[Breast lesion diagnosis: integrating pathology and radiology]

Preoperative breast biopsies do not always provide a complete picture of a breast abnormality, especially in the subgroup of breast lesions classified as BI-RADS category 4 ('suspicious'). In such cases correlation with imaging results is mandatory. Sometimes ultrasound is the best modality, as demonstrated here in a 77-year-old patient with an intracystic papillary carcinoma with invasion. At other times mammography is preferred, as we demonstrate in a 50-year-old patient with screen-detected microcalcifications, initially diagnosed as ductal carcinoma in situ of the clinging type, later diagnosed as benign ductal hyperplasia. Finally, in a 45-year old patient with a palpable mass, caused by a grade III ductal carcinoma in situ, successful excision with tumour-free margins was achieved thanks to preoperative MRI.