ReviewSpindle cell lesions of the breast: Multimodality imaging and clinical differentiation of pathologically similar neoplasms

•Spindle cell lesions of the breast include benign to malignant diseases.•Spindle cell lesions can be pathologically challenging to differentiate.•Clinical history and imaging features are helpful in establishing diagnosis.•Radiologic and pathologic correlation are essential for appropriate treatment.

Spindle cell lesions of the breast comprise a wide-range of entities including reactive, benign and malignant proliferations. They can be pathologically challenging to differentiate as there is often immunohistochemical and morphologic similarities with characteristic spindle shaped cellular patterns. Radiological and pathological correlation is essential. Radiology detects, defines the size and extent, and assists in localizing the lesions. Pathology confirms the diagnosis and provides prognostic parameters. Familiarity with the clinicoradiological features of these diagnostically challenging lesions helps to establish an accurate pathological diagnosis and subsequent clinical decision making.