A 52-year-old woman undergoes screening mammography showing a 1.2 cm irregular mass with spiculate margins in the left upper outer quadrant and ipsilateral axillary lymphadenopathy. The ACR BI-RADS category assigned should be:
- A BI-RADS 3 (Probably benign)
- B BI-RADS 5 (Highly suggestive of malignancy) ✓
- C BI-RADS 4B (Intermediate suspicion)
- D BI-RADS 4C (High suspicion)
Correct answer: B. BI-RADS 5 (Highly suggestive of malignancy)
Explanation
An irregular mass with spiculate margins has a >95% probability of malignancy and warrants BI-RADS 5 (highly suggestive of malignancy), which mandates tissue biopsy. BI-RADS 4C carries 50–95% probability, 4B 15–30%, and 3 <2%. The presence of axillary adenopathy further raises suspicion to BI-RADS 5.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.