Breast imaging-reporting and data system (BI-RADS) assessment category 4
Citation, DOI, disclosures and article data
Citation:
Radswiki T, Niknejad M, Yap J, et al. Breast imaging-reporting and data system (BI-RADS) assessment category 4. Reference article, Radiopaedia.org (Accessed on 29 Mar 2025) https://doi.org/10.53347/rID-15151
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rID:
15151
Article created:
27 Sep 2011,
The Radswiki ◉
Disclosures:
At the time the article was created The Radswiki had no recorded disclosures.
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Last revised:
Disclosures:
At the time the article was last revised Mohammad Taghi Niknejad had no financial relationships to ineligible companies to disclose.
View Mohammad Taghi Niknejad's current disclosures
Revisions:
22 times, by
15 contributors -
see full revision history and disclosures
Sections:
Synonyms:
- BIRADS iv lesion
- BIRADS 4
- BIRADS IV
- BIRADS iv
- BI-RADS 4
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 recommended 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:
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
References
- 1. Raza S, Chikarmane SA, Neilsen SS et-al. BI-RADS 3, 4, and 5 lesions: value of US in management--follow-up and outcome. Radiology. 2008;248 (3): 773-81. doi:10.1148/radiol.2483071786 - Pubmed citation
- 2. BIRADS website : www.birads.at
- 3. Cardeñosa G. Clinical breast imaging, a patient focused teaching file. Lippincott Williams & Wilkins. (2006) ISBN:0781762677. Read it at Google Books - Find it at Amazon
- 4. ACR. ACR BI-RADS Atlas. AMER COLLEGE OF RADIOLOGY. ISBN:155903016X. Read it at Google Books - Find it at Amazon
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Articles:
- Breast calcifications (an approach)
- Focus (breast MRI)
- Complex cystic and solid breast mass
- Punctate microcalcification within the breast
- Ultrasound guided breast biopsy
- Breast imaging-reporting and data system (BI-RADS) assessment category 3
- Round breast calcification
- Mammary duct ectasia
- Breast calcifications
- Breast imaging-reporting and data system (BI-RADS)
- Suspicious breast calcifications
- Stereotactic breast biopsy
- Amorphous calcifications (breast)
- Breast architectural distortion
- Asymmetry (mammography)
- Non-mass enhancement (breast MRI)
- Background parenchymal enhancement (breast MRI)
- Breast imaging-reporting and data system (BI-RADS) assessment category 5
Cases:
- Invasive ductal carcinoma
- Invasive breast carcinoma
- Intraductal papilloma of breast
- Intraductal breast papilloma
- Giant fibroadenoma
- Breast mass (BI-RADS 4)
- Invasive lobular carcinoma of the breast - multifocal multicentric
- Bilateral breast masses (BI-RADS 5 and 4)
- Breast calcifications (BI-RADS 4)
- Breast mass (BI-RADS 4c)
- Breast mass (BI-RADS 4C)
- Polyacrylamide hydrogel breast augmentation
- Squamous cell carcinoma of the breast
- Male breast cancer
- Intraductal papilloma of breast
- Left breast mass (BI-RADS 4c)
- Suspicious breast calcifications - grouped coarse heterogeneous
- BIRADS IV lesion
- Invasive ductal carcinoma
- Infiltrating ductal carcinoma in a 17-year-old
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