From Recall to Reassurance: Common Benign Mimics in Breast Screening Assessment-A Pictorial Review.

Benign breast lesions, anatomical variants, and imaging artefacts can closely mimic malignancy on screening mammography and are a frequent diagnostic challenge in the assessment setting. This pictorial review showcases a spectrum of benign lesions encountered in a high-volume breast screening assessment setting that initially raised suspicion for malignancy but were subsequently confirmed as benign through a combination of digital breast tomosynthesis (DBT), targeted ultrasound, and clinicopathological correlation. Examples include cutaneous lesions, sebaceous cysts, intramammary lymph nodes, hamartomas, fat necrosis, vascular lesions, simple cysts and summation artefact. Through illustrative cases, we highlight key imaging features that support accurate lesion characterization and demonstrate the complementary roles of mammography, DBT, and ultrasound in distinguishing benign entities from breast cancer. Familiarity with these imaging appearances can improve diagnostic confidence, reduce false-positive recalls, and minimize unnecessary biopsies within breast screening programs.