BI-RADS Classification for Management of Abnormal Mammograms

Margaret M. Eberl, MD, MPH; Chester H. Fox, MD; Stephen B. Edge, MD; Cathleen A. Carter, PhD; Martin C. Mahoney, MD, PhD, FAAFP


J Am Board Fam Med. 2006;19(2):161-164. 

In This Article

Patient Education

  • What is BI-RADS? BI-RADS is a system that was developed by radiologists for reporting mammogram results using a common language. The radiologist assigns a single digit BI-RADS score (ranging from 0 to 5) when the report of your mammogram is created.

  • What does BI-RADS 0 mean? BI-RADS 0 identifies a mammogram study that is not yet complete. You need to make sure that further evaluation is completed, perhaps extra mammography views or an ultrasound. Further information is needed to make a final assessment (codes 1 to 5).

  • What does BI-RADS 1 mean? BI-RADS 1 means that the mammogram was negative (ie, no cancer) and that you should continue your routine screening.

  • What does BI-RADS 2 mean? BI-RADS 2 also means that your mammogram was normal (ie, no cancer), but other findings (eg, cysts) are described in the report. You should continue your routine screening.

  • What does BI-RADS 3 mean? BI-RADS 3 means that your mammogram is probably normal but a repeat mammogram should be completed in 6 months. The chance of breast cancer is approximately 2% in this category. You should make sure that these follow-up mammograms are completed as requested.

  • What does BI-RADS 4 mean? BI-RADS 4 means that the findings on your mammogram are suspicious and that there is approximately a 23% to 34% chance that this is breast cancer. You will need a biopsy to get a small tissue sample to make a diagnosis. Talk to your doctors about any questions.

  • What is a biopsy? Biopsy is done to obtain a piece of the breast tissue to determine whether there is cancer. The biopsy may be done using a needle technique (a "needle biopsy") or may require a surgical operation (a "surgical biopsy"). When a needle biopsy is an option, it is usually preferred.

  • What does BI-RADS 5 mean? BI-RADS 5 means that your mammogram results are highly suspicious with a 95% chance of breast cancer. You will need to have a biopsy for diagnosis. Talk to your doctors about what course of action to take.

  • What does BI-RADS 6 mean? BI-RADS 6 means that you have already been diagnosed with breast cancer. Discuss your treatment plan with your doctors.

  • Why do I need to know my BI-RADS score? Knowing your BI-RADS number can help to make sure that you get proper follow-up after your mammogram. It is a good thing for you to know that score so you can keep track, along with your physician, of what you need to do and actively participate in your medical care.


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