BI-RADS
Brief definition
BI-RADS stands for “Breast Imaging Reporting and Data System” — an internationally standardized scale for classifying mammography, breast ultrasound and breast MRI findings. The scale runs from 0 to 6 and says how likely it is that an area the radiologist has spotted is cancer. You will usually find the number right up front in the results letter you get after a mammogram.
What is behind this finding?
Here is what each category means. BI-RADS 0 = the finding is incomplete, more imaging is needed. BI-RADS 1 = normal. BI-RADS 2 = clearly benign, such as a straightforward cyst or a typical calcification. BI-RADS 3 = probably benign, with a follow-up scan in 6 months to be sure (risk of cancer ≤2%). BI-RADS 4 = suspicious enough to biopsy (risk 2–95%, usually split further into 4a, 4b and 4c). BI-RADS 5 = highly suspicious for cancer (>95%). BI-RADS 6 = cancer already confirmed by biopsy. Radiologists assign the number using well-defined criteria: the shape of the finding, its margins, its density and any changes around it.
What does this mean for you?
BI-RADS 1 and 2 are the all-clear: you go back to your normal screening schedule. BI-RADS 3 causes the most anxiety, because it sits in between — the finding is very likely benign, but you are asked to come back sooner to confirm that it has not changed. BI-RADS 4 calls for a biopsy, though that single number covers an enormous range of risk: a 4a is a very different situation from a 4c. The subcategory is what tells you how urgent this is and what happens next.
When is a second opinion worthwhile?
A second read pays off most in the gray zone — BI-RADS 3 and 4a. Radiologists disagree about these categories more often than you might expect: studies put agreement at only 60–70%. A second opinion can spare you a biopsy you did not need, or move a biopsy you do need to the front of the line. At Second View, breast imaging specialists review your mammogram or breast MRI within 48 hours.
How can I request a second opinion?
1. Get in touch
Contact us through our platform.
2. A radiologist gets back to you
A board-certified radiologist contacts you personally and works with you to pin down exactly which question the second opinion should answer — and whether your existing images (MRI, CT, or X-ray) are suitable for a second read.
3. Transparent, upfront pricing
You then receive a firm quote — usually €70–150, depending on the type of exam.
4. The second reading
Once you approve and pay, our radiologists — all licensed to practice in Germany — review your images carefully and independently.
5. Your report & follow-up questions
Your report arrives digitally, written in plain, easy-to-understand language.
If anything is unclear, you can speak directly with the radiologist who read your images.
Tip:
Many private health insurers reimburse some or all of the cost of a radiological second opinion.
You’ll receive an invoice you can submit to your insurer. If you have German statutory health insurance (GKV), you currently pay for the second opinion yourself — statutory insurance does not cover it (Section 27b of the German Social Code, Book V).