Radiology of the Normal Breast and Overview of Breast Imaging Reporting and Data System

  • Eloisa Asia Sanchez-Vivar
  • Isabel Alvarado-Cabrero


Until breast cancer can be prevented, regular screening programs are widely recommended for asymptomatic women. The goal of breast cancer screening is early detection of disease, to be followed by appropriate treatment. Evaluating any screening program is challenging, and breast cancer screening has been subject to many controversies over the years. The many modalities that have been studied for possible inclusion in screening programs include screening mammography, ultrasound, and magnetic resonance imaging. Awareness of the breast anatomy is essential in order to generate an accurate differential diagnosis and guide patient management. Use of standardized terminology, report organization, and assessment structures allows radiologists to communicate breast imaging findings to referring physicians clearly and succinctly. The Breast Imaging Reporting and Data System (BI-RADS) lexicon was released by the American College of Radiology (ACR) with the goal of standardizing mammography reporting by providing a specific lexicon of imaging features. The purpose of this chapter is to review current knowledge of breast anatomy with a focus on relevant anatomy for diagnosis and intervention, and to provide a general overview of the BI-RADS lexicon.


Normal anatomy Imaging BI-RADS Lexicon 


  1. 1.
    Jesinger RA. Breast anatomy for the interventionalist. Tech Vasc Interv Radiol. 2014;17:3–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Kettler MD. Breast overview. In: Berg WA, Birdwell RL, Gombos EC, editors. Diagnostic imaging: breast. Salt Lake City, UT: Amirsys; 2006. p. 12–130.Google Scholar
  3. 3.
    Hassiotou F, Geddes D. Anatomy of the human mammary gland. Current status of knowledge. Clin Anat. 2013;26:29–48.CrossRefPubMedGoogle Scholar
  4. 4.
    Geddes DT. Inside the lactating breast: the latest anatomy research. J Midwifery Womens Health. 2007;52:556–63.CrossRefPubMedGoogle Scholar
  5. 5.
    Going JJ, Moffat DF. Escaping from flatland: clinical and biological aspects of human mammary duct anatomy in three dimensions. J Pathol. 2004;203:538–44.CrossRefPubMedGoogle Scholar
  6. 6.
    Stines J, Tristant H. The normal breast and its variations in mammography. Eur J Radiol. 2005;54:26–36.CrossRefPubMedGoogle Scholar
  7. 7.
    Taplin SH, Rutter CM, Finder C, Mandelson MT, Houn F, White E. Screening mammography: clinical image quality and the risk of interval breast cancer. AJR Am J Roentgenol. 2002;178:797–803.CrossRefPubMedGoogle Scholar
  8. 8.
    Majid AS, de Paredes ES, Doherty RD, Sharma NR, Salvador X. Missed breast carcinoma: pitfalls and pearls. Radiographics. 2003;23:881–95.CrossRefPubMedGoogle Scholar
  9. 9.
    Agbenorku P, Agbemor Brayn VE, Aitpillah F, Akpaloo J, Aboah K, Agbenorku E. Ultrasonography as a breast imaging modality: a review. Br J Med Med Res. 2015;9:1–8.CrossRefGoogle Scholar
  10. 10.
    Gokhale S. Ultrasound characterization of breast masses. Indian J Radiol Imaging. 2009;3:242–7.CrossRefGoogle Scholar
  11. 11.
    Crystal P, Strano SD, Shcharynski S, Koretz MJ. Using sonography to screen women with mammographically dense breasts. AJR Am J Roentgenol. 2003;181:177–82.CrossRefPubMedGoogle Scholar
  12. 12.
    Heywang-Kobrunner SH, Bick U, Bradley WG Jr, Boné B, Casselman J, Coulthard A, et al. International investigation of breast MRI: results of a multicenter study (11 sites) concerning diagnostic parameters for contrast-enhanced MRI based on 519 histopathologically correlated lesions. Eur Radiol. 2001;11:531–46.CrossRefPubMedGoogle Scholar
  13. 13.
    Gavenonis SC. Breast MR imaging: normal anatomy. Magn Reson Imaging Clin N Am. 2011;19:507–19.CrossRefPubMedGoogle Scholar
  14. 14.
    D’Orsi CJ, Mendelson EB, Ikeda DM. Breast imaging reporting and data system: breast imaging atlas. 4th ed. American College of Radiology: Reston, VA; 2003.Google Scholar
  15. 15.
    D’Orsi C, Sickles EA, Mendelson EB, Morris EA, ACR BI-RADS Atlas. Breast imaging reporting and data system. Reston VA: American College of Radiology; 2013.Google Scholar
  16. 16.
    Graf O, Helbich TH, Fuchsjaeger MH, Hopf G, Morgun M, Graf C, et al. Follow-up of palpable circumscribed noncalcified solid breast masses at mammography and US: can biopsy be averted? Radiology. 2004;233:850–6.CrossRefPubMedGoogle Scholar
  17. 17.
    Mainiero MB, Goldkamp A, Lazarus E, Livingston L, Koelliker SL, Schepps B, et al. Characterization of breast masses with sonography. Can biopsy of some solid masses be deferred? J Ultrasound Med. 2005;24:161–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Böhm-Vélez M, et al. Combined screening with USG and mammography vs. mammography alone in women at elevated risk of breast cancer. JAMA. 2008;299:2151–63.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Henrot P, Leroux A, Barlier C, Génin P. Breast microcalcifications: the lesion in anatomical pathology. Diagn Interv Imaging. 2014;95:141–52.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Eloisa Asia Sanchez-Vivar
    • 1
  • Isabel Alvarado-Cabrero
    • 2
  1. 1.Radiology DepartmentHospital de Oncologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro SocialMexicoMexico
  2. 2.Department of PathologyHospital de Oncologia, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro SocialMexico CityMexico

Personalised recommendations