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Table 3 BI-RADS MRI assessment categories and management

From: Breast lesions in women under 25 years: radiologic-pathologic correlation

AssessmentManagement
Category 0: incomplete—need additional imaging evaluationRecommend additional imaging: mammogram or targeted US
Category 1: negativeRoutine breast MRI screening if cumulative lifetime risk ≥ 20%
Category 2: benignRoutine breast MRI screening if cumulative lifetime risk ≥ 20%
Category 3: probably benignShort-interval (6 months) follow-up
If the finding is visible on e.g., US, the most widely available method should be used for follow-up (should be applied only to lesions not fitting categories II and IV, probably benign findings in high-risk screening should rather be biopsied than followed up)
Category 4: suspiciousTissue diagnosis
Category 5: highly suggestive of malignancyTissue diagnosis
Category 6: known biopsy-proven malignancySurgical excision when clinically appropriate