[Current approach to breast imaging: Indications, techniques and developments]

Breast imaging plays a central role in breast cancer screening, diagnosis and treatment planning. In patients undergoing oncoplastic surgery, MRI enables a detailed assessment of multifocality and improves the selection of candidates for extended conservative surgery, with a demonstrated benefit in terms of local control. Non-wire tracking devices (magnetic, radar, radiofrequency) offer a comfortable and precise alternative to wire, facilitating dissection and improving operative organization. Macrobiopsies for excision of certain borderline lesions with no atypia enable surgical de-escalation of lesions. Angiomammography represents a relevant alternative to MRI in certain indications. Finally, artificial intelligence opens up new prospects at every step of the way: improved acquisition quality, automated detection of suspicious anomalies, assisted characterization of lesions to refine diagnoses, and personalized estimation of long-term risk. The radiomics approach, by extracting quantitative biomarkers from images, could eventually enrich this personalization, although it remains limited to date by the lack of transferability of models. These advances, while promising, raise major ethical issues linked to the transparency of algorithms, shared responsibility in interpretation, and the need for rigorous clinical validation.