What percentage of Breast Imaging-Reporting and Data System (BI-RADS) 2 lesions are malignant?

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Last updated: March 22, 2025View editorial policy

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From the Research

The percentage of BI-RADS 2 lesions that are malignant is approximately 0%. BI-RADS 2 is a classification for breast imaging findings that are considered benign, meaning they have characteristics that are clearly non-cancerous. These findings include benign calcifications, simple cysts, fibroadenomas with typical appearances, and other definitively benign lesions. The extremely low risk of malignancy in BI-RADS 2 lesions means that no further diagnostic evaluation is recommended, and patients typically return to routine screening schedules. This classification is designed to provide reassurance to patients while avoiding unnecessary biopsies or additional imaging for findings that have essentially no likelihood of being cancer.

Key Points

  • The provided evidence does not directly address the malignancy rate of BI-RADS 2 lesions, but it does discuss the malignancy rates of BI-RADS 3,4, and 5 lesions 1, 2, 3, 4, 5.
  • A study from 1999 reported that the positive predictive value (PPV) of BI-RADS category 2 lesions was 0% (0 of 40 lesions) 3.
  • Despite the lack of direct evidence, the general consensus is that BI-RADS 2 lesions have a very low risk of malignancy, and therefore, no further diagnostic evaluation is recommended.
  • Continued routine screening is still recommended even after a BI-RADS 2 assessment, as no screening test is perfect.

Recommendation

Based on the available evidence, it is recommended that patients with BI-RADS 2 lesions return to routine screening schedules, as the risk of malignancy is extremely low. However, it is essential to note that the provided evidence does not directly address the malignancy rate of BI-RADS 2 lesions, and therefore, this recommendation is based on the general consensus and the characteristics of BI-RADS 2 lesions.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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