BI-RADS, Risk, and the Rating Game
blog 6 of
This Might Be Dense:
and other stories about your girls
Welcome to This Might Be Dense: and other stories about your girls.
This blog series pulls the curtain back on a part of the body that’s been so sexualized, it’s still censored: on social media, in schools, and even in medical conversations. And yet, over half a million women die each year from breast cancer.
Censoring information about women’s bodies doesn’t protect us: it endangers us.
So, this series is both personal and practical.
It’s a love letter. A rage howl. A guidebook.
It’s a reminder that ya girls were never meant to be a mystery, especially to you.
What Your Report Says and What It Actually Means
Understanding your mammogram report can be daunting, especially when faced with terms like “dense breast tissue” and “BI-RADS score.” Let’s break down these concepts to help you navigate your results with confidence. Because when you go in for a mammogram and you get a letter a few days later and it says something like: “Your screening showed dense breast tissue. Your BI-RADS score is 3. Follow-up in 6 months,” it doesn’t exactly inspire confidence. You might be left feeling like, “Cool. So am I dying or not?”
What Is BI-RADS?
BI-RADS stands for the Breast Imaging Reporting and Data System, a standardized framework developed by the American College of Radiology to categorize mammogram findings. This system ensures consistent reporting across medical professionals and helps in determining the next steps in patient care.
Here’s what those numbers actually mean:
BI-RADS 0: Incomplete. We need more imaging.
BI-RADS 1: Negative. All clear.
BI-RADS 2: Benign findings. Something was there, but it’s fine.
BI-RADS 3: Probably benign. Less than 2% chance of cancer. But come back in 6 months.
BI-RADS 4: Suspicious. Biopsy recommended. (This one has A, B, and C subcategories. Yes, it’s ridiculous.)
BI-RADS 5: Highly suggestive of malignancy. Immediate action needed.
BI-RADS 6: Confirmed cancer. Imaging used for monitoring.
Dense Breast Tissue and Its Implications
Dense breast tissue refers to breasts with higher amounts of fibrous and glandular tissue compared to fatty tissue. On a mammogram, both dense tissue and tumors appear white, making cancer detection more challenging. This means that even a BI-RADS 1 result might not be entirely reassuring if you have dense breasts.
BI-RADS 3: The Emotional Rollercoaster
BI-RADS 3 is the worst roommate. It says, “Hey, this probably isn’t cancer, but I’m gonna live in your head rent-free for six months.”
It’s an in-between category. It tells your doctor to “monitor,” but gives you no plan, no clarity, and no peace of mind.
If you’re assigned BI-RADS 3 and have dense breasts, ask:
Was this because of actual visual concern?
Or just density?
Can I get a second look with ultrasound or MRI?
Understanding Risk Beyond Genetics
While family history and genetic factors like BRCA mutations are well-known risk indicators, other factors also contribute to breast cancer risk:
Early menstruation or late menopause.
Long-term use of hormonal birth control.
Fibrocystic breast changes.
Regular alcohol consumption.
Chronic stress or prolonged inflammation.
Discussing these factors with your healthcare provider can lead to a more accurate assessment of your risk profile.
The Importance of Advocacy in Healthcare
There’s actually a study (yes, a real one) showing that breast cancer patients who are more assertive have better outcomes. The “difficult” women going through a breast cancer diagnosis survive more often. Being assertive — asking questions, seeking second opinions, and requesting detailed explanations — can lead to more personalized and effective care.
Remember, advocating for your health is not being difficult; it’s being proactive. Request your full mammogram report, understand your BI-RADS score, and discuss additional imaging options if necessary. Your health and peace of mind are paramount.
Advocating Isn’t Rude, It’s Smart
Why?
Because people who advocate get second opinions: more brains on the issue at hand.
They ask better questions: curiosity begets curiosity.
They don’t settle for vague because concrete answers matter.
So go ahead and ask for your full report. Get your density score. Say, “I’d like additional imaging given my risk profile.” Sound like what you think a bitch sounds like, it’s really ok.
You are not being dramatic. You’re not being pushy.
You are being alive.
This article is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider regarding any concerns or questions about your health.
If this post helped you feel more informed, keep going. This Might Be Dense: And Other Stories About Your Girls is a full series: part practical guide, part personal reclamation, all grounded in research, rage, and reverence.
🧬 Understand breast tissue types
🍼 Explore milk, hormones & density
🔥 Learn how to manage pain & fibrocystic changes
📊 Decode your BI-RADS score and risk (current post)
🩻 Know your imaging options & how to advocate
💬 Say the quiet parts out loud
🌍 Understand environmental exposures & plastic’s impact
👐 Get the breast ritual PDF to care for your girls
YOU DESERVE TO KNOW YOUR BODY BEFORE ANYONE ELSE DEFINES IT FOR YOU.
