produce these thin deposits, calcifications in the wall of cysts are the most common 'rim' calcifications.
1	RDE1576	Shape	RDE1576
2	RDE1576_irregular	irregular	RDE1576_irregular
2	RDE1576_lobular	lobular	RDE1576_lobular
2	RDE1576_oval	oval	RDE1576_oval
2	RDE1576_round	round	RDE1576_round
1	RDE1577	Type	RDE1577
2	RDE1577_complex	complex	Complex cysts have irregular or scalloped borders, thick walls, and some evidence of solid areas and/or debris in the fluid. These solid areas echo back the sound waves from the ultrasound. A complex cyst is sometimes aspirated, or drained with a fine needle, so that the fluid inside can be tested. If blood or any unusual cells are present, further testing may be needed to rule out breast cancer.
2	RDE1577_complicated	complicated	Complicated cysts are 'in between' simple and complex. Although they share most of the features of simple cysts, they tend to have some debris inside them and echo back some of the ultrasound waves. However, they don't have the thick walls or obvious solid components that a complex cyst has.
2	RDE1577_micro	micro	A microcyst Is a sac-like pocket of tissue that contains fluid, air, or other substances. A Microcyst is small and less than 2-3 mm and are often in clusters and only show up on a mammogram or ultrasound.
2	RDE1577_oil	oil	Oil cysts are filled with fluid that may feel smooth and soft/squishy. Oil cysts are caused by the breakdown of fatty tissue.
2	RDE1577_simple	simple	A simple cyst is a sac-like pocket of membranous tissue that only contains clear fluid.
2	RDE1577_withDebris	withdebris	A cyst that is filled with debris and fluid substance. It Is either considered a complex or complicated cyst. The type of debris determines what kind of cyst.
2	RDE1577_cyst	cyst	RDE1577_cyst
1	RDE1578	Density	RDE1578
2	RDE1578_equal	equal	RDE1578_equal
2	RDE1578_fatContaining	fatcontaining	RDE1578_fat containing
2	RDE1578_high	high	RDE1578_high
2	RDE1578_low	low	RDE1578_low
1	RDE1579	Margin	RDE1579
2	RDE1579_angular	angular	Some or all of the margin has sharp corners, often forming acute angles. The margin of the mass is not circumscribed.
2	RDE1579_circumscribed	circumscribed	A circumscribed margin is one that is well defined, with an abrupt transition between the lesion and the surrounding tissue. For US, to describe a mass as circumscribed, its entire margin must be sharply defined. Most circumscribed lesions have round or oval shapes.
2	RDE1579_indistinct	indistinct	There is no clear demarcation of the entire margin, or of any portion of the margin, from the surrounding tissue. For mammography, this descriptor should not be used when the interpreting physician believes it is likely due to immediately adjacent breast tissue. Use of this descriptor usually implies a suspicious finding.
2	RDE1579_intraductalExtension	intraductalextension	Intraductal tumor extension is a characteristic feature of primary breast carcinoma, and is an important consideration in patients undergoing breast conservative surgery.
2	RDE1579_irregular	irregular	Edges around the soft tissue that don't look smooth. Indicative of some sort of growth or mass rather than a cyst.
2	RDE1579_lobulated	lobulated	The edge of the mass has broad bulges. Much like a 6 or 8 leaf clover. The edge of all of the leaves would be considered lobulated.
2	RDE1579_macrolobulated	macrolobulated	Smooth margin with distinct separation between the mass and the surrounding border. Macrolobulaed margins are oval-shaped and have a wide rather than tall formation.
2	RDE1579_microlobulated	microlobulated	The margin is characterized by short-cycle undulations or scalloped appearance, and the margin of the mass is not circumscribed.
2	RDE1579_nonCircumscribed	noncircumscribed	The mass has one or more of the following features: indistinct, angular, microlobulated, or spiculated in any portion of the margin There is not a clear demarcation between the mass and the surrounding tissue.
2	RDE1579_obscured	obscured	It is hidden by superimposed or adjacent fibroglandular tissue. This is used primarily when some of the margin of the mass is circumscribed, but the rest (more than 25%) is hidden.
2	RDE1579_smooth	smooth	The edges of the mass have a smooth appearance and distinct separation between the mass and surrounding tissue.
