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Breast
Histopathologic Diagnoses
Benign Lesions
Hamartoma (Fibroadenolipoma)
Hamartoma (Fibroadenolipoma)
Hilda Tso, DO; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Mammary hamartoma (MH), fibroadenolipoma (FAL)

            • Synonyms

              • Hamartoma, lipofibroadenoma, adenolipofibroma (named according to relative amount of tissue component in mass)

            • Definitions

              • Discrete fat and fibroglandular proliferation
              • Focal developmental pseudotumor composed of fibrous, glandular, and fatty tissue
              • Myoid hamartoma: Misnomer, as not hamartoma per se; biphasic benign nodule with adenosis and smooth muscle metaplasia of stroma; rarely contains fat

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Eng C et al: PTEN hamartoma tumor syndrome. In Adam MP et al. GeneReviews®[Internet]. Seattle (WA): University of Washington, Seattle; 1993-2018
                                          2. Baer L et al: The first case of HER2+ invasive ductal carcinoma arising from a breast hamartoma and literature review. J Natl Med Assoc. 109(1):55-59, 2017
                                          3. Amir RA et al: Breast hamartoma: A report of 14 cases of an under-recognized and under-reported entity. Int J Surg Case Rep. 22:1-4, 2016
                                          4. Bhatia M et al: "Breast within a breast" sign: Mammary hamartoma. Med J Armed Forces India. 71(4):377-9, 2015
                                          5. Presazzi A et al: Breast hamartoma: ultrasound, elastosonographic, and mammographic features. Mini pictorial essay. J Ultrasound. 18(4):373-7, 2015
                                          6. Ayyappan AP et al: Imaging of fat-containing lesions of the breast: a pictorial essay. J Clin Ultrasound. 41(7):424-33, 2013
                                          7. Tan MH et al: Lifetime cancer risks in individuals with germline PTEN mutations. Clin Cancer Res. 18(2):400-7, 2012
                                          8. Erdem G et al: Advanced MRI findings in patients with breast hamartomas. Diagn Interv Radiol. 17(1):33-7, 2011
                                          9. Desai A et al: Breast hamartoma arising in axillary ectopic breast tissue. Breast J. 16(4):433-4, 2010
                                          10. Chang HL et al: Breast hamartomas in adolescent females. Breast J. 15(5):515-20, 2009
                                          11. Blumenthal GM et al: PTEN hamartoma tumor syndromes. Eur J Hum Genet. 16(11):1289-300, 2008
                                          12. Box I et al: Large mammographic opacity due to hamartoma. JBR-BTR. 91(4):177, 2008
                                          13. Park YM et al: Palpable breast masses with probably benign morphology at sonography: can biopsy be deferred? Acta Radiol. 49(10):1104-11, 2008
                                          14. Chao TC et al: Sonographic features of breast hamartomas. J Ultrasound Med. 26(4):447-52; quiz 453, 2007
                                          15. Murat A et al: Hamartoma of the breast. Australas Radiol. 51 Spec No, 2007
                                          16. da Silva BB et al: Large mammary hamartoma of axillary supernumerary breast tissue. Breast. 15(1):135-6, 2006
                                          17. Lerwill MF: Biphasic lesions of the breast. Semin Diagn Pathol. 21(1):48-56, 2004
                                          18. Baron M et al: Invasive lobular carcinoma in a breast hamartoma. Breast J. 9(3):246-8, 2003
                                          19. Gomez-Aracil V et al: Fine needle aspiration cytology of mammary hamartoma: a review of nine cases with histological correlation. Cytopathology. 14(4):195-200, 2003
                                          20. Lee EH et al: Invasive ductal carcinoma arising in a breast hamartoma: two case reports and a review of the literature. Clin Radiol. 58(1):80-3, 2003
                                          21. Park SY et al: Sonographic findings of breast hamartoma: emphasis on compressibility. Yonsei Med J. 44(5):847-54, 2003
                                          22. Herbert M et al: Breast hamartomas: clinicopathological and immunohistochemical studies of 24 cases. Histopathology. 41(1):30-4, 2002
                                          23. Tse GM et al: Ductal carcinoma in situ arising in mammary hamartoma. J Clin Pathol. 55(7):541-2, 2002
                                          24. Ravakhah K et al: Hamartoma of the breast in a man: first case report. Breast J. 7(4):266-8, 2001
                                          25. Wahner-Roedler DL et al: Hamartomas of the breast: clinical, radiologic, and pathologic manifestations. Breast J. 7(2):101-5, 2001
                                          26. Weinzweig N et al: Giant hamartoma of the breast. Plast Reconstr Surg. 107(5):1216-20, 2001
                                          27. Chiacchio R et al: Mammary hamartomas: an immunohistochemical study of ten cases. Pathol Res Pract. 195(4):231-6, 1999
                                          28. Khunamornpong S et al: Muscular hamartoma of the breast: a rare breast lesion containing smooth muscle. J Med Assoc Thai. 80(10):675-9, 1997
                                          29. Dworak O et al: Hamartoma of an ectopic breast arising in the inguinal region. Histopathology. 24(2):169-71, 1994
                                          30. Altermatt HJ et al: Multiple hamartomas of the breast. Appl Pathol. 7(2):145-8, 1989
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Mammary hamartoma (MH), fibroadenolipoma (FAL)

