Background: To determine whether solid breast masses with benign sonographic features have less than 2% incidence of malignancy, allowing management by follow up instead of biopsy. Patients and Methods: Sonography reports of solid breast masses from February 2021 to the end of February 2022 in Al-Yarmouk teaching hospital, prospectively classified as probably benign (BIRAD III) or low suspicion (BIRAD IVa) were reviewed .The BIRADS categories were correlated with outcome data and tissue diagnosis. Results: The study population included 136 lesions in 100 patients (mean age 36.78 years, range 11-79 years). A total of 63 lesions were prospectively classified as BIRAD III and 73 lesions as BIRAD IVa. A total of 133 lesions were proved as benign lesions and only 3 lesions were malignant. All 3 malignancies seen in women older than 50 years. Conclusions: The incidence of malignancy in solid breast lesions classified as BIRAD III was 1.5 % and in BIRAD IVa was 2.7 %. Palpability alone does not considered as features to rise up the BIRAD grade of any breast lesions.