Understanding Mammogram Results: BI-RADS Explained

After your mammogram, your radiologist assigns a BI-RADS score — a standardized rating that tells your doctor exactly what was found and what should happen next. Understanding this score can help ease anxiety and prepare you for the next steps.

What Is BI-RADS?

BI-RADS stands for Breast Imaging Reporting and Data System. It was developed by the American College of Radiology (ACR) to create a consistent way for radiologists to describe mammogram findings. Every mammogram report includes a BI-RADS category from 0 to 6.

The BI-RADS Categories

BI-RADS 0: Incomplete — Need More Information Your radiologist needs additional images or a prior mammogram for comparison. This does not mean something is wrong. It simply means the pictures need to be clearer.

What happens next: You may be called back for extra mammogram views, an ultrasound, or your previous images will be requested for comparison.

BI-RADS 1: Negative — Normal No suspicious findings. Your breast tissue looks healthy.

What happens next: Continue routine screening. For most women over 40, that means a mammogram every year.

BI-RADS 2: Benign Finding Something was seen, but it is clearly not cancer. Common benign findings include: - Simple cysts - Calcified fibroadenomas - Fat-containing lesions - Lymph nodes

What happens next: Continue routine annual screening. No additional workup is needed.

BI-RADS 3: Probably Benign A finding that has a very high chance — greater than 98% — of being benign. However, it does not look completely typical, so your doctor will want to monitor it.

What happens next: Short-term follow-up, usually a repeat mammogram in 6 months to confirm stability. If the finding stays the same over 2 years, it is reclassified as benign (BI-RADS 2).

BI-RADS 4: Suspicious A finding that does not look clearly benign. BI-RADS 4 is further divided:

• 4A — Low suspicion (2–10% chance of cancer)
• 4B — Moderate suspicion (10–50% chance)
• 4C — High suspicion (50–95% chance)

What happens next: A biopsy is recommended to determine whether the finding is cancerous. Most BI-RADS 4 biopsies — especially 4A — come back benign.

BI-RADS 5: Highly Suggestive of Malignancy The finding has a greater than 95% probability of being cancer based on its appearance.

What happens next: Biopsy is necessary. Your care team will coordinate next steps quickly.

BI-RADS 6: Known Cancer This category is used when cancer has already been confirmed by biopsy and the mammogram is being done to monitor treatment or check the other breast.

What happens next: Continued imaging as directed by your oncology team.

Important Things to Remember

• A callback does not mean cancer. BI-RADS 0 (callback for more images) happens to about 10% of women on their first mammogram. Most callbacks result in a normal finding.
• BI-RADS 3 is not cancer. The overwhelming majority of BI-RADS 3 findings turn out to be completely benign.
• BI-RADS 4 does not equal cancer. Many biopsies prompted by BI-RADS 4A findings come back negative.
• 3D mammography reduces callbacks. 3D tomosynthesis finds more cancers while reducing false alarms by up to 40% compared to 2D alone.

How 3D Mammography Helps

At AMI, we use Hologic 3D tomosynthesis — the gold standard in breast imaging. This technology: - Creates thin-slice images that let radiologists see through overlapping tissue - Detects 20–65% more invasive cancers than 2D mammography - Reduces unnecessary callbacks - Is especially beneficial for women with dense breast tissue

What Should You Do With Your Results?

1. Read the BI-RADS category in your report — it is the bottom line
2. Follow the recommendation — if follow-up is suggested, schedule it
3. Ask your doctor to explain any terms you do not understand
4. Keep copies of your mammogram reports for your records

Schedule Your 3D Mammogram

At Advanced Medical Imaging in Seminole, FL, our ACR-accredited facility and board-certified radiologists provide expert breast imaging with 3D mammography. Most insurance plans, including Medicare, cover annual screening mammograms.

Call (727) 398-5999 or book online.