BIRADS V

Dr Henry Knipe and Dr Craig Hacking et al.

A BIRADS V lesion under the BIRADS (breast imaging reporting and data system) refers to a lesion that is highly suspicious for malignancy, requiring appropriate action to be taken (i.e. biopsy and management as appropriate). BIRADS V lesions have the characteristic morphology of breast cancer with a >95% chance of being malignant.

The implication of a BIRADS 5 finding (in contrast to BIRADS 4) is that if the histology is benign, it should be considered discordant with imaging findings, and lesion excision is still advised.

Radiographic features

Mammogram

A BIRADS V lesion has the typical imaging features of breast malignancy. On mammogram, any two of the following features are demonstrated:

  • spiculated or irregular mass
  • high density
  • fine linear or linear branching segmental calcifications

Nipple retraction, skin thickening and evidence of interval growth, if present, would support the diagnosis.

Breast imaging and pathology
Share article

Article information

rID: 46172
System: Breast
Tag: refs
Synonyms or Alternate Spellings:
  • BIRADS 5
  • BIRADS-V lesion
  • BIRADS 5 lesion

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Case 1
    Drag here to reorder.
  • Drag
    Left breast MLO v...
    Case 2
    Drag here to reorder.
  • Drag
    Case 3
    Drag here to reorder.
  • Drag
    Post compression
    Case 4
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.