Breast neoplasms

Breast neoplasms consist of a wide spectrum of pathologies from benign proliferations, high risk lesions, precursor lesions, to invasive malignancies.​ This article provides an overview for radiologists, with a focus on breast cancer. For a summary article for medical students and nonradiologists, see breast cancer (summary).

Breast cancer is the most common nonskin malignancy in women. In the affluent populations of North America, Europe, and Australia, 6% of women develop invasive breast cancer before age 75, compared to a 2% risk in developing regions of Africa and Asia 8. The difference has been attributed to risks associated with a Westernized lifestyle, including high calorie diet rich in fat and protein and physical inactivity 8.

The main pathological classification of breast neoplasms is published by the World Health Organization: WHO classification of tumors of the breast.

The vast majority of breast cancers are adenocarcinomas (99%). The most common types are 8:

Categories of benign epithelial neoplasms include: 

Nonepithelial malignancies are uncommon and include:

Three molecular biomarkers are routinely evaluated in invasive breast cancers because they have therapeutic implications:

  • estrogen receptor (ER)
  • progesterone receptor (PR)
  • human epidermal growth factor receptor 2 (HER2; protooncogene Neu; receptor tyrosine protein kinase erbB-2)

Staging of breast tumors is performed according to the TNM system published by the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC): breast cancer (staging).

Dedicated evaluation of the breast involves multiple imaging modalities to detect and localize lesions for biopsy. In all modalities, regional metastasis can be suspected by the presence of axillary adenopathy.

Neoplasms have varied appearances, including masses, asymmetriescalcifications, or architectural distortions

Neoplasms can appear as masses or architectural distortionsCalcifications can sometimes be seen.

Neoplasms can manifest as masses with or without enhancement, nonmass enhancement, or foci of enhancement.

Breast masses may be incidentally identified but CT is not the preferred modality for dedicated breast evaluation. If calcifications are visualized on CT, they are nearly all benign 9.

The use of a standard lexicon is recommended to enhance communication with referrers and audit performance: breast imaging-reporting and data system (BI-RADS).

Breast imaging and pathology
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Article information

rID: 1016
System: Breast, Oncology
Synonyms or Alternate Spellings:
  • Breast carcinoma
  • Breast cancer
  • Breast neoplasm
  • Breast cancers
  • Breast malignancy
  • Breast tumours
  • Breast tumors
  • Breast tumor
  • Breast tumour
  • Breast malignancies

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Cases and figures

  • Mass with Nipple ...
    Case 1: mass with nipple retraction
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  • Case 2: metaplastic carcinoma of breast
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  • Case 3: PET scan
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  • Case 4: invasive ductal carcinoma
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  • Case 5: breast cancer metastasis
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  • Case 6: spinal metastases from breast cancer
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  • Diffuse Breast Ca...
    Case 7: diffuse breast cancer metastases
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  • Breast Cancer Met...
    Case 8: breast cancer metastases
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  • Intraductal carci...
    Case 9: intraductal carcinoma
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  • left cc
    Case 10: advanced breast cancer
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  • Case 11: on CT
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  • Case 12: invasive ductal carcinoma
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  • Case 13
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  • Case 14: malignant epithelial neoplasm
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  • Case 15: on chest x-ray
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  • Breast screen fil...
    Case 16: Granular cell tumor of the left breast
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  • Case 17: Diffuse large B-cell lymphoma of the breast
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  • Case 18: intraductal papilloma
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