Mammogram Reports and BI-RADS: The Cheat Sheet

Posted on February 19, 2016 in mammography

Ok, we promised! Here’s a summary of all the BI-RADS categories we’ve been writing about, somewhat extensively, of late.

  • BI-RADS 0: need additional imaging or comparison with prior studies. We didn’t commit a whole post to this rating. This rating is (or at least should be) short-lived - meaning a final category assessment will be given after the next step is done (extra views or comparison). A category 0 means there is a finding on the screening study that needs additional imaging or comparison to prior studies. This may mean an extra view on mammography, a breast ultrasound or occasionally a breast MRI. If your doctor gives you a “zero” it doesn’t mean you’ve flunked anything, but it occasionally means you’ll have to go back for an additional study of some kind.
  • BI-RADS 1: Negative. The good kind of “negative” - in the medical world it means showing no signs of cancer. Happy, healthy breasts!
  • BI-RADS 2: Benign findings. Little, harmless things like unchanged lymph nodes or microcalcifications can show up from time to time. Worry not, benign is a friendly word.
  • BI-RADS 3: Probably benign - short term followup. Statistically this means better than 9 out of 10 patients who get this rating turn out to be completely healthy. Did we say 9 out of 10? Yep! Additional follow up tests are needed, likely in 6 months.
  • BI-RADS 4: “Suspicious abnormality,” which means a biopsy should be considered and discussed.
  • BI-RADS 5: “Highly suggestive of malignancy,” which is a sign that something could be wrong, but nothing can be concluded without a biopsy. A pathologist looking at tissue is the only definitive way of making a diagnosis of cancer.
  • BI-RADS 6: Biopsy-proven cancer. Imaging may be done to help determine effectiveness of treatment given before definitive surgery or to show placement of biopsy clips or markers.

Whew! As fans of knowledge (knowledge is power!) we’re always happy to talk about subjects in-depth, especially when it comes to women’s health. We hope this discussion of BI-RADS brings understanding to a confusing, sometimes stressful topic. If you have further questions feel free to contact us. In the meantime, we wish you happiness and the best possible health! Tomorrow, we’ll talk about something else...



Originally published 7/16/13 on

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