Large breast lipoma

Case contributed by Mohammadtaghi Niknejad
Diagnosis almost certain

Presentation

Large, painless, soft palpable mass on physical exam of the right breast.

Patient Data

Age: 55 years
Gender: Female
mammography

A large, relatively well-defined mass-like lesion with internal diffuse fat and minimal soft tissue density is noted in the UOQ of the right breast, most consistent with lipoma.

Case Discussion

Breast lipomas are benign breast lesions and are classified as BIRADS II lesions. On mammography typically seen as a radiolucent mass with homogeneous fat density and sometimes with minimal soft tissue density. Enlargement of a lipoma is an indication for biopsy, although they rarely undergo malignant transformation and are not associated with an increased risk of developing breast cancer.

Breast hamartoma can be considered in a differential list but usually shows more heterogeneous appearance with scattered areas of soft tissue density, causing a "breast within a breast"  or a "slice of sausage" appearance. Breast hamartomas are also classified as BIRADS II lesions.

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