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Radiologic and Pathologic Correlation for Lactating Adenomas.

Hoiwan Cheung1, Elizabeth U Parker2, Mark R Kilgore2

  • 1University of Washington, Department of Radiology, Seattle, WA.

Journal of Breast Imaging
|March 1, 2024
PubMed
Summary
This summary is machine-generated.

Lactating adenomas are benign breast lesions in pregnant or postpartum women. While typically appearing benign on ultrasound, their variable imaging requires careful radiologist assessment to differentiate from cancer.

Keywords:
Lactating adenomabreast ultrasoundlactationpathology

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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.