1
|
Tazeoğlu D, Dağ A, Arslan B, Berkeşoğlu M. Breast Hamartoma: Clinical, Radiological, and Histopathological Evaluation. Eur J Breast Health 2021; 17:328-332. [PMID: 34651111 DOI: 10.4274/ejbh.galenos.2021.2021-3-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/21/2021] [Indexed: 12/01/2022]
Abstract
Objective Breast hamartomas are rare, benign, and slow-growing breast tumors that can be definitively diagnosed by combining the results of clinical, radiological, and histopathological examination. This study aimed to evaluate the clinical, radiological, and histopathological features of hamartomas and summarize our clinical approach to hamartomas. Materials and Methods Patients diagnosed with breast hamartoma between 2010 and 2020 in our clinic were retrospectively analyzed. Demographic information, clinical examination, radiological findings, histopathological features, changes during follow-up, and follow-up data were obtained and analyzed. Results Of the 1,429 patients operated on in our clinic for benign breast diseases between January 2010 and March 2020, 39 (2.7%) were diagnosed with breast hamartomas with histopathological examination. All patients were women with a median age of 37 (19-62) years. Most of the patients (64%) were in the premenopausal period. Radiological examinations were conducted using mammography (66%), breast ultrasonography (100%), and breast magnetic resonance imaging (48%). Biopsy was performed in 14 preoperative patients, and nine (64%) patients were diagnosed with hamartoma. All patients were operated on; 37 patients underwent a lumpectomy, and two had a mastectomy. No patients had hamartoma recurrence during an average follow-up period of 39 months. Conclusion Hamartomas are similar to other benign breast pathologies. Definitive diagnosis can be achieved by combining the results of clinical, radiological, and histopathological examination. Given its similar composition to normal breast tissue, hamartoma has a low rate of malignancy. Definitive diagnosis and appropriate surgical treatment are required.
Collapse
Affiliation(s)
- Deniz Tazeoğlu
- Department of General Surgery, Faculty of Medicine Mersin University, Mersin, Turkey
| | - Ahmet Dağ
- Department of General Surgery, Faculty of Medicine Mersin University, Mersin, Turkey
| | - Bilal Arslan
- Department of General Surgery, Faculty of Medicine Mersin University, Mersin, Turkey
| | - Mustafa Berkeşoğlu
- Department of General Surgery, Faculty of Medicine Mersin University, Mersin, Turkey
| |
Collapse
|
2
|
Alran L, Chamming's F, Auriol-Leizagoyen S, Velasco V, Deleau F, Brouste V, Bonhomme B, Ben Rejeb H, Marty M, MacGrogan G. Breast hamartoma: reassessment of an underrecognized breast lesion. Histopathology 2021; 80:304-313. [PMID: 34403159 DOI: 10.1111/his.14544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/29/2021] [Accepted: 08/15/2021] [Indexed: 11/29/2022]
Abstract
AIMS Breast hamartomas are an under-recognized lesion because they lack a distinctive microscopic appearance. Microscopic diagnosis can often conclude "no significant lesion" or "normal breast tissue", leading to repeated biopsies and diagnostic delay. We describe the histological, immunohistochemical and radiological features of breast hamartomas in the aim of identifying specific signs to facilitate their diagnosis and to differentiate them from normal breast and fibroepithelial lesions. METHODS AND RESULTS: Forty-seven breast hamartomas were reassessed (histological diagnosis and imaging features). An immunohistochemical study (ER, PR, CD34, HMGA2) was performed. On breast imaging, hamartomas most often presented as probably benign solid masses with circumscribed margins and variable densities. Histologically, breast hamartomas resembled normal breast, although their stromal component was predominant, separating randomly scattered epithelial elements, with areas of pure collagenous stroma. Pseudo angiomatous stromal hyperplasia (PASH) was present in 93.6% of cases and CD34 antibody highlighted intralobular, perilobular and interlobular distribution of CD34-positive fibroblasts. By comparison, CD34 was mostly expressed in the intralobular normal breast tissue stroma. Hamartoma stromal cells expressed HMGA2, ER and PR in 79%, 66% and 76.3% of our cases, respectively, compared to 7.7%, 23% and 19% in normal breast tissue, respectively (P<0.0001; P=0.0005; P<0.0001). CONCLUSIONS After ascertaining that core needle biopsy is effectively intralesional, breast hamartomas can be diagnosed with confidence by taking into account the presence of stromal changes, PASH, interlobular distribution of CD34-positive fibroblasts, HMGA2 and hormonal receptor stromal expression.
