Presentation
Painless left breast enlargement. No familial history of breast cancer.
Patient Data
In the central and outer parts of the left breast, a large oval mass with a dominant fat density and peripheral hyperdense margin is seen. The mass also contains small areas of soft tissue densities, better seen on tomosynthesis images, suggesting hamartoma (B2).
Anterolateral and superior to the mass mentioned in the left breast, a relatively hyperdense, slightly lobulated mass is also seen that shows focal angulation in the superoposterior aspect (B4).
In addition, a few small masses with partially obscured margins, without internal calcification and surrounding parenchymal distortion, are observed in the left breast, which appears more consistent with benign breast lesions (B2).
Foci of calcifications with a benign appearance are scattered in the left breast.
Case Discussion
A targeted ultrasonography and ultrasound-guided core needle biopsy were performed for the left breast, a relatively hyperdense mass with lobulated and focally angulated margin (BI-RADS 4), and histopathology evaluation confirmed a fibroadenoma.
Breast hamartoma, also known as fibroadenolipomas, is a benign breast lesion (BI-RADS 2) that typically occurs in women older than 35 years of age. On mammography, it appears as a well-circumscribed, round or oval mass surrounded by a thin capsule comprising of both fat and soft-tissue internal densities and often demonstrates a "breast within a breast" or a "slice of sausage" appearance. So, the diagnosis of hamartoma is usually straightforward due to an extremely characteristic imaging appearance and no need for further evaluation or follow-up.
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