Magnetic Resonance Imaging in the Diagnosis of Breast Diseases. The Criteria of Assesments

Relevance: Breast diseases remain one of the leading causes of cancer morbidity among women, which necessitates improvement of early diagnostic methods and differential assessment of pathological changes. Dynamic contrast-enhanced magnetic resonance imaging (MRI) plays a key role in detecting focal and infiltrative breast lesions, especially in patients with dense breast tissue and elevated oncologic risk. The update of the BI-RADS v2025 system requires reconsideration of MRI interpretation criteria and their clinical application.

Purpose: To analyse and systematise criteria and uncertainties in MRI assessment for diagnosis and differential diagnosis of breast diseases considering updated BI-RADS v2025 recommendations.

Materials and methods: Publications from 2021–2025 indexed in PubMed, Scopus and eLibrary were analysed. Methodological aspects of multiparametric breast MRI were reviewed, including dynamic contrast enhancement, diffusion-weighted imaging with ADC calculation and morphological assessment according to BI-RADS v2025.

Results: Updated BI-RADS v2025 MRI descriptors improve reproducibility and diagnostic specificity through standardisation of imaging parameters, refinement of margin and peripheral enhancement criteria and formalisation of T2 signal characteristics. MRI demonstrates high sensitivity in detecting both focal and infiltrative breast cancers. Integration with vacuum-assisted biopsy optimises diagnostic and treatment algorithms in indeterminate cases.

Conclusion: Breast MRI remains a key modality for personalised breast diagnostics, surpassing traditional imaging methods in sensitivity. BI-RADS v2025 contributes to reduced interpretation variability, decreased overdiagnosis and expandedclinical application in screening, differential diagnosis and treatment monitoring.

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