Collapse
Affiliation(s)
- Léonie Alran
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France.,Univ. Bordeaux, F-33000, Bordeaux, France
| | - Foucauld Chamming's
- Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France
| | - Sophie Auriol-Leizagoyen
- Department of Surgical Oncology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France
| | - Valérie Velasco
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France
| | - Florian Deleau
- Univ. Bordeaux, F-33000, Bordeaux, France.,Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France
| | - Véronique Brouste
- Department of Clinical Research and Medical Information, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France
| | - Benjamin Bonhomme
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France
| | - Houda Ben Rejeb
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France
| | - Marion Marty
- Department of Pathology, Hôpital de Haut Lévêque, Bordeaux University Hospital, F-33000, Bordeaux, France
| | - Gaëtan MacGrogan
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France
| |
Collapse
|
3
|
Prabhu J, Moyle P. Recurrent myoid hamartoma of the breast mimicking malignancy. Radiol Case Rep 2020; 16:295-299. [PMID: 33304438 PMCID: PMC7710508 DOI: 10.1016/j.radcr.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 10/25/2022] Open
Abstract
Myoid (muscular) hamartoma is a rare form of benign breast hamartoma composed of differentiated mammary glandular and stromal structures, fatty tissue and areas of smooth muscle from which its name originates. It is considered to be a variant of a mammary hamartoma. We report the clinical presentation, imaging appearances and treatment of the initial and recurrent presentation of this rare tumour in a 61year old female, which mimicked malignancy. Although rare, myoid hamartoma's can reoccur and when they do they imaging appearances of benign and malignant tumours can overlap tend to mimic malignancy and histological diagnosis is mandatory.
Collapse
Affiliation(s)
| | - Penelope Moyle
- Cambridge University Hospitals NHS Foundation Trust, United Kingdom
| |
Collapse
|
4
|
Costa RSSD, Silva IFD. P53 Expression in benign Breast Disease Development: A Systematic Review. Asian Pac J Cancer Prev 2020; 21:2485-2491. [PMID: 32986343 PMCID: PMC7779431 DOI: 10.31557/apjcp.2020.21.9.2485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Indexed: 12/03/2022] Open
Abstract
Background: Benign breast disease (BBD) is one of main breast cancer risk factors. Dysfunctions on p53 protein, which has a genome protective role, have been related to breast cancer developments. However, its role on BBD development is still unclear. Methods: A systematic review of literature was proceeded according to PRISMA-P guidelines. PubMed, BVS, MEDLINE and Scholar Google were used as databases, complemented by a manual search in articles references. Articles searches were conducted from May to July 2019 and publications in English, Spanish and Portuguese were selected. P53 expression was set as outcome among women with BBD and were included only articles with good quality according STROBE tools. Data concerning p53 expression frequencies were independently extracted by two review authors, and eligible articles were synthesized. Results: From 12 studies selected for this review, the majority analyzed p53 expression in non-proliferative lesions and general p53 expressions ranged from 0 to 100%. P53 expression was more frequently observed in cases series studies (91.7%) and in studies conducted in Occidental Europe (41.7%). P53 expression was more frequent among tissues with fibrocystic disease (22.5%) and fibroadenoma (22.5%). Conclusion: When compared with all breast tissues types, benign breast disease corresponds to 34.39% of p53 expression. Second outcomes were not evaluated because the heterogeneity observed in selected studies. In addition, more studies considering ethnicity and benign breast disease classification should also be considered for further analysis.
Collapse
Affiliation(s)
| | - Ilce Ferreira Da Silva
- National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| |
Collapse
|
5
|
Rumpf AL, Mathiak M, Schäfer FK, Caliebe A, Farrokh A, Elessawy M, Bauerschlag DO, Maass N, van Mackelenbergh M, Heilmann T. A Giant Mammary Hamartoma in a Young Breast Cancer Patient. Breast Care (Basel) 2020; 16:85-88. [PMID: 33716636 DOI: 10.1159/000507604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/31/2020] [Indexed: 11/19/2022] Open
Abstract
Background Hamartomas of the breast are rare benign tumors. Pre- and also postoperative differentiation from other benign or even malignant tumors is challenging. Case Presentation A 36-year-old female presented with a giant tumor of the left breast. The patient had suffered from an early breast cancer of the contralateral right breast the year before, which was treated with breast-conserving therapy, radiation, and endocrine therapy ever since. The hamartoma was classified as BI-RADS 2 in mammography and BI-RADS 4 in ultrasound. On clinical examination, a tumor of nearly 15 cm in size led to an abstruse deformity of the breast and the nipple-areola complex. We found an indolent, grand bulging tumor with an elastic texture directly beneath the skin. A biopsy that had been performed before was compatible with the suspected hamartoma. Because of the remaining diagnostic uncertainties after contralateral breast cancer and the progressive malformation of the left breast, a tumor extirpation utilizing a reduction mammaplasty was performed without complications. Subsequent genetic analyses excluded a loss of PTEN in this patient. Conclusion We presented the rare case of a 36-year-old woman with a history of breast cancer and a 700-g breast hamartoma. The preoperative and even the postoperative specification of a hamartoma remains challenging, and associations with genetic alterations should be considered.
