The conundrum of breast cancer mimics

The BIRADS lexicon ensures a standard reporting terminology in breast imaging and serves as a means of smooth communication between the radiologist and the referring physician. BIRADS assessment categories 4 and 5 warrant a biopsy to rule out underlying malignancy. However, a substantial number of cases in these categories sometimes turn out to be benign on biopsy. These benign mimics encompass inflammatory, sclerosing, neoplastic and a few other miscellaneous conditions. Awareness of these various mimics of breast cancer can equip the radiologist to handle these apparent cases of radiologic-pathological (rad-path) discordance better, guide overall patient management, avoiding inadvertent excisional biopsies and help alleviate patient anxiety and confusion.