The examination found that breast 4a lumps are malignant and can live for several years, cannot be generalized, mainly related to the specific stage of the tumor and whether active and effective treatment has been carried out, need specific analysis of specific problems. Breast 4a refers to a breast nodule that has reached BI-RADS grade 4a in ultrasound or mammogram grading, suggesting the possibility of malignancy, but the likelihood of malignancy is small, around 5%. For masses graded 4a, patients are advised to have prompt surgery to clarify the nature of the mass. If the diagnosis is benign after surgical excision, regular review will be sufficient and will not affect the patient’s life expectancy. If the diagnosis of breast cancer is confirmed after surgical excision, follow-up treatment is required according to the principles of breast cancer treatment. Generally speaking, if the patient is in early stage of breast cancer, after surgical treatment, most patients have good prognosis and some of them can even be cured and survive for a long time. If the patient has developed extensive spread or metastasis, or the lump is metastasized from other tumors, the prognosis is generally worse and the survival period will be significantly shortened, but the patient’s survival period can still be further prolonged to some extent after active comprehensive treatment. In conclusion, the number of years a breast mass of grade 4a can live varies from person to person, but patients should go to the oncology department of the hospital in time and cooperate with the doctor actively after perfecting the relevant examination to clarify the specific cause. Even if it is malignant, early detection and early treatment can help to reduce the discomfort and prolong the survival period.