Collapse
Affiliation(s)
- Anna-Lena Rumpf
- Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Micaela Mathiak
- Institute of Pathology, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Fritz K Schäfer
- Department of Breast Imaging and Interventions, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Almuth Caliebe
- Institute of Human Genetics, University Hospital Schleswig-Holstein, Campus Kiel, and Christian-Albrechts University, Kiel, Germany
| | - Andre Farrokh
- Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Mohamed Elessawy
- Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Dirk O Bauerschlag
- Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Nicolai Maass
- Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Marion van Mackelenbergh
- Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Thorsten Heilmann
- Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| |
Collapse
|
6
|
Komaki K, Funagayama M, Saitoh T, Maeda Y, Hayashi T, Kanematsu M, Tangoku A. Ductal carcinoma in situ of the breast arising in encapsulated mammary hamartoma ; A case report. THE JOURNAL OF MEDICAL INVESTIGATION 2020; 67:368-371. [PMID: 33148919 DOI: 10.2152/jmi.67.368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Mammary hamartoma is benign lesion and relatively rare. 17 cases of breast cancer associated with a hamartoma had been previously documented in the literature. We describe herein a case of noninvasive ductal carcinoma of the breast arising in hamartoma in a woman of 60's. The discordance of images of the mass between mammogram and ultrasonogram can lead us to detect the carcinoma within the hamartoma in our case. J. Med. Invest. 67 : 368-371, August, 2020.
Collapse
Affiliation(s)
- Kansei Komaki
- Department of Breast Surgery, JA Tokushima Kouseiren Anan Medical Center, Anan City, Japan
| | - Mayumi Funagayama
- Department of Breast Surgery, Breastopia Miyazaki Hospital, Miyazaki, Japan
| | - Tomokazu Saitoh
- Department of Breast Surgery, Breastopia Miyazaki Hospital, Miyazaki, Japan
| | - Yorio Maeda
- Department of Breast Surgery, Breastopia Miyazaki Hospital, Miyazaki, Japan
| | - Toru Hayashi
- Department of Pathology, Breastopia Miyazaki Hospital, Miyazaki, Japan
| | - Miyuki Kanematsu
- Department of Thoracic, Endocrine Surgery and Oncology, Tokushima Graduated School, Tokushima, Japan
| | - Akira Tangoku
- Department of Thoracic, Endocrine Surgery and Oncology, Tokushima Graduated School, Tokushima, Japan
| |
Collapse
|
7
|
Abstract
RATIONALE Mammary hamartoma is a rare benign breast tumor, composed of ducts, lobules, fibers, and adipose tissue. We describe a mammary hamartoma in a man; this is the fourth case being reported in the literature. PATIENT CONCERNS A 30-year-old man presented with a 1-month history of a painless mass in his right breast. DIAGNOSIS Ultrasound imaging and mammography revealed a lesion, approximately 2.0 cm × 2.0 cm in size, in the right breast, which was considered to be either a lipomyoma or an adenoma fibrosum. INTERVENTIONS The mass was surgically resected. Pathological examination confirmed the diagnosis of mammary hamartoma. OUTCOMES The patient was discharged from the hospital after surgery. There was no sign of reoccurrence during a 1-year follow-up period. LESSONS At present, mammary hamartoma is considered to be a benign lesion, usually treated by surgical resection. Some reports have suggested a possible association between a hamartoma and the development of breast malignancy. The pathology and biology of an association between a mammary hamartoma and malignancy have not been defined to date.
Collapse
|
8
|
Abstract
Benign breast disease is a spectrum of common disorders. The majority of patients with a clinical breast lesion will have benign process. Management involves symptom control when present, pathologic-based and imaging-based evaluation to distinguish from a malignant process, and counseling for patients that have an increased breast cancer risk due to the benign disorder.
