Question about BIRADS

I received my mammogram report and the radiologist suggest a surgical biopsy on an area of concern. But my question is he gave it a 4A what does this mean? Thank you in advance for your time.

[CCF-RN,MSN-JS]

Dear rfrancis, The BIRADS rating scale is divided into 5 categories with 1 being negative, nothing to comment on. Routine screening. to 5 being highly suggestive of malignancy, appropriate action should be taken.  A rating of 4 suggests a suspicious looking abnormality, not characteristic but has a reasonable probability of malignancy, and a biopsy should be considered.

[Rfrancis]

But what does it mean when they give you a rating of "4A"?

[surgeon]

Birads 4 is the category in which the classical characteristics of cancer aren't all there, but there's enough to be concerned about. Recently, there have been suggestions to categorize that further by adding A, B, and C, to indicated less or more worrisome within the category. A is less, C is more. I really don't think that adds a heck of a lot: if it's a 4, most people would recommend a biopsy to be safe as possible. However, I suppose in a given circumstance where there were other factors that would make one lean away from biopsy, it'd be more sensible to choose that path with an A than with a C. Many women with category 4 do not have cancer; and fewer still A's will have it than C's. But it's hard not to suggest biopsy when a 4 is seen, unless there are specific mitigating factors.

[ALi273]

I just recently had an MRI which came back as a birad 4B.  Needless to say I was really worried and went for the biopsy.  Thankfully it was benign.  Hopefully yours will be too.  Good luck to you!