Beyond the breast: Mammographic manifestations of systemic disease

Mammography is traditionally regarded as a domain confined to the detection of breast malignancies; however, it can also serve as a mirror for diverse systemic, haematological, autoimmune, infectious, and metabolic diseases. Imaging manifestations may reveal distinctive pathognomonic features that directly suggest an underlying systemic disorder or provide subtle indirect clues that prompt timely multidisciplinary evaluation, thereby sparing patients from unnecessary procedures. In this comprehensive review, we present one of the most diverse compilations of extramammary and systemic disorders manifesting within the breast. Through multimodality imaging and clinico-pathological correlation, we illustrate entities ranging from tubercular mastitis, IgG4-related mastitis, breast lymphoma, breast metastases, to vasculitis, amyloidosis, diabetic mastopathy, and systemic failure states, including cardiac and renal disease. Mammography provides an underutilised opportunity to assess overall patient health, guide systemic illness workup, and aid in risk stratification for conditions such as cardiovascular disease or syndromic malignancy predisposition, in addition to cancer detection. By consolidating these entities into a single resource, this article aims to expand the interpretive lens of breast radiologists, improving diagnostic precision and enabling them to contribute decisively to multidisciplinary patient care.