Collapse
|
9
|
Ross DS, Giri DD, Akram MM, Catalano JP, Olcese C, Van Zee KJ, Brogi E. Fibroepithelial Lesions in the Breast of Adolescent Females: A Clinicopathological Study of 54 Cases. Breast J 2017; 23:182-192. [PMID: 28299887 PMCID: PMC5356480 DOI: 10.1111/tbj.12706] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Fibroepithelial lesions (FELs) are the most frequent breast tumors in adolescent females. The pubertal hormonal surge could impact the growth and microscopic appearance of FELs in this age group. In this study, we evaluate the morphology and clinical behavior of FELs in adolescents. We searched the 1992-2012 pathology data base for FELs in females 18 years old or younger (F ≤18 years). Seven FELs from 1975 to 1983 were also included. Three pathologists reviewed all available material. Patient (pt) characteristics and follow-up information were obtained from electronic medical records. Forty-eight F ≤18 years had 54 FELs with available slides. Thirty (67%) pts were Caucasian, 12 (27%) African-American, two (4%) Hispanic, one (2%) Asian; three were of unknown race/ethnicity. Median age at diagnosis was 16 years. Median age at menarche was 12 years; most (96%) FELs occurred after menarche (median interval 48 months). All patients underwent lumpectomy; one required subsequent mastectomy. The FELs were 34 fibroadenomas (FAs) (11 usual, 23 juvenile), and 20 phyllodes tumors (PTs) (16 benign, one borderline and three malignant). Eight (35%) juvenile FAs showed slight intratumoral heterogeneity. The mean mitotic rate was 1.3 mitoses/10 high-power fields (HPFs) (range, 0-6) in usual FAs, 1.8/10 HPFs in juvenile FAs, 3.1/10 HPFs in benign PTs, 10/10 HPFs in the borderline PT and 17/10 HPFs in malignant PTs. The mean follow-up for 29 pts with 33 FELs was 44 months. Two (10%) PTs recurred locally (a benign PT at 18 months, and a borderline PT at 11 months). Both recurrent PTs had microscopic margins <1 mm. Mitotic activity in FAs from adolescents can be substantial and this finding should be interpreted cautiously. Awareness of the morphologic features of FELs in adolescents is important to avoid overdiagnosis of PTs, which can lead to additional unnecessary and potentially disfiguring surgery.
Collapse
Affiliation(s)
- Dara S. Ross
- Department of Pathology, Memorial Sloan Kettering Cancer Center
| | - Dilip D. Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center
| | | | | | - Cristina Olcese
- Department of Surgery, Memorial Sloan Kettering Cancer Center
| | | | - Edi Brogi
- Department of Pathology, Memorial Sloan Kettering Cancer Center
| |
Collapse
|
10
|
Amir RA, Sheikh SS. Breast hamartoma: A report of 14 cases of an under-recognized and under-reported entity. Int J Surg Case Rep 2016; 22:1-4. [PMID: 27002389 PMCID: PMC4802348 DOI: 10.1016/j.ijscr.2016.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/07/2016] [Accepted: 03/07/2016] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES Mammary hamartoma is a rare benign lesion accounting for approximately 4.8% of all benign breast masses. It is often underdiagnosed and therefore is underreported mostly due to lack of awareness of the characteristic clinical and histological features. Raising awareness of this poorly recognized benign entity is of utmost significance as it clinically mimics other breast tumors including both benign and malignant ones. This study is to report and present our experience of breast hamartomas from Johns Hopkins Aramco Healthcare in the Eastern province of Saudi Arabia from which there have not been previous studies in literature. METHOD A retrospective review of our pathology files was done from 1994 to 2014 for cases diagnosed as breast hamartoma during this 20 year period. RESULTS A total of 14 cases with diagnosis of breast hamartoma were identified in our institute. Histologically the lesion is mostly sharply demarcated showing a mixture of varying proportions of fibrous, adipose, and glandular tissue. 13 cases were seen in females (93%) and only one rare occurrence in a male patient (7%). The age ranges quite vastly from 18 to 51 years (mean 33 years). Two-third of these lesions were seen involving the right breast (9 cases/64.3%) and only one-third in the left side (5 cases/35.7%). 13 out of 14 patients had a well circumscribed lesion (92.9%) while only 1 case showed irregular borders (7.1%). The size varied from 1.4 to 9.5cm. Three cases (21.4%) showed evidence of myoid differentiation, a histopathologic variance which is important to identify however has no clinical significance. 3 cases had associated epithelial ductal hyperplasia of the usual type varying from mild (2 cases) to moderate (1 case); with two of these cases exhibiting additional features of fibrocystic mastopathy including adenosis, apocrine metaplasia, and cyst formation. None of our cases showed any malignancy or pseudoangiomatous stroma hyperplasia (PASH).
