Birads classification 4c represents a high likelihood of malignancy, with a probability of malignancy of about 50-94%. However, it is not as typical of malignant manifestations as grade 5. On ultrasound, it is often seen as an irregular substantial mass with unclear borders, and on molybdenum target, it can be seen as infiltration of the margins, or emerging clusters of polypoidal calcifications, and it is recommended that a puncture biopsy or surgical excisional biopsy be performed to clarify the nature of the mass. In the absence of contraindications to surgery, follow-up without diagnosis and treatment is not an option, and some patients may undergo breast MRI for further investigation before invasive examination.