HomeAnswersRadiologybreast lumpI have a small-sized BI-RADS III lesion. Should I worry?

I have a small-sized BI-RADS III lesion. Should I be worried?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Vivek Chail

Medically reviewed by

iCliniq medical review team

Published At December 23, 2017
Reviewed AtFebruary 5, 2024

Patient's Query

Hello doctor,

I had a breast MRI two months ago, a routine screening due to BRCA1 status. There was a non-mass lesion seen on the left breast which the radiologist said was stable for three years. On the right breast, there were three foci seen, two measuring 5 mm and one 3 mm. The 5 mm foci have been stable in size for one year, but, the 3 mm one is new.

The doctor did not recommend a biopsy because of the small size and after mammogram and ultrasound were performed, he gave it BI-RADS III and told me to go back in six months for another MRI and a mammogram. Should I be concerned about these and ask for a biopsy?

Answered by Dr. Vivek Chail

Hello,

Welcome to icliniq.com.

A BI-RADS III (Breast Imaging-Reporting and Data System) means the lesion has a high probability of being benign and something which is not of a serious concern.

The MRI (magnetic resonance imaging) is a detailed test and has good accuracy.

However, a suspected BI-RADS III lesion needs to be followed up on the MRI and mammogram as recommended by your doctors.

In reply to your questions, you surely need a follow-up testing after six months.

A biopsy for the 3 mm lesion which is showing benign features on MRI is not usually recommended and there is no serious concern right now.

You can possibly get an ultrasound mammogram after three months if waiting six months for the next MRI is causing anxiety.

Patient's Query

Thank you doctor,

Do you mean to say that the foci on the breast MRI are usually benign? Can a mammogram and an ultrasound get a good look at foci since they are so small?

Answered by Dr. Vivek Chail

Hello,

Welcome back to icliniq.com.

Foci seen on the breast MRI (magnetic resonance imaging) are classified depending on the dynamic contrast enhancement curve.

If the curve shows a pattern which categorizes a benign lesion then it is likely benign.

Malignant lesions have a different enhancement.

From the attached reports (attachments removed to protect the patient's identity), the ultrasound scan shows a magnified view of lesions and therefore can see a lesion 3 mm in size.

On the MRI, a lesion stands out from the background tissue and shows enhancement characteristics.

As such we need to evaluate using more than one imaging test.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vivek Chail
Dr. Vivek Chail

General Practitioner

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