Hi
Thank you for posting in Doctor spring.
BI RAD classification will give a clue to the lump in the breast whether it is benign or cancer.
It is not confirmatory test.
The disease is confirmed only by histopathological examination.
Please get an FNAC ( Fine Needle aspiration Cytology ) of the swelling. If it is inconclusive, then Biopsy has to be done for exact diagnosis.
If it comes as malignant, then definitive surgery has to be planned.
Now a days,Wide excision which removes the lump along with surrounding tissue is preferred to Total mastectomy.
But,the procedure depends on the Surgeon and also the hospital.
I prefer to go with wide excision followed by Radiotherapy and chemotherapy.

I saw the report and pics.
There is an irregular lump in the left breast. Another important finding is enlarged axillary lymph node.
Axillary lymphnodes will be enlarged in infection,Cancer of the breast etc.
It is better to get Biopsy of the breast lump and proceed accordingly.
Please do not depend completely on Mammography.
If you come back with histopathological report, I will clarify further.
Hope I answered your query.
If you have any questions, I will clarify further.
Wish you good health.
Regards