Left breast hamartoma (fibroadenolipoma)

Case contributed by Dr Gerard Carbo

Presentation

Palpable lump in the upper outer quadrant (UOQ) of the left breast.

Patient Data

Age: 40 years
Gender: Female

Left breast digital mammography shows a well-circumscribed oval shaped mass of mixed density located at the superior lateral aspect (UOQ) of the left breast (partially included on CC projection given its posterior location).

Notice the thin capsule surrounding the mass (especially appreciable in the MLO projection). In this particular case, given the high breast density, it is difficult to appreciate the typical image "breast within a breast" or a "slice of sausage" appearence.  

Notice an additional rounded and well-circumscribed lesion at the 3:00 o’clock position. 

Typical ultrasound appearance of a breast hamartoma located at the upper outer quadrant of the left breast. It is a well-circumscribed oval-shaped lesion with both hyperechoic and hypoechoic components (depending on breast echotexture the margins are often difficult to delineate). It is a soft lesion and, usually, under pressure it is clearly compressible. 

Simple cyst at the 3:00 o'clock position of the left breast (also depicted on the mammography). 

Case Discussion

Fibroadenolipomas or breast hamartomas are typical but unusual benign breast tumors (accounting for about 5 % of all benign breast tumors). As radiologists it is essential to recognize these lesions and differentiate them from other types of tumors. Given their typical imaging pattern (both in mammography and ultrasound), the accurate diagnosis of these lesions is rarely problematic. 

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