## 3 Results
#### Imaging Findings  
By mammography, 19/21 (90.5%) lesions were detected; 12 (63%) in the BRCA1 group, 2 (10.5%) in the BRCA2 group and 5 (26.3%) in the ATM group. Two cases, one was a BRCA2 mutation carrier and the other was a ATM mutation carrier, were negative at mammography. In the BRCA1 group, 10 of the 12 detected lesions (83.3%) appeared as microcalcifications, and 2 (16.7%) as a mass. In the BRCA2 group, 100% of lesions appeared as a mass. In the ATM group 1, 20% of lesions appeared as a distortion, and 4 (80%) as a mass (Table 3, Scheme 3). The Fisher's exact test showed a statistically significant difference between the mammographic appearance of B3 lesions in the three groups (\(p\) = 0.03). No significant difference was found between the microcalcification morphologies in the three subgroups (\(p\) = 0.821)  
ADHs, FEA and LNs were more frequently associated with the presence of microcalcifications, with values of 15.8% and 10.5%, respectively. RSs appear as a mass, mass + microcalcification and distortion + microcalcifications with the same frequencies (5.3%). No significative difference was found between mammographic features and the histological results of the preoperative breast biopsy (\(p\) = 0.86). By ultrasound, 13/21 (61.9%) lesions were detected. In the BRCA1 group, 7 lesions (58%) were not detectable; in the BRCA2 group, 2/3 (66.7%) lesions were recognizable; and in the ATM group, in all cases a typical finding was recognizable. The most frequent finding was a hypoechoic lesion with an irregular shape, non-circumscribed margins, and a parallel orientation in each group. In 7/9 cases (77.8%) of ADH at core biopsy sampling, any finding was discovered using ultrasound, while the remaining 2 cases appeared as irregular and hypoechoic masses. LNs and RSs were frequently associated with a single mass with posterior acoustic enhancement at ultrasound, with values of 83.3% and 100%, respectively. One case of FEA was discovered by US, appearing as an irregular nodule with obscured margins. By breast MRI, 2 of 12 (16.7 %) BRCA1 and 2 of 6 (33.3 %) ATM lesions exhibited negative findings. Moreover, 10/12 (83.3%) BRCA1, 3/3 (100%) BRCA2 and 4/6 (66.7%) ATM lesions were detected via breast MRI. In the BRCA1 group, six (60%) and four (40%) \begin{table}
\begin{tabular}{c c c} \hline \hline  & **AGE** \\ \hline  & **45–55** & **>55** \\ \hline N & 12 & 9 \\ \hline BENIGN & 1 & 5 \\ \hline MALIGNANT & 11 & 4 \\ \hline \% MALIGNANT & 52\% & 19\% \\ \hline \hline \end{tabular}
\end{table} 
Table 2: Outcome stratified by patient age. \begin{table}
\begin{tabular}{c c c c} \hline \hline
**Mammographic Findings** & **ATM** & **BRCA1** & **BRCA2** \\ \hline Mass & 0 & 2 (16.7\%) & 2 (100\%) \\ \hline Distortion & 1 (20\%) & 0 & \\ \hline Microcalcifications & 4 (80\%) & 10 (83.3\%) & \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Mammographic appearance of B3 lesions in the three groups of mutations analyzed. lesions were mass and non-mass lesions, respectively; in the BRCA2 group, two lesions were mass (66.7%) and one (33.3%) non-mass lesions, whereas in the ATM group, three (75%) and one (25%) were mass and non-mass lesions, respectively (Table 4). **Scheme 3. ** The graphic shows the distribution of mammographic findings in the three groups of mutations analyzed with a prevalence of microcalcifications in patients with BRCA1 mutations. By analyzing the MRI features among the different B3 lesions groups, ADHs appeared more often as a mass lesion, LNs and FEA were associated with mass and non-mass enhancements in the same way, while only a single case of an RS lesion exhibited MRI positive findings with a mass-enhancing lesion with spiculated margins, inhomogeneous contrast enhancement and a positive DWI (Scheme 4). No significant difference was observed in the ratio of mass to non-mass lesions among the groups (\(p\) = 0.917).