Collapse
Affiliation(s)
- R A Amir
- University of Dammam, Dhahran, Saudi Arabia.
| | - S S Sheikh
- Dhahran Health Center, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| |
Collapse
|
11
|
[Rare benign breast tumors including Abrikossoff tumor (granular cell tumor), erosive adenomatosis of the nipple, cytosteatonecrosis, fibromatosis (desmoid tumor), galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma: Guidelines for clinical practice]. ACTA ACUST UNITED AC 2015; 44:1030-48. [PMID: 26530177 DOI: 10.1016/j.jgyn.2015.09.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 09/18/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To provide guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF), based on the best evidence available, concerning rare benign breast tumors: Abrikossoff (granular cell tumor), erosive adenomatosis of the nipple, cytosteatonecrosis, fibromatosis (desmoid tumor), galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma. METHODS Bibliographical search in French and English languages by consultation of Pubmed, Cochrane and international databases. RESULTS For erosive adenomatosis of the nipple, surgical excision is recommended to exclude Paget's disease or cancer (grade C). When surgery is performed for breast desmoid tumor or syringomatous adenoma, free margins are recommended (grade C). Without clinico-radio-histologic discordance, surgical abstention may be proposed for Abrikossoff tumor (granular cell tumor), cytosteatonecrosis, galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma (grade C).
Collapse
|
12
|
Sevim Y, Kocaay AF, Eker T, Celasin H, Karabork A, Erden E, Genc V. Breast hamartoma: a clinicopathologic analysis of 27 cases and a literature review. Clinics (Sao Paulo) 2014; 69:515-23. [PMID: 25141109 PMCID: PMC4129555 DOI: 10.6061/clinics/2014(08)03] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 02/04/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Breast hamartoma is an uncommon breast tumor that accounts for approximately 4.8% of all benign breast masses. The pathogenesis is still poorly understood and breast hamartoma is not a well-known disorder, so its diagnosis is underestimated by clinicians and pathologists. This study was designed to present our experience with breast hamartoma, along with a literature review. METHOD We reviewed the demographic data, pathologic analyses and imaging and results of patients diagnosed with breast hamartoma between December 2003 and September 2013. RESULTS In total, 27 cases of breast hamartoma operated in the Ankara University Medicine Faculty's Department of General Surgery were included in the study. All patients were female and the mean age was 41.8±10.8 years. The mean tumor size was 3.9±2.7 cm. Breast ultrasound was performed on all patients before surgery. The most common additional lesion was epithelial hyperplasia (22.2%). Furthermore, lobular carcinoma in situ was identified in one case and invasive ductal carcinoma was observed in another case. Immunohistochemical staining revealed myoid hamartoma in one case (3.7%). CONCLUSION Breast hamartomas are rare benign lesions that may be underdiagnosed because of the categorization of hamartomas as fibroadenomas by pathologists. Pathologic examinations can show variability from one case to another. Thus, the true incidence may be higher than the literature indicates.
Collapse
Affiliation(s)
- Yusuf Sevim
- Department of General Surgery, Ankara Penal Institution Campus State Hospital, Ankara, Turkey
| | - Akin Firat Kocaay
- Department of General Surgery, Ankara University Medical School, Ankara, Turkey
| | - Tevfik Eker
- Department of General Surgery, Ankara University Medical School, Ankara, Turkey
| | - Haydar Celasin
- Department of General Surgery, Ankara Kavakl?dere Umut Private Hospital, Ankara, Turkey
| | - Ayca Karabork
- Department of Pathology, Ankara University Medical School, Ankara, Turkey
| | - Esra Erden
- Department of Pathology, Ankara University Medical School, Ankara, Turkey
| | - Volkan Genc
- Department of General Surgery, Ankara University Medical School, Ankara, Turkey
| |
Collapse
|
13
|
Vergine M, Scipioni P, Santucci E, Colangelo M, Livadoti G, De Meo D, Maturo A, Monti M. Hamartoma of the breast in a young woman. Case report. G Chir 2013; 34:161-3. [PMID: 23837954 DOI: 10.11138/gchir/2013.34.5.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hamartoma is a benign tumor-like malformation characterized by a focal mixture of mature cells and tissues normally present in affected area. The hamartoma of the breast is rare. We report a case in an asymptomatic young woman coming to our attention for a left breast lesion detected by ultrasound screening.
