Breast MRI is increasingly used as an adjunct to conventional imaging modal
ities, particularly in diagnostic problem cases, but also for pre-operative
staging. It is an extremely sensitive technique, with relatively limited s
pecificity. To avoid both, false-positive, but particularly false-negative
diagnoses, it is imperative to be familiar with the varying MRI appearance
of benign and malignant breast tumors. This review serves to give an overvi
ew of the different criteria that can be used for differential diagnostic p
urposes. Moreover, practical guidelines are given to help with the adequate
management of enhancing lesions.