ADVANCES IN BREAST CANCER DIAGNOSIS AND TREATMENT: ESSENTIALS

Advances in breast cancer diagnosis and treatment Essentials_kapak

RADIOLOGY AND BI-RADS CLASSIFICATION

Hakan Abdullah Özgül

İzmir Atatürk Training and Research Hospital, Department of General Surgery, İzmir, Türkiye

Özgül HA. Radiology and BI-RADS Classification. In: Citgez B editor. Advances in Breast Cancer Diagnosis and Treatment Essentials. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.31-42.

ABSTRACT

Breast cancer remains the most common malignancy among women worldwide, and early diagnosis is critical in reducing mortality and improving treatment success. In this section, current radiological modalities used in the evaluation of breast cancer-mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI)-are comprehensively discussed in the context of technological innovations and their integration with the Breast Imaging Reporting and Data System (BI-RADS) classification system. Mammography is considered the gold standard in community-based screening due to its high-resolution imaging capability, and it has improved the detection of lesions in dense breast tissue, particularly with advanced techniques such as digital breast tomosynthesis (DBTS) and contrast-enhanced spectral mammography (CESM). Ultrasonography is preferred in younger age groups and dynamic clinical situations such as biopsy guidance or axillary evaluation due to its lack of ionizing radiation and real-time imaging capabilities. Advanced techniques such as color Doppler US and sonoelastography provide additional information about the vascular structure and tissue stiffness of lesions, supporting their characterization. Magnetic resonance imaging (MRI) is the most sensitive method for detecting breast cancer, especially in high-risk groups, and provides detailed morphological and functional information through dynamic contrast-enhanced sequences, diffusion-weighted imaging (DWI), and research-level magnetic resonance spectroscopy (MRS). MRI plays an indispensable role in surgical planning, evaluating treatment response, and investigating implant integrity or occult lesions. The chapter also discusses in detail the imaging characteristics of ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), and rarer subtypes (tubular, medullary, mucinous, metaplastic, etc.). Each subtype exhibits unique radiological appearances across different modalities, emphasizing the importance of multimodal correlation. Finally, the BIRADS system, a standardized system for reporting imaging findings, is addressed; clinical guidance and patient management strategies are explained through established criteria and risk classifications for MG, US, and MRI. The integration of advanced imaging techniques into the BI-RADS system contributes to individualized patient care by improving diagnostic accuracy.

Keywords: Breast neoplasms; Magnetic resonance imaging; Mammography; Radiology; Ultrasonography

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