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Breast Imaging

E3163. False-Positive Breast Lesions: Imaging Features and Histologic Correlation

Braga F,  Endo E,  Moraes P,  Kim S,  de Barros N. Radiology Institute, University of São Paulo, São Paulo, Brazil

Address correspondence to E. Endo (quinhapop@gmail.com)

Background Information: A lesion classified as category 5 according to the BI-RADS lexicon is highly suggestive of malignancy. The associated probability of malignancy can be higher than 95%, and appropriate action should be taken. However, in rare cases, a BI-RADS category 5 lesion can have a benign histopathology result. Benign histologic findings in this category should be carefully reviewed and accepted only after close radiology, pathology, and clinical correlation. In this scenario, sometimes other images modalities, such as MRI, can be helpful for planning the best action for each case. The objective of this exhibit is to illustrate various lesions classified as final category 5 that can be accepted as benign after histologic percutaneous diagnosis.

Educational Goals/Teaching Points: Benign histopathology results from a lesion with findings highly suggestive of malignancy may cause diagnostic dilemmas and may be misinterpreted as a discordant breast biopsy. We will discuss different types of benign breast lesions with histology concordant with BI-RADS category 5. Mammography, ultrasound, and MRI will be used to show specific and expected findings in each case (literature review).

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: The goal of this exhibit is to recognize different types of benign breast diseases that can cause false-positive lesions on mammography, ultrasound, and MRI and correlate with histology results. We will also discuss the management approach to such cases.

Conclusion: Radiologists must be aware of several diseases that can be highly suggestive of malignancy and should not be misinterpreted as a discordant breast biopsy, thus reducing false-positives and avoiding unnecessary surgeries.