Giant breast mass
Updates to Article Attributes
Introduction:
Many patients, particularly in developing countries, present late with giant breast masses. They may be single or multiple, and either benign or malignant. Many of these conditions are indistinguishable on physical examination alone. Some of these lesions require mastectomy while others can be treated by local excision, aspiration or even conservative measures. 1,2
Terminology
Giant breast masses are those larger than 5 cm acrossin maximum dimension.
Pathology
A wide variety of breast conditions such as lipoma, hamartoma, cyst, fibroadenoma, phyllodes tumour, haematoma, abscess and carcinoma can result in solitary or multiple giant masses.:
Radiographic features
Ultrasonography (US) and mammography are the two basic imaging techniques for routine diagnostic imaging of breast diseases. For women over the age of 35 years presenting with a palpable or suspected breast mass, mammography is often the first imaging investigation to be performed. The US is used to determine whether the mass is a simple cyst, or a complex mass, or a solid mass.
An algorithmic approach based on mammographic features, i.e. whether a mass is well-circumscribed or not, and the presence of fat density is proposed by Muttarak M &and Chaiwun B with the US used to determine whether the mass is a simple cyst, a complex mass, or a solid mass.2
Well circumscribed masses with fat density on mammogram include lipoma and hamartoma &and without fat density includedinclude a cyst, hematoma, giant fibroadenoma, Phyllodes tumour &and malignant masses as medullary carcinoma &and primary lymphoma.
Ill defined mass on mammogram included breast carcinoma & breast abscess.
Differentiation between giant fibroadenoma &and Phyllodes tumour is done viaon a clinical, mammographic &and sonographic basis.
Giant fibroadenoma occurs at a younger age (35-55 years) with no malignancy risk, possible regression with age, treated by simple excision &and no local recurrence after surgical excision.On the mammogram, it will appear as a circumscribed low or intermediate density with the incidence of calcifications being more common.On sonography, it appears as homogeneous echogenicity with uncommon cystic changes or posterior acoustic enhancement.2,3,4
Phyllodes tumour occurs at an older age (35-55 years) with pathology divided into benign-borderline-Malignant. It has a rapidly progressive course with a high rate of recurrence after surgery up to 20 %. It is treated by wide local excision or mastectomy. On Mammographymammography it appears as a circumscribed high-density mass with a less common incidence of calcifications than giant fibroadenoma. On sonography, it appears as a well-defined mass with low-level uniform or scattered internal echoes, fluid-filled, elongated spaces or clefts within. 2,3,4
-<h4>Introduction:</h4><p>Many patients in developing countries present late with giant breast masses. They may be single or multiple, either benign or malignant. Many of these conditions are indistinguishable on physical examination alone. Some of these lesions require mastectomy while others can be treated by local excision, aspiration or even conservative measures. <sup>1,2</sup></p><h4>Terminology</h4><p>Giant breast masses are those larger than 5 cm across. </p><h4> </h4><h4>Pathology</h4><p>A wide variety of breast conditions such as lipoma, hamartoma, cyst, fibroadenoma, phyllodes tumour, haematoma, abscess and carcinoma can result in solitary or multiple giant masses.</p><h4><strong>Radiographic features</strong></h4><p>Ultrasonography (US) and mammography are the two basic imaging techniques for routine diagnostic imaging of breast diseases. For women over the age of 35 years presenting with a palpable or suspected breast mass, mammography is often the first imaging investigation to be performed. The US is used to determine whether the mass is a simple cyst, a complex mass, or a solid mass.</p><p>An algorithmic approach based on mammographic features, i.e. whether a mass is well-circumscribed or not, and the presence of fat density is proposed by Muttarak M & Chaiwun B with the US used to determine whether the mass is a simple cyst, a complex mass, or a solid mass<sup>.2</sup></p><p>Well circumscribed masses with fat density on mammogram included <a title="Lipoma of breast" href="/articles/breast-lipoma">lipoma</a> & <a title="Hamartoma of breast" href="/articles/breast-hamartoma">hamartoma</a> & without fat density included cyst, hematoma, giant fibroadenoma, Phyllodes tumour & malignant masses as medullary carcinoma & primary lymphoma.</p><p>Ill defined mass on mammogram included breast carcinoma & breast abscess.</p><p>Differentiation between giant fibroadenoma & Phyllodes tumour is done via clinical, mammographic & sonographic basis.</p><p><a href="/articles/giant-fibroadenoma">Giant fibroadenoma</a> occurs at a younger age (35-55 years) with no malignancy risk, possible regression with age, treated by simple excision & no local recurrence after surgical excision.On the mammogram, it will appear as a circumscribed low or intermediate density with the incidence of calcifications being more common.On sonography, it appears as homogeneous echogenicity with uncommon cystic changes or posterior acoustic enhancement.