Hamartoma of the Breast, an Underrecognized Breast Lesion:A Clinicopathologic and Radiographic Study of 25 Cases

Abstract

This study investigated the clinical, radiographic, and pathologic features of breast hamartoma. The patients ranged in age from 18 to 89 years, with a mean age of 45 years, and a median age of 43 years. Seventy-five percent of the patients were asymptomatic, other than reporting a breast lump. In two patients, the lesions recurred at 7 and 18 months after the initial resection. The clinical diagnoses were fibroadenoma in 10 cases, carcinoma in 5 cases, hamartoma in 4 cases, and phyllodes tumor and lipoma in 2 other cases. Mammograms were available in 12 cases, the majority of which showed a well-defined mass of homogeneous density. Grossly, these lesions were oval to round, well-circumscribed masses, ranging in size from 1 to 7 cm in maximum dimension (mean, 3.9 cm). The microscopic appearance of these tumors corresponded to their gross appearance. Lesions that were grossly firm, rubbery, and white consisted largely of dense fibroconnective tissue with variable amounts of glandular elements with little adipose tissue. Softer, pale, yellow lesions contained more adipose tissue. A consistent and important diagnostic feature was the presence of both lobules and ducts, in contrast to fibroadenoma in which lobules are often absent or rare. The current trend of mammographic breast screening has made us aware that mammary hamartomas are not uncommon. These lesions may go unrecognized by the pathologists because they show all the constituents of normal breast tissue and may be reported as "no pathological diagnosis" or "normal breast tissue," which are inappropriate diagnoses for a lesion that presents as a palpable and a well-circumscribed mass.

Masq U Erading Mammary Hamartomas

“…This feature was noted in 55.5% of cases in the present study which was consistent with the rates reported in literature. [7,9,11] Cystic changes and apocrine metaplasia were noted in more than 50% of cases in our study. However this feature was observed to a lesser extent by few other authors.…”

“…In the present series 6 patients were above 35years of age. [1,5,8,9] 16 cases in the present study were suspected to be fibroadenomas and 2 cases were cystosarcoma phyllodes on clinical examination.…”

“…The mammographic appearance is typically described as 'slice of containing fat, varying radiodense fibrous & 'salami' or 'piece of cut sausage' or 'breast in breast' appearence. [9,10,11] Mammography was not done in any of the cases in the present study.…”

Advanced MRI findings of breast hamartoma

“…The presence of lobules and ducts differentiates hamartomas from fibroadenomas (11). However, hamartomas do not have specific diagnostic histological findings (4,5).…”

The effectiveness of Power Doppler vocal fremitus imaging in the diagnosis of breast hamartoma

“…Pseudoangiomatous stroma and cystic changes may also be present in hamartomas [10]. Hamartomas represent between 0.1−0.7% all benign breast lesions.…”