Edit concept Question Editor Create issue ticket

Breast Hamartoma

Breast Fibroadenolipoma

A hamartoma is a benign tumor composed of various tissues, and one of its locations may be the breast. Patients can present with a painless, asymptomatic and well-demarcated palpable mass in a breast hamartoma. Imaging studies such as mammography, ultrasonography, and magnetic resonance imaging (MRI) show specific radiologic features, whereas a biopsy, either fine needle aspiration or core needle, may be sometimes necessary to confirm the diagnosis.


Presentation

Defined as a well-established mass with a still incomplete etiology, hamartoma is a rare benign tumor that contains a mixture of different tissues (fibrous, adipose, glandular, and potentially other) in various proportions [1] [2] [3]. Numerous sites in the body may be the location of its development, including the breast, and between 4-8% of all benign breast lesions, are attributed to hamartomas [3]. This benign tumor has been reported across different age groups after puberty [3] [4], but the majority of patients are women in their 30s and 40s [1] [2] [4] [5]. The clinical presentation is characterized by the presence of a sharply defined, painless, and asymptomatic oval or round-shaped mass in the breast area that is freely palpable [2] [3] [4] [6]. The nodular appearance of the mass is accompanied by its smooth surface and a soft consistency [3]. However, studies show that up to 60% of breast hamartomas are not possible to palpate, and are thus interpreted as subclinical tumors [3]. Hamartomas are most commonly found in the outer quadrants, and it is not uncommon for the diagnosis to be made incidentally during evaluation of other breast-related pathologies [2] [4]. Additional symptoms are not present in the setting of hamartomas, which is one of the main clinical features of this tumor [3]. Furthermore, breast hamartomas are mobile and not attached to the surrounding muscle or skin tissue, which might be an important clinical sign as well [6] [7].

