eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2025-03-31 18 1 483 497 10.13005/bpj/3102 63761 article Reem Kalakattawi 1 Lena Gowharji 2 Alaa marzogi 3 Tahani Alghamdi 4 Department of Breast imaging, Alhada armed forces hospital, Taif Saudi Arabia Department of Diagnostic Radiology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia Department of Breast imaging, King Abdullah medical City, Makkah, Saudi Arabia Department of Radiology, consultant radiologist, King Abdullah Medical City, Makkah, Kingdom of Saudi Arabia This systematic review evaluates the diagnostic effectiveness of breast-specific gamma imaging (BSGI), MRI, mammography, and ultrasound in detecting breast lesions and their associations with molecular subtypes. Following PRISMA guidelines, a comprehensive search of PubMed, Embase, and Cochrane databases was conducted for studies published between January 2014 and October 2024. Nine studies met the inclusion criteria, encompassing clinical trials and observational studies that provided data on sensitivity, specificity, and diagnostic accuracy. Methodological quality was assessed using the QUADAS-2 tool, and pooled diagnostic measures were calculated with STATA V.14.0. BSGI demonstrated high diagnostic performance, with a sensitivity of 91.7% and specificity of 80.7%, surpassing mammography (77.3% sensitivity, 74.5% specificity) and ultrasound (82.1% sensitivity, 70.8% specificity). MRI exhibited the highest sensitivity at 92.5% but lower specificity at 69.7%. The diagnostic odds ratio for BSGI was 4.90 (95% CI: 3.12–7.68), emphasizing its role as a valuable adjunct to mammography and MRI, particularly in dense breast tissues and cases of inconclusive findings. The findings highlight the potential of BSGI to improve diagnostic accuracy and assist in identifying molecular subtypes, such as HER2-positive and triple-negative cancers, facilitating more personalized breast cancer treatment strategies. BSGI’s integration into diagnostic workflows offers promising advancements for breast cancer management.     https://biomedpharmajournal.org/vol18no1/evaluating-diagnostic-technologies-for-breast-lesions-a-focused-review-of-breast-specific-gamma-imaging-magnetic-resonance-imaging-mammography-and-ultrasound-with-molecular-subtype-insights/ Breast Cancer Diagnosis Breast-Specific Gamma Imaging Mammography Molecular Subtypes MRI Ultrasound