乳腺影像学放射科医生经常根据与恶性肿瘤概率相关的特征，在乳腺成像引导下对可疑乳腺病变进行活检，恶性肿瘤的可能性在2%至95%以上（乳腺成像报告和数据系统分类4和5）。作为诊断合作伙伴，病理学家对这些组织样本进行组织病理学评估以确认诊断。将成像结果与组织病理学结果进行对应是多学科乳腺护理的一个重要方面。评估放射病理一致性在指导适当管理方面至关重要，因为它可以帮助发现不一致的结果，从而减少误诊的机会。取样不足可能导致假阴性结果，假阴性诊断的频率因多种因素而异，包括活检类型（如穿刺针、吸引针）、针头规格和活检时样本取自的病变类型（例如肿块、钙化、不对称性、结构紊乱）。提高放射科医生对宏观和微观乳腺解剖学以及常见乳腺疾病及其预期成像结果的认识，可以确保更准确的放射病理学对应和管理建议。生物检测乳腺病变的组织病理学和分子特征有助于做出准确的诊断。血红蛋白-伊红染色提供了关键的形态学细节，而免疫组织化学染色则可以实现许多良性和恶性病变的分子特征描述，这对于个体化治疗非常关键。作者回顾了常见的良性和恶性乳腺疾病，它们相应的组织病理学表型以及确诊这些病变所必需的组织病理学标志物。作为提供最佳患者护理的多学科团队的一部分，放射科医生应了解组织病理学诊断的基础知识和对患者管理的影响，以确保适当的放射病理一致性。©RSNA，2023本文的测验问题可在补充资料中找到。

Breast imaging radiologists regularly perform image-guided biopsies of suspicious breast lesions based on features that are associated with a likelihood of malignancy ranging from 2% to greater than 95% (Breast Imaging Reporting and Data System categories 4 and 5). As diagnostic partners, pathologists perform histopathologic assessment of these tissue samples to confirm a diagnosis. Correlating the imaging findings with the histopathologic results is an integral aspect of multidisciplinary breast care. Assessment of radiologic-pathologic concordance is vital in guiding appropriate management, as it enables identification of discordant results, minimizing the chance of misdiagnosis. Undersampling can lead to false-negative results, with the frequencies of false-negative diagnoses varying on the basis of multiple factors, including biopsy type (eg, core needle, vacuum-assisted needle), needle gauge, and type of lesion sampled at biopsy (ie, mass, calcifications, asymmetry, architectural distortion). Improving a radiologist's knowledge of macroscopic and microscopic breast anatomy and more common breast diseases and their expected imaging findings ensures more accurate radiologic-pathologic correlation and management recommendations. The histopathologic and molecular characteristics of biopsy-sampled breast lesions aid in making an accurate diagnosis. Hematoxylin-eosin staining provides critical morphologic details, whereas immunohistochemical staining enables molecular characterization of many benign and malignant lesions, which is critical for tailored treatment. The authors review commonly encountered benign and malignant breast diseases, their corresponding histopathologic phenotypes, and the histopathologic markers that are essential to clinching the diagnosis of these entities. As part of a multidisciplinary team that provides optimal patient care, radiologists should be knowledgeable of the foundations of histopathologic diagnosis and the implications for patient management to ensure appropriate radiologic-pathologic concordance. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.