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
![](pic/CASE.jpg)
, indistinct masses
![](pic/CASE.jpg)
, masses with pleomorphic microcalcifications
![](pic/CASE.jpg)
, and fine linear segmental calcifications
![](pic/CASE.jpg)
are all included in the classical morphological imaging features of breast cancer of the BI-RADS 5 category. Associated features such as nipple retraction
![](pic/CASE.jpg)
, skin thickening
![](pic/CASE.jpg)
, or developing asymmetry
![](pic/CASE.jpg)
as an interval change support the diagnosis of a malignant mass.