Imaging Characteristics and Diagnostic Implications of Breast Amyloidoma

Breast amyloidoma is an extremely rare and potentially underdiagnosed entity with underreported diagnostic implications. Breast amyloidomas typically present as painless masses with varying imaging characteristics ranging from nonspecific asymmetries to mammary carcinoma mimics. Calcifications are visualized in many described cases in the literature with a characteristic histopathologic appearance following Congo red staining under polarized light. While breast amyloidomas are benign lesions, there are proposed associations with systemic autoimmune and hematolymphoid disorders in the literature. This suggests the need for standardized management parameters following diagnosis, as the treatment of localized amyloidosis differs greatly from that of its systemic counterpart. To date, no consensus guidelines for follow-up or management of breast amyloidomas exist, owing to its rarity and dearth of cases in the literature. Due to the necessity of employing specific staining to establish the diagnosis, underdiagnosis and occasionally misdiagnosis may contribute to its apparent rarity. In this radiologic-pathologic correlation, a unique case of breast amyloidoma is presented to highlight the imaging characteristics, underlying histopathology, and proposed clinical management, with the goal of improving understanding of this rare entity.