A 45-year-old woman undergoes mammography as part of a breast cancer screening programme. The radiologist classifies the finding as BI-RADS 4B. What does this classification imply for further management?
- A Routine annual mammography; probability of malignancy <2%
- B Short-interval follow-up (6 months); probability of malignancy 2–10%
- C Tissue sampling (biopsy) recommended; intermediate-high suspicion with malignancy probability 15–95% ✓
- D Immediate surgical excision; highly suggestive of malignancy >95%
Explanation
BI-RADS (Breast Imaging Reporting and Data System) classification: 0 = incomplete; 1 = negative (routine screening); 2 = benign; 3 = probably benign (<2% malignancy, 6-month follow-up); 4 = suspicious (biopsy recommended) — subdivided: 4A (low: 2–10%), 4B (intermediate: 10–50%), 4C (moderate-high: 50–95%); 5 = highly suggestive of malignancy (>95%, biopsy mandatory); 6 = known malignancy. BI-RADS 4B carries intermediate-high suspicion (10–50%) and mandates tissue biopsy. Option D describes BI-RADS 5. Option B describes BI-RADS 3 or 4A. Option A describes BI-RADS 1 or 2.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.