[Medical Q&A] Does a Class 4a breast nodule mean high risk?

Planner: Chinese Medical Association

Reviewer: Kong Xiangyi, deputy chief physician, Cancer Hospital, Chinese Academy of Medical Sciences

When the ultrasound report shows that the breast nodule is BI-RADS (Breast Imaging Reporting and Data System) 4a category, it means that the possibility of a benign nodule is greater and the possibility of a malignant nodule is smaller, but the possibility of breast cancer cannot be completely ruled out.

There is no need to panic at this time. There are usually two ways to deal with it: regular check-ups or surgical treatment.

1. Regular review: The recommended review frequency is once every three months. If the results of continuous review are stable, the doctor may downgrade the nodule to Category 3, at which point the review frequency can be reduced to once every six months or once a year. However, since the possibility of malignancy cannot be completely ruled out, regular review of Category 4a nodules still has certain risks.

2. Surgical treatment: If the breast nodule is palpable, a puncture is usually performed before surgery to obtain a cytological diagnosis. If the puncture result is cancer, it is treated as breast cancer; if not, a frozen pathological examination is required after the nodule is removed during surgery to determine subsequent treatment. If the nodule is not palpable, a wire needle positioning is required under B-ultrasound guidance before surgery to ensure accurate removal of the nodule. The pathological examination after removal will guide subsequent treatment.

In short, although there is no need to worry too much about type 4a nodules, they need to be handled with caution. Whether to undergo surgery should be determined based on personal circumstances and doctor's advice. Regular check-ups and maintaining communication with doctors are the key to maintaining breast health.