BI-RADS 0 on a Mammogram: Why Is the Result Incomplete?

BI-RADS 0 means the mammogram is incomplete. The radiologist cannot give a final result yet and needs more imaging, such as extra mammogram views or an ultrasound, or a comparison with your older mammograms. It is not a diagnosis, and most people who are called back are not found to have breast cancer.

BI-RADS stands for Breast Imaging Reporting and Data System, a shared scale radiologists use to word mammogram reports consistently. Categories 1 to 6 are final assessments. Category 0 is the only one that says, in effect, 'not finished yet'. This guide explains the category in general terms and cannot interpret your own images.

A recall appointment does not replace seeing a clinician about new symptoms. The NHS advises seeing a GP or other clinician if you notice any of the changes below, or anything in your breasts or nipples that is not normal for you. If you are already waiting for recall imaging, mention it when you get in touch.

• A lump or swelling in the breast, chest or armpit.
• Dimpling of the skin, or skin that looks like orange peel.
• A change in skin colour, such as redness or darker skin than usual.
• A change in the size or shape of one or both breasts.
• Nipple discharge when not pregnant or breastfeeding, especially if it contains blood.
• A nipple that turns inwards, changes shape or develops a rash.

A screening mammogram looks for signs of cancer in people with no breast symptoms. When something needs a closer look, the result is often reported as BI-RADS 0 and you are invited back. The American Cancer Society lists several common reasons:

• The images were unclear or did not show all of the breast, so they need to be retaken.
• The radiologist saw something that needs a closer look, such as calcifications or a mass, which could be a fluid-filled cyst or a solid lump.
• One area looks different from the rest of the breast tissue.
• There are no earlier mammograms to compare with. Recalls are more common after a first mammogram for this reason.

No. The American Cancer Society says it is common to be called back and that fewer than 1 in 10 women called back for more tests are found to have cancer. The National Cancer Institute and the NHS also say that most people who need further tests are not found to have breast cancer.

RadiologyInfo, from the American College of Radiology and RSNA, says that 5 to 15 percent of screening mammograms need more testing, such as additional mammograms or ultrasound, and that most of these tests turn out to be normal. Rates vary between countries and services, so ask your own service if you want local figures.

The extra tests depend on why you were called back. The American Cancer Society describes a diagnostic mammogram, which takes more images of the area of concern, and sometimes an ultrasound of the breast. The NHS lists a breast examination, more mammograms and ultrasound, and says a needle biopsy is sometimes done. Some services do several of these on the same day.

Sometimes no new imaging is needed. Cleveland Clinic notes that a BI-RADS 0 result can mean the radiologist wants to compare the latest images with older ones. The American Cancer Society adds that findings which have not changed from older mammograms are not likely to be cancer. If you have had mammograms elsewhere, tell the service so the images can be requested. The National Cancer Institute describes category 0 simply as needing additional imaging before a final category can be assigned, so the recall is a step in the assessment rather than an answer in itself.

After the extra imaging, the radiologist gives a final BI-RADS category. Many recalls end with a normal or benign result and a return to routine screening. Some lead to a 'probably benign' result with short-interval follow-up, and a smaller number lead to a biopsy recommendation.

Your letter or the imaging service should give an appointment or tell you how to book one. The American Cancer Society suggests asking your doctor when further tests should be scheduled. If you have not heard anything, or the date you are offered seems a long way off, contact the service or the clinician who ordered the mammogram and ask whether that timing is right for you.

Waiting for a recall can feel stressful. The NHS notes that recall letters usually explain how to contact a breast care nurse, who can answer questions before the appointment.

Bring the written report and, if you know them, the dates and places of earlier mammograms. These questions can help.

• Why was my result incomplete: image quality, a specific finding, or missing older images?
• Which side of the breast, and which area, needs another look?
• Which tests are planned: extra mammogram views, ultrasound or something else?
• Will I get the result on the day, and who will explain it?
• Can my older mammograms be obtained for comparison?
• Does my breast density affect what happens next?
• Who should I contact if I notice a breast change before the appointment?

On SameCase, patients and verified doctors share de-identified cases. Reading how other people's BI-RADS 0 recalls went, such as which extra views or scans were done, can help you write down questions before your appointment.

Someone else's case cannot predict your result. Use these cases only to prepare questions, and rely on your radiologist and care team for decisions about your imaging.

A BI-RADS 0 result means the picture is not complete yet. Attending the recall appointment lets the radiologist reach a final category. Keep copies of your reports, note your appointment date, and seek care sooner if you notice any new change in your breasts.