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

Dr Francis Deng and Radswiki et al.

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
  • BI-RADS 4B: intermediate suspicion for malignancy
  • BI-RADS 4C: moderate suspicion for malignancy
Breast imaging and pathology
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Article information

rID: 15151
System: Breast, Oncology
Synonyms or Alternate Spellings:
  • BIRADS iv
  • BI-RADS 4
  • BIRADS 4
  • BIRADS iv lesion

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Cases and figures

  • Case 1: BI-RADS 4 on combined imaging
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  • Case 2
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