Learning objectives
1-Describe a wide variety of benign breast lesions that may simulate malignancy on imaging using clinical examples.
2-Describe the radiological signs and features of these entities with clinical and pathological correlation.
Background
Background:
Most of the lesions encountered during breast imaging exams are benign.
Many of these have a typical and definite appearance on mammograms and ultrasound and require no further evaluation.
Nonetheless there is a group of benign lesions that cannot be differentiated from carcinomas because of their suspicious radiological features. These lesions include:
Diabetic mastopathy
Carbon granulomas
Pseudoangiomatous Stromal Hyperplasia
Granular Cell Tumor
Sclerosing Adenosis
Radial Scar
Fat Necrosis
We discuss the radiological features and clinical presentation of the entities above mentioned.
Imaging findings OR Procedure details
Diabetic Mastopathy
This is an unusual form of benign proliferative mastopathy consisting in lobulitis,
lymphocitic infiltration and stromal fibrosis.
It typically occurs in premenopausal women with long standing type I diabetes mellitus.
Clinically patients present with solitary or multiple hard breast masses.
Mammography usually shows dense parenchima ( Fig 1) Ultrasound examination shows hypoecoic irregular masses with marked posterior acoustic shadowing (1,2) ( Fig 2)
Magnetic resonance examination usually shows no enhancement of the palpable areas.
Diagnosis by means of core needle biopsy is recommended....
Conclusion
Radiologists should be aware of the imaging characteristic of these entities which may simulate breast carcinomas on images and include them in the differential diagnosis of a malignant appearing finding.
References
1- Mysler D,
Sarquis F,
Castro Barba M et al.
Imágenes en Mastopatía Diabética.
Rev Chil Radiol 2009; 15 (4): 192-196.
2- Mak CW,
Chou CK,
Chen SY,
Lee PS,
Chang JM.
Diabetic Mastopathy.
Br J Radiol 2003;76:192-194.
3- Ruiz Delgado ML,
López-Ruiz A,
Sáiz López A.
Abnormal Mammography and Sonography Associated with Foreign-Body Giant-Cell Reaction after Stereotactic Vacuum-Assisted Breast Biopsy with Carbon Marking.
Acta Radiol 2008; 49 (10 ): 1112-1118.
4- Ibrahim RE,
Sciotto CG,
Weidner N: Psedoangiomatous hyperplasia of mammary stroma.
Some observations...