Today I learned about the BI-RADS rating system.
It is used for breast cancer screening.
BI-RADS 0 means the testing is incomplete and further tests – like say an ultrasound – need to be carried out.
BI-RADS 1 means there is nothing to worry about. Testing has been completed properly and the results are negative. Nothing to worry about.
BI-RADS 2 includes some visible things but nothing of concern. Things like:
- Round opacities with macrocalcifications (typical calcified fibroadenoma or cyst)
- Round opacities corresponding to a typical cyst at ultrasonography
- Oval opacities with a radiolucent center
- Fatty densities or partially fatty images (lipoma, galactocele, oil cyst, hamartoma )
- Surgical scar
- Scattered macrocalcifications (fibroadenoma, cyst, cytosteatonecrosis, secretory ductal ectasia);
- Vascular calcifications
- Breast implants, silicone granuloma.
BI-RADS 3 means whatever they found is probably benign and wait 6 months to have a check-up. Apparently, this is not used very often because the 6 months wait causes too much anxiety. There is an official chance of cancer being less than 1% so I guess that means some people have had a 3 and then been diagnosed with cancer. I have one mass rated a 3
BI-RADS 4. 4 has three levels. This is where we start to get serious. This is where there is a real, though low, chance of cancer and we start getting %’s attached.
In this category we have 4A, 4B and 4C.
4A being the least likely to be cancer. There is a low suspicion of malignancy. Officially I have read it is where the chance of cancer is believed to be less than 10% but it seems the diagnosis is more around 13-14% as positive for real cancer.
4B is moderate at 36% and 4C high risk given at about 79%.
Then there is BI-RADS 5 which is highly suggestive. Something around 95% chance of being cancer. Scary right.
The next level is the last. BI-RADS 6, it is known to be cancer. You have cancer, it is cancer, you have a level 6.
I have a 4A. Given I have a 3 and a 4 BI-RADS rating, I get to have a fun biopsy.
My stress isn’t so much about the risk of cancer. It is low, I have cysts all over my body so it is likely just some random cyst near a cyst making the scan unclear. Having some scary man touch and then poke a needle into my boob isn’t a fun thought though. Not super excited about that.