Radiologic and Pathologic Correlation for Lactating Adenomas

Area of Science:

• Radiology
• Breast Imaging
• Pathology

Background:

• Lactating adenomas are benign breast lesions specific to pregnant, lactating, and postpartum women.
• Their exact origin remains debated, with no consensus on whether they are hyperplastic or neoplastic.
• These lesions possess no inherent malignant potential.

Purpose of the Study:

• To describe the imaging and histological characteristics of lactating adenomas.
• To highlight the importance of recognizing variable appearances that may mimic malignancy.
• To guide appropriate management strategies for pregnant and lactating women with palpable breast masses.

Main Methods:

• Review of ultrasound imaging features of lactating adenomas.
• Description of histological findings.
• Discussion of differential diagnoses, including pregnancy-associated breast cancer.

Main Results:

• Classically, lactating adenomas appear as solid, circumscribed, parallel masses with iso/hypoechoic echotexture and posterior enhancement on ultrasound.
• Histologically, they present as circumscribed nodules with lobular acini and lactational changes.
• Some lactating adenomas exhibit overlapping features with malignancy, such as non-circumscribed margins.

Conclusions:

• Masses with probably benign imaging characteristics (oval, circumscribed, parallel, iso/hypoechoic) can be managed with short-interval follow-up (BI-RADS 3).
• Biopsy is necessary when imaging characteristics overlap with pregnancy-associated breast cancer.
• Breast imaging radiologists must be aware of the diverse presentations of lactating adenomas for accurate diagnosis and management.