Collapse
|
14
|
|
15
|
Kim EY, Ko EY, Han BK, Shin JH, Hahn SY, Kang SS, Cho EY, Kim MJ, Chun SY. Sonography of axillary masses: what should be considered other than the lymph nodes? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2009; 28:923-939. [PMID: 19546334 DOI: 10.7863/jum.2009.28.7.923] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The purpose of this study was to review the sonographic findings of various axillary masses other than lymph nodes in correlation with other imaging and pathologic findings. METHODS From a sonographic database, we collected interesting cases of axillary masses with pathologic or other imaging corroboration from the last 10 years. RESULTS Images of various soft tissue masses were reviewed. They included masses associated with accessory breasts (fibroadenomas, hamartomas, fat necrosis, and cancer arising from axillary breasts), other soft tissue masses (lipomas, schwannomas, hemangiomas, fibromatosis, epidermoid cysts, and malignant fibrous histiocytomas), and complications presenting as masses after axillary lymph node dissection (seromas, hematomas, suture granulomas, pseudoaneurysms, and lymphangiectasia). CONCLUSIONS Awareness of the characteristic sonographic findings of various disease entities that cause axillary masses will help in the correct diagnosis of axillary masses.
Collapse
Affiliation(s)
- Eun Young Kim
- Department of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Oueslati S, Salem A, Chebbi A, Mhiri S, Kribi L, Ben Romdhane K, Rajhi H, Hamza R, Mnif N. Hamartome du sein. IMAGERIE DE LA FEMME 2007. [DOI: 10.1016/s1776-9817(07)88603-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
17
|
Abstract
Benign breast diseases constitute a heterogeneous group of lesions including developmental abnormalities, inflammatory lesions, epithelial and stromal proliferations, and neoplasms. In this review, common benign lesions are summarized and their relationship to the development of subsequent breast cancer is emphasized.
Collapse
Affiliation(s)
- Merih Guray
- University of Texas M. D. Anderson Cancer Center, Unit 85, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | | |
Collapse
|
18
|
Herbert M, Mendlovic S, Liokumovich P, Segal M, Zahavi S, Rath-Wolfson L, Sandbank J. Can hamartoma of the breast be distinguished from fibroadenoma using fine-needle aspiration cytology? Diagn Cytopathol 2006; 34:326-9. [PMID: 16604552 DOI: 10.1002/dc.20404] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In an attempt to determine if it is possible to distinguish hamartoma of the breast from fibroadenoma using fine-needle aspiration cytology, we reviewed the cytological slides of 13 histopathologically confirmed cases of hamartoma of the breast and compared them with the cytological features of 13 histologically confirmed fibroadenomas. In each case, we studied the epithelial and stromal features. Cytologic characteristics were retrospectively evaluated in a semiquantitative manner. In conclusion, the finding of intact lobular units and a relative paucity of stroma may suggest the diagnosis of hamartoma.
Collapse
Affiliation(s)
- Mehrdad Herbert
- Department of Pathology, Assaf Harofeh Medical Center, Zerifin, Affiliated to Tel-Aviv University, Tel-Aviv, Israel.
| | | | | | | | | | | | | |
Collapse
|
19
|
Kuroda N, Goishi K, Ohara M, Hirouchi T, Mizumo K, Nakagawa K. Bilateral hamartoma arising in axillary accessory mammary glands. Case report. APMIS 2006; 114:77-8. [PMID: 16499666 DOI: 10.1111/j.1600-0463.2006.apm_349.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 57-year-old Japanese woman presented with a lump, originally noticed 10 years previously, in both axillary regions. Histologically, the axillary tumors consisted of a random admixture of ducts, lobules and fibrous stroma with predominant adipose tissue. This is the first case of bilateral ectopic hamartoma arising in the axillary regions. Surgeons and pathologists should be aware that ectopic breast hamartoma can occur in both axillary regions.
Collapse
Affiliation(s)
- N Kuroda
- Department of Pathology and Laboratory Medicine, Kochi Red Cross Hospital, Japan.
| | | | | | | | | | | |
Collapse
|
20
|
Los hamartomas de la mama. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2004. [DOI: 10.1016/s0210-573x(04)77334-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|