Overwhelmed by this looming cancer cloud I logged in to mychart to look at the radiologist’s notes from the mammogram and ultrasound the day before.
“BIRADS Score – 4C – suspicious abnormality – very suspicious for malignancy – biopsy should be considered.”
What the hell is a BIRADS score? What are the scoring categories and what does 4C even mean? I pick up my phone and begin to search, thus beginning the dark descent into the world of google-medicine.
Here’s how the scoring goes…
BIRADS 0 – incomplete; need additional imaging
BIRADS 1 – negative; no mass
BIRADS 2 – benign
BIRADS 3 – less than a 2% chance of malignancy so probably benign
BIRADS 4 – here we goooo!
BIRADS 4A – low suspicion for malignancy; between 2-9%
BIRADS 4B – moderate suspicion for malignancy; between 10-49%
BIRADS 4C – high suspicion for malignancy; between 50-94%
BIRADS 5 – greater than a 95% probability of malignancy
BIRADS 6 – known malignancy proven by biopsy
I read my score again; 4C. It’s almost the highest score on the chart. The radiologist said 50-75% chance, but she never mentioned a BIRADS score. A 50% risk feels very different from a 94% risk. How are these two numbers even in the same category?
By the end of this search, I could give a lesson on BIRADS, the breast imaging-reporting and data system assessment designed to package the probability of your lesion being malignant into an easy to decipher numeric and alphabet score. Ha – easy to decipher. There’s nothing about cancer, or the potential of cancer, that’s easy to decipher. I’d never heard of a BIRADS score before now. Little did I know, I’d have lots of these “I’ve never heard of that before” moments in the coming months.