<sup>2,3,4</sup></p><p><a href="/articles/phyllodes-tumour">Phyllodes tumour</a> occurs at an older age (35-55 years) with pathology divided into benign-borderline-Malignant. It has a rapidly progressive course with a high rate of recurrence after surgery up to 20 %. It is treated by wide local excision or mastectomy. On Mammography it appears as a circumscribed high-density mass with a less common incidence of calcifications than giant fibroadenoma. On sonography, it appears as a well-defined mass with low-level uniform or scattered internal echoes, fluid-filled, elongated spaces or clefts within. <sup>2,3,4</sup></p><h4> </h4><p> </p><p> </p>- +<p>Many patients, particularly in developing countries, present late with <strong>giant breast masses</strong>. They may be single or multiple and either benign or malignant. Many of these conditions are indistinguishable on physical examination alone. Some of these lesions require mastectomy while others can be treated by local excision, aspiration or even conservative measures. <sup>1,2</sup></p><h4>Terminology</h4><p>Giant breast masses are those larger than 5 cm in maximum dimension. </p><h4>Pathology</h4><p>A wide variety of breast conditions can result in solitary or multiple giant masses:</p><ul>
- +<li><a href="/articles/breast-lipoma">lipoma</a></li>
- +<li><a href="/articles/hamartoma-of-breast">hamartoma</a></li>
- +<li><a href="/articles/breast-cyst-1">cyst</a></li>
- +<li><a href="/articles/fibroadenoma-breast">fibroadenoma</a></li>
- +<li><a href="/articles/phyllodes-tumour">phyllodes tumour</a></li>
- +<li><a href="/articles/haematoma-of-breast">haematoma</a></li>
- +<li><a href="/articles/breast-abscess">abscess</a></li>
- +<li><a href="/articles/breast-carcinoma">carcinoma</a></li>
- +</ul><h4><strong>Radiographic features</strong></h4><p>Ultrasonography (US) and mammography are the two basic imaging techniques for routine diagnostic imaging of breast diseases. For women over the age of 35 years presenting with a palpable or suspected breast mass, mammography is often the first imaging investigation to be performed. The US is used to determine whether the mass is a simple cyst or a complex or solid mass.</p><p>An algorithmic approach based on mammographic features, i.e. whether a mass is well-circumscribed or not, and the presence of fat density is proposed by Muttarak M and Chaiwun B with the US used to determine whether the mass is a simple cyst, a complex mass, or a solid mass<sup>.2</sup></p><p>Well circumscribed masses with fat density on mammogram include <a href="/articles/breast-lipoma">lipoma</a> and <a href="/articles/breast-hamartoma">hamartoma</a> and without fat density include a cyst, hematoma, giant fibroadenoma, Phyllodes tumour and malignant masses as medullary carcinoma and primary lymphoma.</p><p>Ill defined mass on mammogram included breast carcinoma & breast abscess.</p><p>Differentiation between giant fibroadenoma and Phyllodes tumour is done on a clinical, mammographic and sonographic basis.</p><p><a href="/articles/giant-fibroadenoma">Giant fibroadenoma</a> occurs at a younger age (35-55 years) with no malignancy risk, possible regression with age, treated by simple excision and no local recurrence after surgical excision.On the mammogram, it will appear as a circumscribed low or intermediate density with the incidence of calcifications being more common.On sonography, it appears as homogeneous echogenicity with uncommon cystic changes or posterior acoustic enhancement.<sup>2,3,4</sup></p><p><a href="/articles/phyllodes-tumour">Phyllodes tumour</a> occurs at an older age (35-55 years) with pathology divided into benign-borderline-Malignant. It has a rapidly progressive course with a high rate of recurrence after surgery up to 20 %. It is treated by wide local excision or mastectomy. On mammography it appears as a circumscribed high-density mass with a less common incidence of calcifications than giant fibroadenoma. On sonography, it appears as a well-defined mass with low-level uniform or scattered internal echoes, fluid-filled, elongated spaces or clefts within. <sup>2,3,4</sup></p><p> </p><p> </p>
References changed:
- 3. Parker S. Phyllodes Tumours. Postgrad Med J. 2001;77(909):428-35. <a href="https://doi.org/10.1136/pmj.77.909.428">doi:10.1136/pmj.77.909.428</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/11423590">Pubmed</a>
- 4. Yilmaz E, Sal S, Lebe B. Differentiation of Phyllodes Tumors Versus Fibroadenomas. Mammographic and Sonographic Features. Acta Radiol. 2002;43(1):34-9. <a href="https://doi.org/10.1034/j.1600-0455.2002.430107.x">doi:10.1034/j.1600-0455.2002.430107.x</a>
- 1. A. F. I. Moustafa, O. M. M. Shetat, H. Fadl. Sonomammographic Evaluation of Circumscribed Giant Solid Breast Masses. European Congress of Radiology - ECR 2015. 2015. <a href="https://epos.myesr.org/poster/esr/ecr2015/C-0382">https://epos.myesr.org/poster/esr/ecr2015/C-0382</a>
- 2. Muttarak M, Chaiwun B. Imaging of giant breast masses with pathological correlation. (2004) Singapore medical journal. 45 (3): 132-9. <a href="https://www.ncbi.nlm.nih.gov/pubmed/15029418">Pubmed</a> <span class="ref_v4"></span>
- Parker SJ, Harries SA. Phyllodes tumours. 2001;428–35.
- Eyl D. DIFFERENTIATION OF PHYLLODES TUMORS VERSUS FIBROADENOMAS Mammographic and sonographic features. 2002;43:34–9.
- Moustafa A. Sonomammographic evaluation of circumscribed giant solid breast masses. European Congress of Radiology 2015.
- Muttarak M, Chaiwun B. Imaging of giant breast masses with pathological correlation. 2004;45(3):132–9
Sections changed:
Image 1 Mammography (CC) ( update )
Image 2 Ultrasound (Transverse) ( update )
Image 3 Mammography (MLO) ( update )
Image 4 Mammography (CC) ( update )
Image 5 Ultrasound (Longitudinal) ( update )
Image 6 Mammography (CC) ( update )
Image 7 Mammography (CC) ( update )
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