Breast hemangiomas: Correlation between imaging and pathologic findings

Abstract

Hemangiomas are benign vascular tumors that are rare in the breast. A high percentage of hemangiomas are diagnosed incidentally during imaging examinations. They have mammographic, sonographic, and pathologic characteristics that allow radiologists and pathologists to diagnose them. We present four different cases of breast hemangiomas showing their mammographic and sonographic features. Two were diagnosed with an 18-gauge core needle biopsy and they underwent surgical excision. The other two cases were diagnosed with a 14-gauge core needle biopsy and their radiologic and pathologic appearances were concordant with breast hemangiomas, so they did not need surgical excision and are being followed.

Sinusoidal hemangioma of the breast: diagnostic evaluation management and literature review

“…Breast hemangiomas do not have pathognomonic imaging features (2,5,7,8) and thus imaging studies can be misleading in some cases (2,9,16,17). There are no imaging modalities that can reliably differentiate between vascular benign tumors and angiosarcomas (3,7,14).…”

“…There are no imaging modalities that can reliably differentiate between vascular benign tumors and angiosarcomas (3,7,14).…”

“…In some cases, the tumor may be difficult to be seen on craniocaudal or mediolateral oblique views and thus a tangential view may be necessary for evaluation (7). Mammography may have additional limitations, especially in young patients, due to the dense parenchymal pattern (2).…”

“…Internal echostructure is variable and the tumor can be hypoechoic, isoechoic or hyperechoic (1,(3)(4)(5)11). Compressibility of the tumor may be detected only in the absence of thrombosis (7). In some cases an isoechoic tumor cannot be clearly displayed from the surrounding adipose tissue (5).…”

“…Fifteen of these cases were hemangiomas and three were angiolipomas. Breast hemangioma is usually very small and asymptomatic and is discovered incidentally in biopsies performed for unrelated reasons (6,7). Breast hemangioma presenting as a palpable tumor is a very rare clinical entity (8,9).…”