Breast lipoma
Breast lipomas are a benign breast lesion and is classified as a BIRADS II lesion.
On this page:
Clinical presentation
Lipomas are mostly asymptomatic and coincidentally discovered on routine mammography. Patients may present with a painless palpable breast lump which is soft and mobile. In these cases the diagnosis is clinically obvious.
Skin tethering or fixation are not features of lipomas.
Pathology
Lipomas are benign mesenchymal tumors that are composed of mature adipose tissue
Radiographic features
Classically it appears as a fat composed lesion seen predominantly in the subcutaneous plane; however can be seen anywhere in the breast. Ideally lipomas measure anywhere up to 2 cm in size.
Mammography
Typically seen as a radiolucent mass with no calcification (in rare situation there may be areas of fat necrosis presenting as calcification). They may have a thin, peripheral, fluid density capsule. Mammographic detection may be easier in a dense breast. In the vast majority of cases lipoma is incidentally seen on routine screening.
Ultrasound
May be seen as a rounded lesion that is iso-echoic or at times slightly hyperechoic to surrounding fat. Occasionally a lipoma can be hypoechoic 4. Multiple thin echogenic septations may be seen running parallel to the skin surface. The lipoma can be readily distinguished from a hamartoma by the ultrasound and mammogram appearances. Compressibility of the lesion can also be demonstrated on ultrasonography.
These lesions are also found in males.
Treatment and prognosis
These lesions are rarely a diagnostic or imaging dilemma. Enlargement of a lipoma is an indication for biopsy. They rarely undergo malignant transformation and are not associated with an increased risk of developing breast cancer.
Related Radiopaedia articles
Breast imaging and pathology
- breast screening
-
mammography
- breast imaging and the technologist
- forbidden (check) areas in mammography
-
mammography views
- craniocaudal view
- mediolateral oblique view
- additional (supplementary) views
- true lateral view
- lateromedial oblique view
- late mediolateral view
- step oblique views
- spot view
- double spot compression view
- magnification view
- exaggerated craniocaudal (axillary) view
- cleavage view
- tangential views
- caudocranial view
- bullseye CC view
- rolled CC view
- elevated craniocaudal projection
- caudal cranial projection
- 20° oblique projection
- inferomedial superolateral oblique projection
- Eklund technique
- normal breast imaging examples
- digital breast tomosynthesis
- breast ultrasound
- breast ductography
- breast MRI
- breast morphology
- breast intervention
- breast pathology
- malignant lesions
-
breast cancer
- breast adenocarcinoma
- ductal breast carcinoma
- ductal carcinoma in situ (DCIS)
- invasive ductal carcinoma
- lobular breast carcinoma
- ductal breast carcinoma
- adenoid cystic carcinoma of the breast
- apocrine carcinoma of the breast
- breast cancer metastases
- breast lymphoma
- breast sarcoma
- inflammatory carcinoma of breast
- intracystic breast cancer
- male breast cancer
- malignant phyllodes tumor
- metastases to the breast
- metaplastic carcinoma the breast
- gamuts
- breast adenocarcinoma
-
breast cancer
- borderline breast disease / high risk breast lesion
- benign lesions
- adenosis of the breast
- benign papillary lesions of the breast
- breast cyst
- breast hematoma
- breast hamartoma
- breast lipoma
- ductal adenoma of the breast
- epidermal inclusion cysts of the breast
- fat necrosis of the breast
- fibroadenoma
- granular cell tumor of the breast
- gynecomastia
- lymphocytic mastitis
- mammary fibromatosis
- oil cyst
- phyllodes tumor
- post-surgical breast scar
- post-radiation breast changes
- post-traumatic fibrosis
- pseudoangiomatous stromal hyperplasia (PASH)
- pseudogynecomastia
- tubular adenoma
-
breast calcifications (approach)
- morphology
- distribution
- location
- lobular calcification within breast tissue
- intraductal calcification within breast tissue
- milk of calcium within a breast cyst
- vascular calcification in breast tissue
- skin (dermal) calcification in / around breast tissue
- suture calcification within breast tissue
- stromal calcification within breast tissue
- artifactual calcification from outside the breast
- suspicious breast calcifications
- infection/inflammation
- vascular lesions
- systemic disease
- gamuts
- classification systems
- malignant lesions
- breast cancer staging