Breast Imaging Terminology

Women First Care
Through every stage of life

Make an Appointment
Middle Aged Woman Wearing Glasses
Stethoscope Icon


Pelvic Helath Icon


Menopause & Hormones

Icon to represent Common GYN Conditions

Common GYN Conditions

Diagnostics & Treatment

Uterus Icon to Represent Gynecologic Surgeries

Gynecologic Surgeries

Preventive Exams
Pelvic Health
Menopause & Hormones
Common GYN Conditions
Diagnostics & Treatment
Gynecologic Surgeries

The terminology used in breast imaging can be somewhat confusing and possibly a cause for concern if the meaning isn’t readily clear. So Women First wants you to know the categories used to define results of breast imaging, be familiar with the most common imaging findings, and understand the breast diagnostic procedures that may be used to follow up after a mammogram.

There are 6 categories that are used for reporting and tracking breast imaging reports.

Category 0: Mammography Incomplete. Need additional imaging evaluation and/or prior mammograms for comparison

Category 1: Negative

Category 2: Benign (but other comments may be present)

Category 3: Probably Benign (usually follow up needed)
While the BI-RADS category 3 can be confusing, this category uses standardized terminology based on science demonstrating that follow-up (usually 3 to 6 months) rather than a biopsy is a safe and effective management plan for imaging findings that are very likely benign.

Category 4: Suspicious

  • Category 4A: Low suspicion for malignancy
  • Category 4B: Moderate suspicion for malignancy
  • Category 4C: High suspicion for malignancy

Category 5: Highly Suggestive of Malignancy

Category 6: Known Biopsy-Proven Malignancy

Breast Cysts

Our breasts have fluid filled systems that can become congested at times; this fluid may collect and become visible on breast images.

  • Breast cysts can be described as “simple” or “complicated.”
  • A “simple” cyst is filled with watery-like fluid. These are generally a benign finding and, on occasion, can be aspirated (drained) for a patient’s comfort, or if they are very large.
  • “Complicated” cysts have a different appearance on ultrasound; they appear to have debris floating within them. This could be caused by the cyst being older and the fluid has become thicker—like syrup, or the cyst may have a solid component to it.

Focal Asymmetry

This is not a mass or a nodule. Focal asymmetry is a description of an area of tissue that looks a bit different within the breast itself, possibly a more dense area. This usually proves to be a normal change. Our breasts begin as dense tissue, and as we age, and/or have children and/or gain a little weight, our breast tissue becomes more fatty. The islands of breast tissue may appear differently because of the more fatty tissue surrounding it, or due to other changes such as weight gain or loss, more or less caffeine use, or hormonal changes.


A mass is a nodular finding on the breast image. It may be solid, fatty, or fluid-filled. Additional images are generally needed to determine exactly what this is and/or if further tests are needed.

Architectural Distortion

The breast tissue in an architectural distortion appears different than expected. This could be scar tissue or due to other changes such as weight gain or loss, caffeine use, or hormonal changes.

Cyst Aspiration:

Cyst aspiration is done under local anesthesia with ultrasound for guidance. The radiologist will numb the area and, using ultrasound for guidance, insert a small needle into the cyst to drain it. The fluid is sent to pathology if it is bloody, brown, or green. If the fluid is clear or straw colored, it is usually discarded.

Ultrasound Guided Biopsy:

Done under local anesthesia with ultrasound for guidance, the radiologist will numb the area and insert a needle into the area of concern, using ultrasound to direct these efforts. The needle has suction attached to it to make the process easier. The extracted tissue samples will be sent to pathology and the radiologist or healthcare provider will contact the patient with the results.

Stereotactic Biopsy:

For this type of biopsy, the patient is positioned with her breast through an opening in the machine. The breast is compressed, as with a mammogram machine, and a series of pictures is taken to determine exactly how deep the area of concern is in the breast. Next, a local anesthesia is injected and a small (1/8 inch) incision is made. A needle is inserted to biopsy the tissue, and several tissue samples may be taken. A biopsy clip will be placed at the biopsy site. A post-procedure mammogram will usually be obtained. The tissue samples are sent to pathology and the radiologist or healthcare provider will contact the patient with the results.

Excisional Biopsy:

This type of biopsy is performed by a breast surgeon. The patient is taken to the operating room and put under a heavier sedation. Generally, a needle is placed in the area of concern prior to the biopsy to guide the surgeon to the exact point. The tissue to be biopsied will be removed and sutures placed. The tissue will be sent to pathology, and the breast surgeon will contact the patient with the results.

Is it Time to Schedule Your Annual Wellness Exam?

Your annual women’s health appointment is a vital part of your health care, and the perfect time to talk to your Care Team about your personal health questions.

Learn More

Is it Time to Schedule Your Annual Wellness Exam?

Learn More

What People Are Saying

Toni G
I've been seeing Dr. Price for many years and have always had a great experience with her. Dr. Price has always listened to me and addressed all of my questions and concerns. My only complaint is with a former nurse I saw for medical issues who didn't further investigate them and it got progressively worse. Luckily the current nurse practitioner diagnosed me correctly and have received the correct treatment.
Morgan Miller
When I was looking for a gyno, Jeanette and Dr. Booth came highly recommended from family that see them and rightly so! Jeanette has the best bedside manner and takes the time to be thorough and understand the patient. When I had an issue outside of office hours, I was able to submit a question on the Follow My Health app and got a phone call in less than 30 minutes from the care team. They’re the best and I tell everyone about them!
Jennifer Stephens
I’ve been a patient at Women 1st for 16 years and cannot say enough about this practice. Every staff member is caring, friendly, and very good at what they do. The physicians & nurses are some of the best in the state of Kentucky, which is why I currently live in Georgetown and drive to Louisville to continue my care. Highly recommend Dr. Warren or Dr. Price!
Kailee Kaiser
Jeannette Jaggers, APRN is GREAT! I drive a hour and a half just to see her! Makes you feel comfortable and truly cares about YOU! Very happy to have her as my OB/GYN.