Asymptomatic
  • Patients can present with a painless, asymptomatic and well-demarcated palpable mass in a breast hamartoma.[symptoma.com]
  • Case 1 was an asymptomatic 47-year-old woman who had never been screened previously. A 90 mm mass was found in her left breast on MX. Case 2 was a 35-year-old woman with pain in her right breast where a 50 mm mass was found on MX.[ncbi.nlm.nih.gov]
  • They are mostly found in women older than 35 and they are generally asymptomatic, although they can be easily detected through palpitation in a breast exam.[ic.steadyhealth.com]
  • Breast hamartomas most commonly are asymptomatic or present as a painless soft breast lump. They may also present as unilateral breast enlargement without a palpable localized mass 4 .[radiopaedia.org]
Pathologist
  • The pathogenesis is still poorly understood and breast hamartoma is not a well-known disorder, so its diagnosis is underestimated by clinicians and pathologists.[ncbi.nlm.nih.gov]
  • This is followed by a multidisciplinary review of the respective techniques of the clinician, radiologist, pathologist, surgeon, and reconstructive surgeon.[books.google.com]
  • The consistent, practical format with a wealth of illustrations, at-a-glance boxes, and tables, make this title ideal for quick reference for both novices and experienced breast pathologists.[books.google.com]
  • I asked the surgeon and the pathologist what the diagnosis is and they will not tell me. The only diagnosis on the pathology report is the DCIS and the Invasive Ductal Carcinoma. I suspect the palpable lump was discarded and never diagnosed.[whatnext.com]
  • A pathologist might note fibrous tissue within the breast lobules, or fibrous tissue and fat in the supporting stroma with or without pseudo-angiomatous changes, (relating to blood vessels ).[breast-cancer.ca]
Swelling
  • Breast swelled by February. Painless lump formed by May in L.Breast. Breast nearly tripled in size by June with severe pain and new lump formed in R.Breast. Went to Gyno this week who suspected fluid cysts consistent with oral side effects.[community.breastcancer.org]
  • Clinically, it presents as a soft, slow-growing, fusiform swelling and may be accompanied by pain, redness and diminished sensation. It can present with macrodactyly on the affected side. 1 article features images from this case[radiopaedia.org]
  • The left thigh examination showed a diffuse swelling with an old healed longitudinal scar over the anterolateral aspect of the left thigh and wasting of the quadriceps muscles with superficial varicosities.[webmedcentral.com]
  • He had noticed a swelling at the back of his throat on the left side, which was gradually increasing in size. There was no history of fever or change of voice.[ijpmonline.org]
Severe Pain
  • Breast nearly tripled in size by June with severe pain and new lump formed in R.Breast. Went to Gyno this week who suspected fluid cysts consistent with oral side effects. Hamartoma diagnosed instead.[community.breastcancer.org]
  • Nevertheless, the condition may require surgery as an option to treat if… Lipoma becomes tender or severely painful It gets inflamed It catches some infection and becomes infectious Starts collecting foul-smelling fluid and discharges it Interferes with[emedicalhub.com]
Crying
  • […] stress it did not hurt. she did this twice, bandegded me up and i sat back to wait. the consultant then examined me and said they didnt think it was cancer but a fibroadenoma but the results would take a week to come back. back in the car i burst out crying[forum.breastcancercare.org.uk]
Aspiration
  • METHODS: Fine-needle aspirates from eight patients with histologically proven hamartomas were reviewed. None of the cases had a preoperative fine-needle aspiration diagnosis of hamartoma.[ncbi.nlm.nih.gov]
  • Imaging studies such as mammography, ultrasonography, and magnetic resonance imaging (MRI) show specific radiologic features, whereas a biopsy, either fine needle aspiration or core needle, may be sometimes necessary to confirm the diagnosis.[symptoma.com]
  • Get more of the information you need from new and expanded chapters covering a broad range of diseases and topics including fine needle aspiration cytology and the physical handling of core biopsy specimens; handling and evaluation of sentinel lymph nodes[books.google.com]
  • Hamartomas are usually diagnosed through a mammogram or an ultrasound and in some cases needle aspiration is done to determine the nature and the density of the growth.[ic.steadyhealth.com]
  • Can hamartoma of the breast be distinguished from fibroadenoma using fine-needle aspiration cytology. Diagn Cytopathol, 34 (2006), pp. 326-329 Copyright 2013. SESPM[elsevier.es]
Palpitations
  • They are mostly found in women older than 35 and they are generally asymptomatic, although they can be easily detected through palpitation in a breast exam.[ic.steadyhealth.com]
Suggestibility
  • Mammography demonstrated two typical hamartomas: one containing a spiculated opacity, the other irregular opacities with suspicious calcifications, suggesting the presence of carcinomas in these benign lesions.[ncbi.nlm.nih.gov]
  • The characteristic feature of hamartomas was a change of the mammographic round shape mass into an elongated oval shape mass by sonography (11/11), suggesting the compressibility of hamartomas.[ncbi.nlm.nih.gov]
  • The findings of intact lobular units and a relative paucity of stroma in an aspirate from a well circumscribed breast lesion may suggest the diagnosis of hamartoma. Copyright 2003 American Cancer Society.[ncbi.nlm.nih.gov]
  • If there is a distinct ‘lump’, and if there is evidence of asymmetrical breast density on the X-ray, this could suggest something more serious.[breast-cancer.ca]
  • It is suggested that sebaceous gland can develop into lipofibroma.[rowland98.com]
Breast Mass
  • CONCLUSION: PDVF imaging during breast sonography is an invaluable technique in the identification of breast hamartomas from other benign or malign breast masses.[ncbi.nlm.nih.gov]
  • It can present as a breast mass and therefore additional care needs to be taken to rule it out in the differential diagnosis of breast carcinoma. We report a case of a breast hamartoma treated at the European Institute of Oncology.[ncbi.nlm.nih.gov]
  • The mammographic appearance of breast hamartoma, a benign cause of a breast mass, is characteristic. We present four cases from the University of Virginia to review the mammographic, pathologic, and clinical features of this unusual entity.[ncbi.nlm.nih.gov]
  • OBJECTIVES: Breast hamartoma is an uncommon breast tumor that accounts for approximately 4.8% of all benign breast masses.[ncbi.nlm.nih.gov]
  • The main concern about hamartoma is that it can present as either a palpable lump or an apparent breast mass on a mammogram (diagnostic chest x-ray ), and this naturally leads to follow-up investigations to rule out possible breast cancer .[breast-cancer.ca]
Breast Mass
  • CONCLUSION: PDVF imaging during breast sonography is an invaluable technique in the identification of breast hamartomas from other benign or malign breast masses.[ncbi.nlm.nih.gov]
  • It can present as a breast mass and therefore additional care needs to be taken to rule it out in the differential diagnosis of breast carcinoma. We report a case of a breast hamartoma treated at the European Institute of Oncology.[ncbi.nlm.nih.gov]
  • The mammographic appearance of breast hamartoma, a benign cause of a breast mass, is characteristic. We present four cases from the University of Virginia to review the mammographic, pathologic, and clinical features of this unusual entity.[ncbi.nlm.nih.gov]
  • OBJECTIVES: Breast hamartoma is an uncommon breast tumor that accounts for approximately 4.8% of all benign breast masses.[ncbi.nlm.nih.gov]
  • The main concern about hamartoma is that it can present as either a palpable lump or an apparent breast mass on a mammogram (diagnostic chest x-ray ), and this naturally leads to follow-up investigations to rule out possible breast cancer .[breast-cancer.ca]
Forgetful
  • Don't give in to them and just forget it. Push them until you get an answer. Good luck. I hope you get your answer soon. 1 Like about 5 years ago StamPurr I have always had lumpy, bumpy, dense breast tissue.[whatnext.com]
  • Back to Types of Benign Lesions list OR our up-dated Survival, Incidence and Mortality Rates OR breast cancer Treatments … and don’t forget our brand new Homepage .[breast-cancer.ca]
  • You are your own best advocate, don't forget that. Hugs to you in this scary time. When life knocks you down, roll over, and look at the stars.[community.breastcancer.org]

