Sonographic and Mammographic Appearances of Breast Hemangioma

Abstract

A mass displaying an oval or lobular shape with well-circumscribed or microlobulated margins on mammography and sonography, and in a superficial location, should alert the radiologist to the possible diagnosis of hemangioma. Imaging-guided biopsy appears sufficiently reliable to rule out any malignant or premalignant component and to avoid a surgical excision if doing so is clinically appropriate.

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

“…Histologically, breast hemangiomas are characterized by the presence of interconnecting dilated thin-walled vascular channels lined by flat endothelial cells, in the absence of atypia (1,3,10). Depending on the size of the vessels involved breast hemangiomas can be classified into capillary and cavernous types (1,11). Cavernous hemangiomas are the most common subtype (12).…”

“…The tumor affects most commonly women (2,11) and occurs over a wide age range (18 months to 82 years) (4,11,15). Men are very rarely affected (5).…”

“…At mammography, breast hemangioma may appear as a well-defined, circumscribed or microlobulated mass isodense to the surrounding breast parenchyma (4,11). 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).…”

“…It most commonly appears as a superficially located oval mass with parallel orientation and circumscribed margins. 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).…”

“…However, in carefully selected cases the surgical intervention can be avoided, when the imaging features are classic and an imaging guided biopsy has been adequately performed, as the latter appears to be sufficiently reliable to exclude a malignant process (11).…”