The variability in non-mass enhancement (NME) presentation underscores the necessity of a multimodal diagnostic approach, integrating advanced imaging techniques and histopathological evaluation to improve diagnostic accuracy. Our findings confirm the high sensitivity of MRI in detecting malignancies, particularly in cases where mammography or ultrasound fail to reveal suspicious findings.

Segmental enhancement patterns, clustered-ring internal enhancement, and wash-out kinetic curves were strongly associated with malignancy, reinforcing the critical role of MRI in risk stratification. Additionally, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values provided valuable insights into lesion characterization, with significantly lower ADC values observed in malignant lesions.

This study supports a personalized and evidence-based approach to the management of NME, where imaging biomarkers and histopathological findings guide decision-making. MRI-guided biopsy should be considered in cases with high-risk imaging features, ensuring appropriate patient management and reducing unnecessary interventions for benign lesions. Further prospective studies with larger cohorts are warranted to refine diagnostic algorithms and enhance the specificity of MRI in differentiating benign from malignant NME.