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Mammography will continue as the breast cancer screening imaging study of choice for the foreseeable future. Ultrasound and magnetic resonance imaging (MRI) are widely available adjunctive studies for women with suspicious mammographic or clinical findings, and MRI is a screening tool for women with specific increased risks for breast cancer. Options for diagnosis will continue to evolve and progress. This article discusses a wide variety of imaging options currently used and in development, their strengths, limitations, and potential future roles in the continuing pursuit of early breast cancer diagnosis, treatment, and follow-up.

A common endeavor shared by physicians practicing in specialty fields of Radiology and Obstetrics and Gynecology is the comprehensive care and diagnosis of women with breast problems and breast disease. Because each specialty provides its respective clinical expertise in breast health, each also shares a concern, which is the high risk of litigation associated with a missed or delayed diagnosis of breast cancer. This shared concern is well documented for both specialties. Instead, it is argued that physicians are better prepared by engaging in the practice of evidence-based breast care in their respective specialties.

The following topics are discussed in this article. A historical review of the evolution of breast cancer imaging from thermography through digital breast tomosynthesis, molecular breast imaging, and advanced breast magnetic resonance imaging. Discussion of multiple clinical trials, their strengths, and weaknesses. Historical perspective on the Mammography Quality Standards Act and its relationship with development and implementation of the Breast Imaging-Reporting and Data System (BI-RADS).