American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is indicated by a BIRADS 5 classification?

1. Benign finding; follow-up in 1 year

2. Probably benign; short-term follow-up suggested

3. Highly suggestive of malignancy; consider biopsy or surgery

4. Negative; mammogram in 1 year

The correct answer is: Highly suggestive of malignancy; consider biopsy or surgery

A BIRADS 5 classification indicates that a finding on a mammogram is highly suggestive of malignancy. This designation is part of the Breast Imaging-Reporting and Data System (BIRADS), which helps in standardizing the assessment of breast lesions. The number 5 specifically implies that there is a strong suspicion of breast cancer based on the imaging characteristics observed. In practice, when a mammogram is categorized as BIRADS 5, it prompts the healthcare provider to take further action, which typically includes considering a biopsy to obtain tissue for diagnosis or planning surgical intervention if the clinical scenario warrants it. This classification is crucial because it guides clinical decision-making toward more definitive management instead of mere observation or follow-up. The other classifications, such as benign findings or probably benign results, denote a lower suspicion for malignancy and typically involve less immediate action, such as routine follow-up imaging. The classification system is designed to prioritize patient safety and ensure timely intervention when there is a significant risk of cancer.