BI-RADS 3 - requested biopsy

Oh gosh, so young!

My 3's came post treatment. Once I think I just tapped my breast with a weight and I injured it. Had it only go to a 4 in six 6 months after doing that, so had a biopsy last year and it was fat necrosis. I'm at a 3 (again) so don't know yet if this stuff in there will change it again to a 4 or not. Like I said though, at least I know what it is, and it isn't cancer. Let us know how you make out.

The cancer rate for lesions rated as BI-RADs 3 is less than 2%. The studies I've seen range from 06% to 1.9%.

I am one of the unfortunate 2% with a Birads 3 that turned out to be IDC. It was recommended I return for more imaging in 6 months.
However, I felt my risk was high enough to warrant a biopsy, as I had a positive anterior margin after my mastectomy. My mastectomy surgery was only 14 months prior to me finding a small bb lump in my reconstruction. All my docs believed it was fat necrosis by the way it felt, the timing and imaging results.

Sending you well wishes and I hope you get your biopsy soon for your piece of mind and the result is B9!

General surgery? Usually core needle biopsies are done at imaging centers by radiologists - this is their area of expertise and what they are trained for. Surgeons are trained to do surgery. Hopefully the surgeon sets you up for a core needle biopsy with a radiologist. The one fly in the ointment could be the very tiny size of the lesion, which perhaps could make a needle biopsy more difficult. To me, surgery seems excessive for a BI-RADs3 and if that is the recommendation, it puts back into question whether you should follow the original recommendation and do a short-term imaging follow-up.

Since your lesion is visible on an ultrasound, I would expect that you will have an ultrasound-guided core needle biopsy. This is definitely easier than a stereotactic biopsy, which is a mammogram-guided core needle biopsy. I've had 2 ultrasound-guided and 2 stereotactic. With ultrasound-guided you are lying down relatively comfortably. The radiologist does an ultrasound, you get an injected with a local anesthesia, and then several samples are take using the core needle, which is a hollow needle that retrieves a small amount of the breast tissue. The one thing to be aware of is the sound - the core needle sounds like a loud staple gun. The other thing to be aware of is that if you feel anything, you should immediately let the radiologist know - the biopsy should be painless. It is really is an easy biopsy. Stereotactic biopsies use the same needle but you are either sitting in a chair or lying face down on a table, with your breast squished in a mammogram machine. Much more awkward and uncomfortable, which is why ultrasound-guided biopsies are always done as the first choice, if the area of concern shows up clearly on both an ultrasound and a mammogram.

Excisional biopsies are essentially the same as lumpectomies, although with a different objective (to biopsy rather than to remove a known cancer) and without the requirement that the surgeon remove extra tissue to try to get clear surgical margins. It's usually a short surgery but with general anaesthesia. I've had 3 of those. Never had any problems but I'll always be happy to avoid general anaesthesia if I can.

Hi~hope it turns out well for you. I had a Birad 3 on a sono that returned out to be benign but when they did the other breast a mass showed up which was not. I had a core biopsy and then surgery, chemo & now radiation. It was a stroke of luck that the cancer was found. The entire thing got delayed by Covid but I feel very lucky that it was found when it was. You def did the right thing to request a biopsy. Better safe than sorry. Good luck!