Breast imaging-reporting and data system (BI-RADS) assessment category 4

Changed by Mohammad Taghi Niknejad, 23 Jun 2023
Disclosures - updated 11 Jun 2023: Nothing to disclose

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A BI-RADS 4 lesion under the breast imaging-reporting and data system refers to a suspicious abnormality. BI-RADS 4 lesions may not have the characteristic morphology of breast cancer but have a definite probability of being malignant. A biopsy is recommendedfor these lesions. If possible, the relevant probabilities should be cited so that the patient and her physician can decide on the ultimate course of action. BI-RADS 4 lesions can be further subclassified into:

  • BI-RADS 4A: low level of suspicion for malignancy and has a >2% to ≤10% likelihood of malignancy 4

  • BI-RADS 4B: moderate level of suspicion for malignancy and has a >10% to ≤50% likelihood of malignancy 4

  • BI-RADS 4C: high level of suspicion for malignancy and has a >50% to <95% likelihood of malignancy 4

  • -<p>A<strong> BI-RADS 4</strong> lesion under the <a href="/articles/breast-imaging-reporting-and-data-system-bi-rads">breast imaging-reporting and data system</a> refers to a suspicious abnormality. BI-RADS 4 lesions may not have the characteristic morphology of breast cancer but have a definite probability of being malignant. A biopsy is recommended<strong> </strong>for these lesions. If possible, the relevant probabilities should be cited so that the patient and her physician can decide on the ultimate course of action. BI-RADS 4 lesions can be further subclassified into:</p><ul>
  • -<li><p>BI-RADS 4A: low level of suspicion for malignancy and has a &gt;2% to ≤10% likelihood of malignancy <sup>4</sup></p></li>
  • -<li><p>BI-RADS 4B: moderate level of suspicion for malignancy and has a &gt;10% to ≤50% likelihood of malignancy <sup>4</sup></p></li>
  • -<li><p>BI-RADS 4C: high level of suspicion for malignancy and has a &gt;50% to &lt;95% likelihood of malignancy <sup>4</sup></p></li>
  • +<p>A<strong> BI-RADS 4</strong> lesion under the <a href="/articles/breast-imaging-reporting-and-data-system-bi-rads">breast imaging-reporting and data system</a> refers to a suspicious abnormality. BI-RADS 4 lesions may not have the characteristic morphology of breast cancer but have a definite probability of being malignant. A biopsy is recommended<strong> </strong>for these lesions. If possible, the relevant probabilities should be cited so that the patient and her physician can decide on the ultimate course of action. BI-RADS 4 lesions can be further subclassified into:</p><ul>
  • +<li><p>BI-RADS 4A: low level of suspicion for malignancy and has a &gt;2% to ≤10% likelihood of malignancy <sup>4</sup></p></li>
  • +<li><p>BI-RADS 4B: moderate level of suspicion for malignancy and has a &gt;10% to ≤50% likelihood of malignancy <sup>4</sup></p></li>
  • +<li><p>BI-RADS 4C: high level of suspicion for malignancy and has a &gt;50% to &lt;95% likelihood of malignancy <sup>4</sup></p></li>
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