Understanding BIRADS Scores: What Do They Really Mean for Breast Cancer Risk?

Question
My doctor told me that 60% of lesions labeled as BIRADS 5 are cancerous.  Yet everything I've read on-line says BIRADS 5 findings have a high probability (at least 95%) of being cancer.  Would a doctor intentionally mislead a patient?  Now I don't know if I can believe what he says.  

Answer
Yes, certain radiological clues indicate a higher or lower probablity for breast cancer. Birad 4 is called suspicious and a cancer risk of around 20 % is claimed, BIRAD 5 is highly suspicious for breast cancer and a risk for cancer of more than 80% is claimed. But all such materials deals with vast number of cases. It is not of much help when dealing with a single case! Furthermore X-ray pictures do not give us any firm cancer diagnosis. The only way to get that is by a biopsy, easiest & quickest by a needle biopsy. If mammography always was combined with MRI & ultrasound scans and biopsies (mostly needle biopsies) of ALL significant lesions a very high diagnostic security would be obtained! A discussion of BIRAD should not be allowed to become too scholastic. It is an easy rule of thumb method. But the firm basis of diagnosis remains as before to be the biopsy!
Maybe he was himself misled? The important lesson here is to do biopsies even when the signs of cancer are not that evident to be on the safe side. With needle biopsies that is not too difficult or expensive or time consuming!