2	RDE1579_spiculated	spiculated	The margin is characterized by sharp lines radiating from the mass, often a sign of malignancy, but the significant feature is that the margin of the mass is not circumscribed.
1	RDE1580	Orientation	RDE1580
2	RDE1580_parallelToSkin	paralleltoskin	RDE1580_parallel to skin
2	RDE1580_perpendicularToSkin	perpendiculartoskin	RDE1580_perpendicular to skin
2	RDE1580_tallerThanWide	tallerthanwide	RDE1580_taller than wide
2	RDE1580_widerThanTall	widerthantall	RDE1580_wider than tall
1	RDE1586	Assessment category	RDE1586
2	RDE1586_category0IncompleteNeedAdditionalImaging	category0needadditionalimaging	RDE1586_category 0, incomplete - need additional imaging
2	RDE1586_category1Negative	category1,negative	RDE1586_category 1, negative
2	RDE1586_category2BenignFinding	category2,benignfinding	RDE1586_category 2, benign finding
2	RDE1586_category3ProbablyBenignFinding	category3,probablybenignfinding	RDE1586_category 3, probably benign finding
2	RDE1586_category4SuspiciousAbnormality	category4,suspiciousabnormality	RDE1586_category 4, suspicious abnormality
2	RDE1586_category4ASuspiciousAbnormalityLowLikelihoodOfBeingCancer	category4A,suspiciousabnormalitylowlikelihoodofbeingcancer	RDE1586_category 4A, suspicious abnormality - low likelihood of being cancer
2	RDE1586_category4BSuspiciousAbnormalityModerateLikelihoodOfBeingCancer	category 4B,suspiciousabnormality-moderatelikelihoodofbeingcancer	RDE1586_category 4B, suspicious abnormality - moderate likelihood of being cancer
2	RDE1586_category4CSuspiciousAbnormalityHighLikelihoodOfBeingCancer	category4C,suspiciousabnormality-highlikelihoodofbeingcancer	RDE1586_category 4C, suspicious abnormality - high likelihood of being cancer
2	RDE1586_category5HighlySuggestiveOfMalignancy	category5,highlysuggestiveofmalignancy	RDE1586_category 5, highly suggestive of malignancy
2	RDE1586_category6KnownBiopsyProvenMalignancy	category6,knownbiopsy-provenmalignancy	RDE1586_category 6, known biopsy - proven malignancy
1	RDE1587	Breast composition category	RDE1587
2	RDE1587_categoryATheBreastsAreAlmostEntirelyFatty	categorya,thebreastsarealmostentirelyfatty	RDE1587_category a, the breasts are almost entirely fatty
2	RDE1587_categoryBThereAreScatteredAreasOfFibroglandularDensity	categoryb,therearescatteredareasoffibroglandulardensity	RDE1587_category b, there are scattered areas of fibroglandular density
2	RDE1587_categoryCTheBreastsAreHeterogeneouslyDense	categoryc,thebreastsareheterogeneouslydense	RDE1587_category c, the breasts are heterogeneously dense
2	RDE1587_categoryDTheBreastsAreExtremelyDense	categoryd,thebreastsareextremelydense	RDE1587_category d, the breasts are extremely dense
1	RDE1588	Breast laterality	RDE1588
2	RDE1588_right	right	RDE1588_right
2	RDE1588_left	left	RDE1588_left
2	RDE1588_bilateral	bilateral	RDE1588_bilateral
1	RDE1589	Implant presence	RDE1589
2	RDE1589_left	left	RDE1589_left
2	RDE1589_right	right	RDE1589_right
2	RDE1589_bilateral	bilateral	RDE1589_bilateral
2	RDE1589_none	none	RDE1589_none
1	RDE1590	Prior mastectomy	RDE1590
2	RDE1590_right	right	RDE1590_right
2	RDE1590_left	left	RDE1590_left
2	RDE1590_bilateral	bilateral	RDE1590_bilateral
2	RDE1590_none	none	RDE1590_none
1	RDE1602	Type	RDE1602
2	RDE1602_mass	mass	RDE1602_mass
2	RDE1602_intraductal	intraductal	RDE1602_intraductal
2	RDE1602_partiallySolid	partiallysolid	RDE1602_partially solid
2	RDE1602_solid	solid	RDE1602_solid