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Topic: BIRADS 4

Forum: Not Diagnosed but Worried —

Meet others worried about developing breast cancer for the first time. PLEASE DO NOT POST PICTURES OF YOUR SYMPTOMS. Comparing notes, symptoms, or characteristics is not helpful here, as only medical professionals can accurately evaluate and assess your individual situation.

Posted on: Jul 29, 2009 11:45AM

mommyalways wrote:

Hi All..newby here. I have a couple questions for you all.  I had several diagnostic mammos done. The radiologist has been comparing each of them. I went for a 6 mo mammo and conditions changed.

The report states "moderately puncatate w/slightly pleomorphic calcifications. They do not layer and appear to have increased in number."  = BIRADS 4, and scheduled for stereotactic biopsy on Aug 6th. 

Does anyone know what the odds are of this being cancer?  


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Jul 29, 2009 12:13PM Beesie wrote:

BIRADs 4 means that there is enough suspicion to warrant a biopsy, but a BIRADs 4 mass does not have the characteristics of cancer.  Here's a link that explains BIRADs ratings:  http://www.radiologyassistant.nl/en/4349108442109

And here's how BIRADs 4 is described:

Suspicious Abnormality - Biopsy Should Be Considered:
BI-RADS 4 is reserved for findings that do not have the classic appearance of malignancy but have a wide range of probability of malignancy (2 - 95%).

I suspect that a range as large as 2% - 95% doesn't help you much!  I''ve also read various studies that put the average % malignant in the range of 20% - 30%.  The majority of BIRADs 4 biopsies end up being benign.

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage IA, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Jul 29, 2009 12:40PM mommyalways wrote:

Thank you for your reply. I have been frequenting this sight for close to a month now, which is also about how long I have been waiting to even get the appt. for the biopsy!

The waiting for everyone is awful. I have decided that if it is cancer, I can handle it...I believe.

I do see your status (DCIS) I am sorry for you and hope you are doing well!


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Jul 29, 2009 01:21PM tweekerbeeker wrote:

mommysta, I also had a BIRADS 4 mammo and U/S. Then my MRI was a 4 also!! I drove myself nuts, but then I joined this board and lots of women assured me that birads 4 was suspicious for cancer, but I still had an 80% chance of it being benign-even w/ a BRCA+ diagnosis! And guess what? It WAS benign!!

I guess it was encouraging to me to see that there is a BIRADS 5, which is "highly suspicious for cancer". I also had to wait for the tests-that is hard. From suspicious mammo to biopsy results was 3 -4 months!!

Try to occupy your mind and wait until you know for sure. Then if it is positive, you know where to come for help. If it is neg. (as 80% ARE!!) then you will be so happy!! Please let us know your journey and results.

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Jul 29, 2009 01:37PM mommyalways wrote:


  Sounds very encouraging! Thanks.  I'm trying to look at all the scenarios and what really bothers me is that my Hematologist/Oncologist usually has a great outlook and says don't worry. This time she said if you do have cancer, it'll be a stage 0.  I'm wondering if she read more into my report than I did. Like I said, just going through scenarios..preparing.. 

I probably will be driving you all batty anxiously awaiting next Wed.'s biopsy.

Thank you!!!!

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Jul 29, 2009 04:03PM coffeelatte wrote:

mommysta, I am just now going through the waiting process regarding a BIRADS 4 category on my right breast.  This all started back on May 28 when my first mammogram showed a new, solid, 1 centimeter mass.  I had more pictures and US then I saw a breast surgeon three weeks ago.  I then saw a second surgeon last week to be sure I needed to have an excisional biopsy.  I am waiting for the second surgeon to decide how to do the excisional biopsy since I have had problems in the past with anesthesia and he wants to avoid future problems.  The waiting is driving me crazy.  I find I wake up at three in the morning obsessing about breast cancer.  This is certainly a rough patch in the road.

Just know you are not alone and that the odds of it being cancer is in our favor until told otherwise.  Reading this forum has really helped me calm down; however, when I get in the car to go to the surgeon, or even get more tests, my legs are like jelly and I can't even see straight.  It is so amazing what fear can do.  I am crossing my fingers for your good news.  I just wanted to jump in and let you know I understand the fear part of this ordeal.

Dx 7/2/2013, Grade 3, ER-/PR- Surgery 8/13/2013 Lymph node removal: Left, Sentinel; Mastectomy: Left; Prophylactic mastectomy: Right
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Jul 29, 2009 10:23PM lamomimax1 wrote:

I also had a birad 4 US and MRI.  I went crazy too.  When I went in for my stereotactic they took my blood pressure and it was 169/114 with a pulse of 110.  My blood pressure is usually 116/80!!  Talk about stressed. However, the whole time I tried to remember the 80% stat.  Turns out that the results were b9.  Keep positive, take care of yourself, and try to keep yourself busy - it helps.  Hugs to you!

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Jul 30, 2009 10:05AM mommyalways wrote:

Coffeelatte and Lamomimax1,

Such great encouraging, optomistic people here! I am so glad this week is almost over..that'll leave Mon & Tues-work and then my biopsy!! I can't wait to get it over with. 

I'm glad to hear so many of our breasts problems turn out to be b9. No matter what, I'm now prepared...you all are amazingly supportive!!! 

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Jul 31, 2009 12:45PM mommyalways wrote:

Hey all..Just realizing Wed. is not the 6th, Thurs. is.  I'm nervous as can be. I haven't seen many people talking about pleomorphic cells. Do most reports on calcifications mention pleomorphic?

It's scary to hear that word in itself. And what about calcifications that DO NOT layer..Is that a bad thing or a good? Are pleomorphic cal a bad thing?

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