Introducción:
Algunas patologías benignas de la mama tienen características clínicas y/o de imagen que imitan enfermedades malignas. Este ensayo pictórico describe las características mamográficas, de tomosíntesis digital de mama (DBT) y de ultrasonido (US) de patologías mamarias con hallazgos de imagen sospechosos de malignidad y confirmación histopatológica de benignidad.

Métodos:
Esta serie de casos presenta mujeres con lesiones mamarias que imitan malignidad. Se incluyeron categorías BI-RADS 4 o 5 en mamografía, DBT y US. Se describen la historia, las manifestaciones clínicas y los hallazgos histopatológicos con confirmación diagnóstica de patología mamaria inflamatoria, patología mamaria proliferativa o tumores benignos de mama.

Resultados:
Evaluamos nueve casos de lesiones mamarias con sospecha de malignidad, describiendo hallazgos en mamografía, DBT y US, con correlaciones clínicas y patológicas. Se presentan absceso mamario, mastitis granulomatosa, necrosis grasa, fibrosis estromal, adenosis esclerosante, hiperplasia estromal pseudoangiomatosa (PASH), adenoma tubular, tumor de células granulares y fibromatosis tipo desmoide. Los diagnósticos diferenciales de las patologías benignas que simulan malignidad se basaron en la correlación de hallazgos de imagen y clínico-patológicos.

Conclusión:
Las nueve patologías mamarias descritas no presentaron hallazgos radiológicos patognomónicos para el diagnóstico de benignidad. Se recomendó realizar biopsia de mama y examen histopatológico cuando se encontraran características sospechosas de malignidad en mamografía, DBT y/o US.

Palabras clave:
Lesión mamaria benigna. Masa mamaria. Ultrasonido. Mamografía. Cáncer de mama.

Introduction:
Some benign breast pathologies have clinical and/or imaging features that mimic malignant disease. This pictorial essay describes the mammographic, digital breast tomosynthesis (DBT), and ultrasound (US) features of breast pathologies with imaging findings suspicious for malignancy and histopathologic confirmation of benignity.

Methods:
This case series presents women with breast lesions that mimic malignancy. BI-RADS 4 or 5 categories on mammography, DBT, and US were included. The history, clinical manifestations, and histopathologic findings with diagnostic confirmation of inflammatory breast pathology, proliferative breast pathology, or benign breast tumors are described.

Results:
We evaluated nine cases of breast lesions with suspected malignancy, describing mammography, DBT, and US findings, with clinical and pathologic correlations. Breast abscess, granulomatous mastitis, fat necrosis, stromal fibrosis, sclerosing adenosis, pseudoangiomatous stromal hyperplasia (PASH), tubular adenoma, granular cell tumor, and desmoid-type fibromatosis are presented. The differential diagnoses of the benign pathologies simulating malignancy were based on correlating imaging and clinicopathologic findings.

Conclusion:
The nine breast pathologies described had no pathognomonic radiologic findings for the diagnosis of benignity. Breast biopsy and histopathologic examination were recommended when features suspicious of malignancy were found on mammography, DBT, and/or US.

Key words:
Benign breast lesion. Breast mass. Ultrasound. Mammography. Breast cancer.

Introduction:
Some benign breast pathologies have clinical and/or imaging features that mimic malignant disease. This pictorial essay describes the mammographic, digital breast tomosynthesis (DBT), and ultrasound (US) features of breast pathologies with imaging findings suspicious for malignancy and histopathologic confirmation of benignity.

Methods:
This case series presents women with breast lesions that mimic malignancy. BI-RADS 4 or 5 categories on mammography, DBT, and US were included. The history, clinical manifestations, and histopathologic findings with diagnostic confirmation of inflammatory breast pathology, proliferative breast pathology, or benign breast tumors are described.

Results:
We evaluated nine cases of breast lesions with suspected malignancy, describing mammography, DBT, and US findings, with clinical and pathologic correlations. Breast abscess, granulomatous mastitis, fat necrosis, stromal fibrosis, sclerosing adenosis, pseudoangiomatous stromal hyperplasia (PASH), tubular adenoma, granular cell tumor, and desmoid-type fibromatosis are presented. The differential diagnoses of the benign pathologies simulating malignancy were based on correlating imaging and clinicopathologic findings.

Conclusion:
The nine breast pathologies described had no pathognomonic radiologic findings for the diagnosis of benignity. Breast biopsy and histopathologic examination were recommended when features suspicious of malignancy were found on mammography, DBT, and/or US.

Key words:
Benign breast lesion. Breast mass. Ultrasound. Mammography. Breast cancer.