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Birad 4 reading
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Birad 4 reading

Hi all,

In 2 more days I am doing the core needle biopsy.  On my ultrasound report it said that is probable fibrodenoma but I got a BIRAD 4.  I heard that usually means it is cancer.  Is this true?  Do most Birad 4 readings turn out to be benign?  I will know for sure through the biopsy but I am so scared, b/c I am nursing and I hope they don't hit a milk duct or anything or I get an infection.  I hope I can still nurse on the breast that they did the procedure after it has been done.

Thanks
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Avatar_n_tn
Dear Cally44:  A BIRAD Category 4 means that there is a suspicious abnormality. Most category 4 abnormalities are benign but may require biopsy since this category can be malignant in 25-50% of cases.  You should discuss with your radiologist or surgeon when it is safe to breast feed from that breast again.  
29 Comments
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Avatar_n_tn
Hi,

A BIRADs 4 average percentage is 80% benign.  It is NOT usually cancer by any means!! Good luck.
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25201_tn?1255584436
Actually it's 25 to 50 % that can be something OTHER than benign with a score of BIRAD 4.
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Avatar_n_tn
I was told that I probably had just a fibroadenoma with some microcalcifications.  I was so nervous that the biopsy would show cancer.  Thank goodness they were right!
I'm hoping for good news for you too.  They can usually tell by the shape (rounded edges  & smooth) that a lump is probably benign.
I know how you must be feeling right now but the odds are greatly in your favour. Hugs & Best Wishes
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Avatar_n_tn
In reference to the answer from the nurse here that a Birad 4 rating has a 25-50% chance of being cancer: I respectfully disagree. Women should not automatically freak out and think their chances go up to 50%. You may want to try logging on to Johns Hopkins Breast Center website. The chances of a Birad 4 mammo for calcifications being cancer is 20%. I really feel the nurse there is excellent at answering all types of questions, even more thoroughly than they do here. Here's the link: http://www.hopkinsbreastcenter.org/services/ask_expert/index.asp
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Avatar_n_tn
I respectfully disagree also.  I had a BIRAD 4. My breast surgeon, with 30+ years experience, advised that there is a 15% chance that a suspicious cluster of microcalcifications is malignant, meaning that 85% of the time, it is benign.  It's too bad the 50% figure had to be thrown at us, causing unnecessary worry.
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Avatar_n_tn
I was told my calcs were a BIRAD 4 last August and after an unsuccessful Stereotactic Biopsy (sometimes with dense tissue they can't get a sample) I went for a second opinion to a Breast Center and had a Surgical Oncologist look at my films. He gave me the option of waiting 4 months, which I did, since he didn't believe they were as suspicious as the first hospital radiologist classified them as. I just went for a follow-up mammo last Friday and NOTHING HAS CHANGED, so I can choose to come back again in 6 months and be followed (which I did), or do a biopsy again. This time even the radiologist took the time to talk to  me and said they looked benign, but it's the pattern of them that makes medical obligated to classify them as suspicious, hence the "protocol" calls for a biopsy. I had a great conversation with her and again felt better about my decision. I really think that's the key, to feel in control and that it is your body and your decision. If you have doubts and your insurance will pay for it, get a second opinion at a Breast Center by a Surgical Oncologist and their radiology department.
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Avatar_f_tn
Thank you for your post. I feel I'm in the same category as you, with one radiologist saying I need a biopsy and the next saying it is a benign condition. I'm glad to hear your calcifications haven't changed.
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Avatar_n_tn
Thanks Montanagirl. I know, a lot of women are in the same boat and just need to know that there are options. I think many women get scared and think they need to react on the first radiologist/doctor's reccomendations. But if they are comfortable with doing so, a second opinion by a surgical oncologist along with their radiologist, who deals with BC day in and day out (and is very experienced in knowing what suspicious calcs are), would be my advice. I know getting a mammo every 6 months is a drag, but if after 2 years there are no changes, I can just be followed annually. For me, it's a better way to go than being cut open again. Good luck to you and to all here.
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Avatar_n_tn
I am a 38 year old mother of two with a history of cancer in my family.  9 years ago I had a lump removed that turned out to be benign (luckily).  I was told to start having mammos at 35 because of this.  I put it off (the usual excuses, no time, doesn't effect me, etc.)  Now I have gone for my baseline mammo and am terrified.  They took 3 sets of films plus a magnified view.  I was then told that I need an ultrasound right now because they found abnormalities in both breast.  My left breast is scheduled for a stereotactic biopsy after Christmas with a Birad 4 rating.  My right breast is Birad 3 and I should have that mammogramed again in 6 months.  They also stated that the lymph nodes are enlarged in the right but feel that mostly in part due to the severity of my psoriasis.  I know they are cluster calfications and very little else.  I was so shocked when I had the mammo and us that I didn't think to ask anything at the time.  The doctors I have spoken to don't give indication one way or another how they feel about the radiology report.  The surgeon did say that my left breast was more grandular and indicated more cell activity?  I don't know what this means.  Any information would be appreciated.
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127512_tn?1193745816
You can post this question to the doctor. Just go to the top of these hreads and click on post a question. You may get more comments there. We only get two questions a day here so hurry.
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Avatar_n_tn
Hello Everyone,well I am new here.First Thank you for sharing your stories and giving such great advice.Well I am 35 years old and had my first breast  mri @ 34 ,my result came back birad 4A and suspicious for dcis.Was told to have mammo and untlasound which I did however they could see anything and to follow up with another mri in 6 months.again still showing same results so this time was told to have breast mri with biospy.The result should a few different things: atypical ductal hyperlasia , flat epithelial columnar cell and microcalcificatio so they recommended to remove the area.I had the operation last week and just waiting for the result.I don't know if I am looking for help or just telling my story.May God bless each one of you
Thank you
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Avatar_f_tn
Thanks for sharing your story.  Are you hoping that surgery removed the entire area so you won't need follow-up treatment? I hope you get a good pathology report. Waiting is soooo hard.
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127512_tn?1193745816
Thanks for sharing your story. They are helpful to the many women who come here in search of hope, answers or of course just to vent. We will help in anyway we can. If not for this site and another site I visit often, my husband and kids, I just don't know how I would have made it. I think I was close to a nervous breakdown.
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HI ,Thank-You for the message and kind words.I have found site site very helpfull.Right now I am waiting for my resuly from the lumpectomy and as you know waiting is the hardest part.If I only knew , than I could deal with it however the not knowing is the hardest for myself.May God watch over yu and again Thank-You