                                                    • Synonyms

                                                      • Hamartoma, lipofibroadenoma, adenolipofibroma (named according to relative amount of tissue component in mass)

                                                    • Definitions

                                                      • Discrete fat and fibroglandular proliferation
                                                      • Focal developmental pseudotumor composed of fibrous, glandular, and fatty tissue
                                                      • Myoid hamartoma: Misnomer, as not hamartoma per se; biphasic benign nodule with adenosis and smooth muscle metaplasia of stroma; rarely contains fat

                                                    IMAGING

                                                    • General Features

                                                      • Mammographic Findings

                                                        • Ultrasonographic Findings

                                                          • MR Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Eng C et al: PTEN hamartoma tumor syndrome. In Adam MP et al. GeneReviews®[Internet]. Seattle (WA): University of Washington, Seattle; 1993-2018
                                                                                  2. Baer L et al: The first case of HER2+ invasive ductal carcinoma arising from a breast hamartoma and literature review. J Natl Med Assoc. 109(1):55-59, 2017
                                                                                  3. Amir RA et al: Breast hamartoma: A report of 14 cases of an under-recognized and under-reported entity. Int J Surg Case Rep. 22:1-4, 2016
                                                                                  4. Bhatia M et al: "Breast within a breast" sign: Mammary hamartoma. Med J Armed Forces India. 71(4):377-9, 2015
                                                                                  5. Presazzi A et al: Breast hamartoma: ultrasound, elastosonographic, and mammographic features. Mini pictorial essay. J Ultrasound. 18(4):373-7, 2015
                                                                                  6. Ayyappan AP et al: Imaging of fat-containing lesions of the breast: a pictorial essay. J Clin Ultrasound. 41(7):424-33, 2013
                                                                                  7. Tan MH et al: Lifetime cancer risks in individuals with germline PTEN mutations. Clin Cancer Res. 18(2):400-7, 2012
                                                                                  8. Erdem G et al: Advanced MRI findings in patients with breast hamartomas. Diagn Interv Radiol. 17(1):33-7, 2011
                                                                                  9. Desai A et al: Breast hamartoma arising in axillary ectopic breast tissue. Breast J. 16(4):433-4, 2010
                                                                                  10. Chang HL et al: Breast hamartomas in adolescent females. Breast J. 15(5):515-20, 2009
                                                                                  11. Blumenthal GM et al: PTEN hamartoma tumor syndromes. Eur J Hum Genet. 16(11):1289-300, 2008
                                                                                  12. Box I et al: Large mammographic opacity due to hamartoma. JBR-BTR. 91(4):177, 2008
                                                                                  13. Park YM et al: Palpable breast masses with probably benign morphology at sonography: can biopsy be deferred? Acta Radiol. 49(10):1104-11, 2008
                                                                                  14. Chao TC et al: Sonographic features of breast hamartomas. J Ultrasound Med. 26(4):447-52; quiz 453, 2007
                                                                                  15. Murat A et al: Hamartoma of the breast. Australas Radiol. 51 Spec No, 2007
                                                                                  16. da Silva BB et al: Large mammary hamartoma of axillary supernumerary breast tissue. Breast. 15(1):135-6, 2006
                                                                                  17. Lerwill MF: Biphasic lesions of the breast. Semin Diagn Pathol. 21(1):48-56, 2004
                                                                                  18. Baron M et al: Invasive lobular carcinoma in a breast hamartoma. Breast J. 9(3):246-8, 2003
                                                                                  19. Gomez-Aracil V et al: Fine needle aspiration cytology of mammary hamartoma: a review of nine cases with histological correlation. Cytopathology. 14(4):195-200, 2003
                                                                                  20. Lee EH et al: Invasive ductal carcinoma arising in a breast hamartoma: two case reports and a review of the literature. Clin Radiol. 58(1):80-3, 2003
                                                                                  21. Park SY et al: Sonographic findings of breast hamartoma: emphasis on compressibility. Yonsei Med J. 44(5):847-54, 2003
                                                                                  22. Herbert M et al: Breast hamartomas: clinicopathological and immunohistochemical studies of 24 cases. Histopathology. 41(1):30-4, 2002
                                                                                  23. Tse GM et al: Ductal carcinoma in situ arising in mammary hamartoma. J Clin Pathol. 55(7):541-2, 2002
                                                                                  24. Ravakhah K et al: Hamartoma of the breast in a man: first case report. Breast J. 7(4):266-8, 2001
                                                                                  25. Wahner-Roedler DL et al: Hamartomas of the breast: clinical, radiologic, and pathologic manifestations. Breast J. 7(2):101-5, 2001
                                                                                  26. Weinzweig N et al: Giant hamartoma of the breast. Plast Reconstr Surg. 107(5):1216-20, 2001
                                                                                  27. Chiacchio R et al: Mammary hamartomas: an immunohistochemical study of ten cases. Pathol Res Pract. 195(4):231-6, 1999
                                                                                  28. Khunamornpong S et al: Muscular hamartoma of the breast: a rare breast lesion containing smooth muscle. J Med Assoc Thai. 80(10):675-9, 1997
                                                                                  29. Dworak O et al: Hamartoma of an ectopic breast arising in the inguinal region. Histopathology. 24(2):169-71, 1994
                                                                                  30. Altermatt HJ et al: Multiple hamartomas of the breast. Appl Pathol. 7(2):145-8, 1989