Just turned 41 (found out about my BI-RADS 5 a couple days before my bday).

Went in for first mammo, they found a suspicious area and I went for diag mammo and US. Confirmed architectural distortion and had stereotatic biopsy. Also recommended MRI due to 21% lifetime risk and dense tissue.

Biopsy was normal but MRI was pushed heavily on me. MRI showed 4 additional areas of concern, plus the main reason they pushed for the MRI, an architectural distortion approx 4cm x 2cm x 3cm - adjacent to the original finding they biopsied. Recommended MRI biopsy - the 3 radiologists debated for the longest if they could even do it without contrast or do they premedicate me to try and prevent the allergic reaction to the contrast. I guess in the end my anaphylaxis risk was too great to attempt it with contrast and the BI-RADS 5 meant they already planned to recommended removal regardless of biopsy outcome.

In talking to the radiologist before 2nd biopsy, even the original normal biopsy result was discordant with their finding which is why they really pushed me to do the MRI - which confirmed what they suspected leading to the BI-RADS 5 category. He said in no uncertain terms that it needs to be removed, based on presentation in the diagnostic mammo which was only further supported by the MRI.

With my risk factors I’m definitely planning on having this removed. I guess it’s more wondering if after removal, there’s a chance they find it malignant and we’d have to figure out further treatment.

Side note, I also had a nearby clumped enhancement biopsied (normal) and 3 other areas US and marked for follow up in 6 months, all on same breast.