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Avatar_n_tn
Hi,Thanks for the message.yes I beleive they have removed the whole area.I had a lumpectomy done and just waiting for the result.They have been keeping a close eye on me and taking good care of the issue.Boy when this all started , I didn't realize How many woman are being affected by breast cancer and other cancers that are going on.Breast cancer runs in the family (aunts).I guess in these times we have to be thankfull for the treatment and doctors.I will be seeing my doctor this wed so I am getting a little nervous .Thank you for your support and for caring.May god watch over you.Thanks again
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Photogirl, I know what you are going through.  The waiting is almost unbearable at times.  Your dx sounds a lot like mine, I recently had lumpectomy for two areas of calcifications with columnar cell change in one and LCIS.  Now waiting for results.  This web forum has helped me cope sooooo much, I can't even begin to tell everyone here how much it has helped me.  Let us know how your path report comes back, and I will be thinking of you.
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Avatar_n_tn
Hi,Thank You for the message.yes waiting is the hardest part and this site is helping me also.I do hope all works out for yourself and I will keep you in my prayers...I will keep you posted....Thanks Again...
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Hi All,Just wanted to let everyone know my result came back and there is no cancer .Thanks everyone for the support , I will be keeping everyone in thoughts and prayers and check in to see how everyone is  doing...again a big thank you , keeping each one of you in my thoughts and prayers.
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Avatar_f_tn
Hooray! I'm so glad everything turned out alright. Thanks so much for sharing.
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Great!
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Avatar_n_tn
Great news!!!!
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Hi. I've been reading your posts and greatly appreciate all your comments.  I am a 52 y/o RN, I work med-surg at a small local hospital.  I went for my routine mammo and then was sent back for "spot checks" which lead to US, which showed NOTHING. According to the Radiologist there is an "area of density" that will need to be followed up with by a biopsy.  I felt like a deer in the headlights.  Well now I have a report that says I have a "BIRAD 4.  Focal density in the posterior right breast.  Evaluation with stereotactic biopsy is recommended."  Am I wrong to want to know what IT is?  Size, shape, is not mentioned anywhere in the report.  I meet with my GYN today to discuss these issues.  Is it a lump or a mass or whatever.  I am scared.  There is no history of breast cancer in my family which is positive.  But the fact that it is near the chest wall is very concerning to me.  I started reading your forum last night.  It is nice to see that the chances of this being cancer is as low as 15%, from what I gather.  Thanks for listening.  Thanks for being there. :)
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127512_tn?1193745816
Ask questions of your doctor. I was so upset my husband had to call with a list of question. Phone him and demand answers to your questions. It may be nothing but please follow up. Do you have any new info? I am glad you found this site. Please let us know what we can do to help.
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Avatar_n_tn
It looks like I get the biopsy.  I met with my GYN today.  I should be scheduled next week I hope.  He says because of the location and the BIRAD 4 rating, that the biopsy is the best place to start.  He also stated that this may be nothing but to take it seriously.  I will keep you updated.  Thanks again.
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Avatar_n_tn
First Thank-You for sharing your story.The best thing I found was asking the Dr,What are the chances this is cancer.It is hard, However he explained to me that there was a 20 percent chance.I pray that God will watch over you and everyone who comes here.Everyone here has helped me out and I am so Thankfull..
P.s:I had two areas in the breast that showed birad 4a , one at one o'clock and another at three , the three o'clock lump was removed and both birads  4a weren't cancer.Just thought I shared that infor with you.All the best and keep posting.
GOD BLESS
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Avatar_n_tn
I am now trying to decide weather or not to go forth with the radiologist for the biopsy or go to the breast center.  The Rose is a nationally recognized breast center from what I understand and is not far from me.  I havent been scheduled for anything yet and I think maybe I'm just getting a little paranoid.  The waiting is consuming.  I will call both places tomorrow and try to make sure I am going in the right direction.  Will keep you posted.  Thanks for the words of encouragement.  Thanks for listening.
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Thanks for the update.yes I think by calling both places , this will help you decide what to do.Pls keep us update.In my prayers.GOD BLESS
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I went to the hospital and obtained all my mammo's and US films.  I took them to The Rose for a second opinion.  It paid off.  According to the radiologist at The Rose, the same "abnormality" has been there for the past 4 years with no change.  He did not feel I needed the biopsy at this time.  He feels it is completely benigh.  I am so relieved.  He will forward reports to my GYN and my PCP.  It was well worth the $50.00 for the second opinion.  I will follow up as recommended and will never again put off my mammo.  This was a wake-up call for me and made me aware of you all.  My prayers are with you all.  I can't thank you enough for being there the past few days.  I know there are many of you who will not be so lucky.  I feel as if I just doged a bullet.  Take care and GOD BLESS ALL OF YOU.
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