BI-RADS 5 includes mammography findings with features highly suggestive of malignancy and appropriate action needs to be taken (i.e. biopsy and appropriate management).
BI-RADS 5 lesions have imaging morphological features highly suggestive of breast cancer. There is > 95% chance of these lesions being confirmed malignant on histopathology. If the biopsy is benign, the findings are considered discordant.
Spiculated high-density mass lesions

, indistinct masses

, masses with pleomorphic microcalcifications

, and fine linear segmental calcifications

are all included in the classical morphological imaging features of breast cancer of the BI-RADS 5 category. Associated features such as nipple retraction

, skin thickening

, or developing asymmetry

as an interval change support the diagnosis of a malignant mass.