Workup

A detailed physical examination, together with a properly obtained patient history, is the first and perhaps most important step in order to make the diagnosis of a breast hamartoma. Adequate palpation of both breasts and the respective quadrants can result in detection of a mass, after which the use of various imaging studies might be employed. Various procedures have been mentioned, one of the more useful being mammography, the gold-standard procedure in the assessment of breast tissue [5] [8]. A nonhomogeneous mass composed of adipose, fibrous and glandular tissue that is often enclosed by a thin capsule is the hallmark of a breast hamartoma on mammography, but the variability in the percentage of fat and glandular/connective tissue might pose a challenge to the physician [1] [2] [8]. For this reason, ultrasonography (US), but also MRI, might be used as adjunctive or even superior methods compared to mammography [1] [5]. Main findings on the US are the absence of a retrotumor acoustic phenomenon, which is frequently found in malignant lesions [2] [8]. On MRI, breast hamartomas are visualized as heterogeneous lesions with a sharp and clearly delineated capsule described as a hypointense rim [1]. As mentioned previously, the distribution and dominance of different tissues may necessitate for a biopsy sample to be obtained, either by a core needle biopsy or a fine needle aspiration (FNAC), both valuable in the workup of this tumor [1] [2] [6].

Treatment

  • […] and Treatment "John Paul II", Campobasso, Italy. 3 Department of Radiotherapy, Catholic University of the Sacred Heart-Foundation for Research and Treatment "John Paul II", Campobasso, Italy.[ncbi.nlm.nih.gov]
  • TREATMENT: She underwent unilateral reduction mammaplasty. Intraoperative findings were that of a giant hamartoma. The tumour was removed and the breast reconstructed using an inferior pedicled reduction mammaplasty.[ncbi.nlm.nih.gov]
  • Radiology, Catholic University of the Sacred Heart-Foundation for Research and Treatment “John Paul II”, L.go Agostino Gemelli, n 1, 86100, Campobasso, Italy.[content.iospress.com]
  • Generously illustrated with over 700 photographs, drawings, histopathology slides, radiographs, and mammographs, this color atlas provides a step-by-step guide to the differential diagnosis and treatment of the most prevalent diseases of the breast.[books.google.com]
  • In this study, we report a case of giant hamartoma of the breast in a young postlactational female patient, including treatment of the tumor by excisional biopsy and correction of the resultant breast deformity by mastopexy.[journals.lww.com]

