The American College of Radiology (ACR) BI-RADS Breast Imaging Reporting Lexicon for mam mography is in its fifth edition. Since the first mammography lexicon publication, there had been the addition of both the first editions of the Ultrasound and MRI Lexicons. The updated ACR BI-RADS Breast Imaging Reporting Lexicon for Mammography and Ultrasound has an expected publication date of winter, 2013. Evidence-based information on both mammography and ultrasound (US) descriptors and incorporation of new technology since the last BIRADS Lexicon publications have been incorporated into the new Lexicons with hyperlinks to the mammography and ultrasound literature. The terms for both mammography and US have been adapted to allow harmonization of terms between the Lexicons, including harmonization with the breast MRI Lexicon. The Chairs of the ACR BIRADS Lexicons are Dr. Edward A. Sickles for Mammography and Dr. Ellen B. Mendleson for Ultrasound.