@churlgurl it seems like a two hour drive would be worth it? I saw oncology surgeon before oncologist but was lucky in that the guy who did the imaging (radiologist did an immediate biopsy. It is apparent you cannot rely on PCP and need to make calls yourself, and I am sorry for that!

Here is BIRADs 4-A from Dr. Google along with other 4's: Looks like low risk for you and hope that is true!

A BI-RADS 4 lesion under the breast imaging-reporting and data system refers to a suspicious abnormality. BI-RADS 4 lesions may not have the characteristic morphology of breast cancer but have a definite probability of being malignant. A biopsy is recommended for these lesions. If possible, the relevant probabilities should be cited so that the patient and her physician can decide on the ultimate course of action. BI-RADS 4 lesions can be further subclassified into:

BI-RADS 4A: low level of suspicion for malignancy and has a >2% to ≤10% likelihood of malignancy 4

BI-RADS 4B: moderate level of suspicion for malignancy and has a >10% to ≤50% likelihood of malignancy 4

BI-RADS 4C: high level of suspicion for malignancy and has a >50% to < 95% likelihood of malignancy 4