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Objectives: To evaluate the necessity of a prolonged follow-up after one year for lesions incidentally diagnosed as Breast Imaging Reporting and Data System (BI-RADS)(®) 3 on magnetic resonance imaging (MRI)., Methods: Institutional review board approved this study (CRC_june 2014_ project 11). We retrospectively analysed 218 consecutive MRI BI-RADS(®) 3 lesions in 110 women followed-up at 6, 12, 18 and/or 24 months from 2011 through to 2015. We excluded MRI scans of BRCA mutation carriers, in staging before treatment and in patients undergoing therapy for breast cancer. Second-look ultrasound and mammography were normal. We analysed 43 masses, 46 foci and 129 non-mass enhancements. In the follow-up, the image was scored as BI-RADS(®) 2 if it was completely resolved, BI-RADS(®) 3 if it was stable, and BI-RADS(®) 4 if a suspicious change occurred., Results: Forty-four lesions (20%) completely resolved during the follow-up. Six were scored as BI-RADS(®) 4: five at 6 months (benign) and one at 12 months (8 mm invasive ductal carcinoma). One hundred and sixty eight stable lesions were assigned BI-RADS(®) 2 at 18 or 24 months. The predictive positive value of cancer for BI-RADS(®) 3 lesions is 0.5% (95% CI [0.08-2.55]) in our study., Conclusions: Our results suggest that a one year follow-up instead of two years is sufficient for BI-RADS 3 lesions, in case of using rigorous inclusion criteria. Given the very low PPV of the BI-RADS(®) 3 lesions incidentally found on MRI, further studies with very large inclusions are necessary to establish new guidelines for MRI follow-up., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The new molecular classification of breast cancers defines cancer sub-groups with a distinct prognosis and response to treatment. Studies on the literature deal with the imaging of each tumour sub-type. The radiologist should be familiar with them in order to adapt the care of an aggressive sub-type. In view of the current knowledge, the following have been significantly more often observed: mammographical spiculated mass with echogenic halo in luminal A sub-type; architectural distortion in luminal B sub-type; an irregular mass with indistinct margin comprising microcalcifications, with an abrupt interface in the sonography, or non-sonographic mass in the HER2 sub-type; a very hypoechogenic, lobulated mass with indistinct or microlobulated margin, with an abrupt interface, sometimes pseudo-benign, in the triple-negative sub-type., (Copyright © 2013 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

The histological type of tumour according to the WHO: ductal, lobular, rare forms, is correlated with specific aspects of the imaging based on each type. This morphological classification was improved by knowledge of the molecular anomalies of breast cancers, resulting in the definition of cancer sub-groups with distinct prognoses and different responses to treatment: luminal A, luminal B, HER2 positive, basal-like, triple-negative. Studies are beginning to deal with the appearance of each sub-type in the imaging. It is now important for the radiologist to be familiar with them., (Copyright © 2013 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.)