Prognosis

  • They are treated, if at all, by surgical resection, with an excellent prognosis: generally, the only real danger is the inherent possibility of surgical complications.[en.wikipedia.org]
  • Surgical excision is the treatment of choice, and the prognosis is generally good as recurrence rate is very less.[jiaomr.in]
  • Lipoma Prognosis No mortality or serious problems have been reported after removal of subcutaneous lipoma. Some practitioners prefer steroid injections that can shrink the size of lipoma significantly (up to 75%).[emedicalhub.com]

Etiology

  • Defined as a well-established mass with a still incomplete etiology, hamartoma is a rare benign tumor that contains a mixture of different tissues (fibrous, adipose, glandular, and potentially other) in various proportions.[symptoma.com]
  • Breast: 8 cases of hamartoma per 20,000 mammograms Kidney: renal hamartoma (angiomyolipoma) found in 40–80% of patients with tuberous sclerosis Etiology and Pathophysiology Functional disorder will depend on tissue of origin.[unboundmedicine.com]

Epidemiology

  • Epidemiology Can be hard to assess because many hamartomas are asymptomatic Incidence Depends on organ system affected Breast hamartomas are not common; estimated incidence is 0.1–0.7%.[unboundmedicine.com]
Sex distribution
Age distribution

Pathophysiology

  • Breast: 8 cases of hamartoma per 20,000 mammograms Kidney: renal hamartoma (angiomyolipoma) found in 40–80% of patients with tuberous sclerosis Etiology and Pathophysiology Functional disorder will depend on tissue of origin.[unboundmedicine.com]

Prevention

  • The author collated important benign lesions and based on peer-reviewed publications documented the relative risk of subsequent cancer to allow the patient and the clinician to institute preventative measures where possible.[books.google.com]
  • Lipoma Prevention There are no specific preventive measures to avoid lipomas. Lipoma Prognosis No mortality or serious problems have been reported after removal of subcutaneous lipoma.[emedicalhub.com]
  • For some women with dense breast tissue that can make it harder to detect breast cancers, preventative mastectomy may be an option.[uihc.org]

References

Article

  1. Sevim Y, Kocaay AF, Eker T, et al. Breast hamartoma: a clinicopathologic analysis of 27 cases and a literature review. Clinics. 2014;69(8):515-523.
  2. Amir RA, Sheikh SS. Breast hamartoma: A report of 14 cases of an under-recognized and under-reported entity. Int J Surg Case Rep. 2016;22:1-4.
  3. Presazzi A, Di Giulio G, Calliada F. Breast hamartoma: ultrasound, elastosonographic, and mammographic features. Mini pictorial essay. J Ultrasound. 2015;18(4):373-377.
  4. Tatar C, Erözgen F, Tüzün S, et al. Surgical approach to breast hamartoma and diagnostic accuracy in preoperative biopsies. J Breast Health. 2013;9:186–190.
  5. Tse GM, Law BK, Ma TK, et al. Hamartoma of the breast: a clinicopathological review. J Clin Pathol. 2002;55(12):951–954.
  6. Ruiz Tovar J, Reguero Callejas ME, Aláez Chillarón AB, et al. Mammary hamartoma. Clin Transl Oncol. 2006;8(4):290-293.
  7. Erdem G, Karakaş HM, Işık B, Fırat AK. Advanced MRI findings in patients with breast hamartomas. Diagn Interv Radiol. 2011;17:33–37.
  8. Bhatia M, Ravikumar R, Maurya VK, Rai R. “Breast within a breast” sign: Mammary hamartoma. Med J Armed Forces India. 2015;71(4):377-379.

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!
Last updated: 2019-06-28 12:01