Management of atypical breast lesions continues to evolve. There is considerable controversy as to whether these entities represent risk factors for future breast cancer or whether they are instead precursor lesions.  A better understanding of the prognostic and therapeutic implications of each of these lesions is important for assessing subsequent breast cancer risk.  Risk assessment tools are available for screening high risk patients and understanding the utility and limitations of these tools is important for all clinicians involved in the care of patients. There have been significant advances in breast cancer screening in the last several year including breast tomosynthesis, automated breast RADIOLOGIA, molecular imaging, as well as accelerated breast MRI protocols.