August 2025
August 2025
| Assessment | Management | Likelihood of cancer |
| Category 0: Incomplete – Need additional imaging evaluation and/or prior mammograms for comparison | Recall for additional imaging and/or comparison with prior examination(s) | N/A |
| Category 1: Negative | Routine mammography screening | Essentially 0% likelihood of malignancy |
| Category 2: Benign | Routine mammography screening | Essentially 0% likelihood of malignancy |
| Category 3: Probably benign | Short-interval (6-month) follow-up or continued surveillance mammography | >0 but ≤2% likelihood of malignancy |
| Category 4: Suspicious | Tissue diagnosis* | >2 but <95% likelihood of malignancy |
| Category 4A: Low suspicion for malignancy | >2 to ≤10% likelihood of malignancy | |
| Category 4B: Moderate suspicion for malignancy | >10 to ≤50% likelihood of malignancy | |
| Category 4C: High suspicion for malignancy | >50 to <95% likelihood of malignancy | |
| Category 5: Highly suggestive of malignancy | Tissue diagnosis* | ≥95% likelihood of malignancy |
| Category 6: Known biopsy-proven malignancy | Surgical excision when clinically appropriate | N/A |
BI-RADS: Breast Imaging-Reporting and Data System.
* Practice guidelines recommend biopsy for all BI-RADS 4 and 5 lesions. If there are clinical factors (eg, age, comorbidities, etc) for which the patient, in consultation with the clinician, chooses to defer biopsy, the reasoning should be documented in the medical record.
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