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Hamartomas of the breast: clinical, radiologic, and pathologic manifestations
D L Wahner-Roedler1, T J Sebo, J J Gisvold
1Breast Clinic, Division of General Internal Medicine, Division of Anatomic Pathology, Department of Diagnostic Radiology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
Insights
Breast hamartomas are benign tumors typically presenting as palpable lumps or identified mammographically. This study reviews 35 cases, detailing their clinical, imaging, and pathological characteristics.
Area of Science:
- Pathology
- Radiology
- Oncology
Background:
- Breast hamartomas are rare, benign tumors composed of fibrous, fatty, and epithelial tissues.
- They can mimic malignant lesions on clinical examination and imaging.
- Understanding their characteristics is crucial for accurate diagnosis and management.
Purpose of the Study:
- To review the clinical, mammographic, sonographic, and pathologic features of breast hamartomas.
- To characterize the composition and associated findings of these lesions.
Main Methods:
- Retrospective review of 35 patients diagnosed with breast hamartoma at Mayo Clinic between 1986 and 1996.
- Analysis of clinical presentation, imaging findings (mammography, sonography), and histopathologic features.
Main Results:
- 35 patients (mean age 50 years) presented with 36 hamartomas.
- 18 were palpable lumps, 18 detected mammographically.
- Mammography showed ovoid, well-circumscribed lesions; sonography revealed solid masses with occasional cystic areas.
- Pathologically, mean diameter was 3.2 cm, predominantly fibrous tissue (78%).
- Associated findings included ductal hyperplasia (27%) and adenosis (70%); 12% had coexistent fibroadenomas.
Conclusions:
- Breast hamartomas exhibit characteristic features on imaging and pathology.
- While benign, their varied presentation necessitates careful evaluation to differentiate from malignancy.
- Histopathologic analysis confirms their mixed tissue composition and frequent association with other benign breast conditions.
Abstract:
Between 1986 and 1996, 35 patients with a diagnosis of hamartoma of the breast were seen at the Mayo Clinic. One patient had two lesions. The mean age was 50 years (range 21-86 years). Hamartomas were clinically identified as a palpable lump in 18 cases (11 were detected by the patient and 7 by a physician). The other 18 were identified mammographically. Twenty-four lesions were in the left breast and 12 were in the right breast; 39% were located in the upper outer quadrant. Mammographically most hamartomas were ovoid, and the lesions were well circumscribed. Sonographically they were all solid, but 24% showed cystic areas. Pathologically the mean greatest diameter was 3.2 cm (range 1.0-7.5 cm). All but one lesion showed circumscription. The mean percentage of fibrous tissue was 78% (range 5-95%), fat 13% (range 0-95%), and epithelium 9% (range 1.0-60%). Calcifications were seen in four lesions. Ductal hyperplasia was present in 27% and adenosis in 70% of lesions. Twelve percent of patients had coexistent fibroadenomas.