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Breast hamartoma is a benign mass in the breast tissue that may require monitoring or surgical removal if it changes shape or size. Hormones may contribute to its formation, and it is frequently diagnosed in young women. Diagnostic tests include clinical exams, imaging tests, and biopsies. Surgical removal may cause disfigurement and the formation of scar tissue. Regular monitoring is recommended for those who do not undergo surgery.
A breast hamartoma, also known as a fibroadenolipoma, is a solid, benign mass that forms in the soft tissue of the breast. Frequently diagnosed in young women, breast hamartoma that remains unchanged often requires regular monitoring, but no treatment. In cases where the hamartoma changes shape or increases in size, a biopsy and surgical removal of the mass may be done. Rarely does a hamartoma lead to the development of breast cancer, but, for some women, the presence of a fibroadenolipoma can increase the chance of breast cancer later in life.
There is no known cause for developing a breast hamartoma. Made up of both connective and glandular tissue, hormones have been claimed to contribute to the formation of a fibroadenolipoma. The hormonal connection is further evidently confirmed by the frequency of hamartoma diagnoses occurring in women of reproductive age.
The solid mass that forms within the breast tissue is palpable and can be easily moved and has a distinct shape. Although many do not cause pain, if a hamartoma grows large enough it can compress surrounding tissue or nerves and cause pain. Masses measuring up to 0.7 inches (about 2 cm) are considered normal, and those measuring 2 inches (about 5 cm) or more are classified as extremely large. Often, pregnant or breastfeeding women with breast hamartoma may experience an enlargement of the lump, which should be monitored.
There are several tests that can be administered to evaluate a hamartoma. Commonly, a doctor initially asks a series of questions, such as when the lump first appeared and what types of symptoms the woman might be experiencing, and performs a clinical breast exam to check the lump and determine if there are any further abnormalities . Imaging tests, such as an ultrasound and a mammogram, may be administered to produce a clear picture of the hamartoma’s location, size, and shape. In addition, a fine needle aspiration and core needle biopsy can also be performed.
A fine needle aspiration is a diagnostic test used to determine the density of the mass. During the procedure, a needle is inserted into the mass to extract the fluid; if no fluid is withdrawn, the mass is determined to be solid. A small collection of cells may also be obtained for further testing to rule out the presence of cancer. A core needle biopsy involves using a large needle to collect tissue samples from the lump, which are sent to a lab for analysis. Because these tumors are made up of different types of cells, often the only way to definitively diagnose a lump as a breast hamartoma is after it has been removed.
Surgical removal of a hamartoma is often recommended when clinical and diagnostic test results are abnormal. Women whose breast shape has been altered due to the mass or who are uncomfortable leaving the hamartoma in place may consider having the mass removed surgically. It is important that women discuss the risks associated with a lumpectomy with their doctor before opting for surgery. In some cases, the removal of a fibroadenolipoma can cause disfigurement of the breast and the creation of scar tissue.
An excisional biopsy, also known as a lumpectomy, is an invasive procedure that involves removing the fibroadenolipoma and some of the surrounding tissue; all sent to a laboratory for analysis. Once the mass has been removed, it is possible for another fibroadenolipoma to form in its place, which may require another lumpectomy later. Women who have not had the mass surgically removed should continue to be conscientious about having regular exams to monitor the mass for any changes that may occur.
