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A 45-year-old female asked:

My mammogram report results came back birads 4 but my sonogram report came back negative so why does my doctor recommend a breast biopsy?

4 doctor answers13 doctors weighed in
Dr. Haluk Tezcan
Medical Oncology 35 years experience
Because ...: If a suspicious lesion is noted on mammography an us is obtained. This allows for better definition of the lesion in the breast. However, a "negative" us does not rule out an underlying problem and the correct next step is to proceed with your physicians recommendation, in this case a biopsy. None of the imaging techniques are perfect, the final decision is based on all the information.
Dr. Jennifer Giltnane
Pathology 13 years experience
Better safe: Different types of breast imaging can be better or worse at finding certain abnormalities. A biorads 4 suggests that the radiologist cannot completely exclude cancer; however, benign lesions can also have this score. Consider a second opinion if you are not confident that a biopsy is necessary.
Dr. Daniel Para
General Surgery 30 years experience
Get it done!: A birads-4 mammogram describes a finding consistent with possible cancer in the breast. The lesion may be a suspicious cluster of microcalcifications which would not be necessarily seen as a mass on ultrasound. It is important to have the area biopsied.
Dr. Michael Gabor
Diagnostic Radiology 33 years experience
Mammo and : ultrasound are complementary tests. Some abnormalities may be seen on one, but not the other. So a suspicious mammo finding that cannot be seen on ultrasound is still a suspicious mammo finding, and likely needs biopsy.

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Last updated Mar 13, 2019

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