Viva · Specialty
Breast Viva Questions
Oral-exam style questions and answers on breast for MD, DNB and super-specialty practical examinations. Each answer links back to the playbook or Library entry it was written from.
- What is the purpose of the BI-RADS assessment categories?
- They provide a standardised final breast imaging assessment linked to malignancy likelihood and an appropriate management recommendation.
- Enumerate the BI-RADS final assessment categories.
- Category 0 is incomplete; 1 negative; 2 benign; 3 probably benign; 4 suspicious; 5 highly suggestive of malignancy; and 6 known biopsy-proven malignancy.
- What does BI-RADS category 0 mean?
- The assessment is incomplete because additional imaging evaluation and/or comparison with prior examinations is required before assigning a final category.
- What is the malignancy likelihood and management of BI-RADS category 3?
- The likelihood of malignancy is greater than 0% but no more than 2%. Short-interval imaging follow-up is recommended after a complete diagnostic evaluation.
- How is BI-RADS category 4 subdivided?
- Category 4A represents greater than 2% to 10% risk, 4B greater than 10% to 50%, and 4C greater than 50% but less than 95%. Tissue diagnosis should be considered for all three.
- What distinguishes BI-RADS category 5 from category 4C?
- Category 5 has at least a 95% likelihood of malignancy and imaging features highly suggestive of cancer, whereas category 4C remains below 95% despite high suspicion.
- What is the essential requirement for assigning BI-RADS category 6?
- The malignancy must already have been confirmed histologically, and the imaging must be performed before definitive treatment.
- What is a common misuse of BI-RADS category 3?
- Using it for an incompletely evaluated or indeterminate finding. Category 3 is restricted to appropriately characterised probably benign findings with a malignancy likelihood of no more than 2%.