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Breast hamartoma
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Presentation A 35-year-old woman presented with a palpable mass in her right breast. A mammogram and ultrasound were performed.
Caption: Cranio-caudal view of right breast
Description: The breast shows dense fibro-glandular architecture. No mass is discernible in this image.
Caption: Medio-lateral oblique view of right breast
Description: Another view reaffirms the presence of a dense fibro-glandular architecture with no specific mass.
Caption: Ultrasound of the palpable abnormality
Description: Ulrasound demonstrates a well-defined hypoechoic mass in the right breast. The mass is predominantly hypoechoic with some internal hyperechoic areas.
Caption: Ultrasound of the palpable abnormality
Description: This is the same image with the borders of the mass delineated by arrows.
Caption: Ultrasound of the palpable abnormality
Description: This composite image demonstrates the entire extent of the mass.
Differential Diagnosis fibroadenoma, hamartoma
Final Diagnosis Breast hamartoma
Discussion The typical ultrasound appearance of a breast hamartoma has been described as a well-defined hypoechoic mass with hyperechoic lines /bands within it 1. The hyperechogenicity may be attributed to the fibrous components of the hamartoma.3
Case References

1. Berná J.D.; Nieves F.J.; Romero T.; Arcas I. A Multimodality Approach to the Diagnosis of Breast Hamartomas with Atypical Mammographic Appearance. The Breast Journal, Volume 7, Number 1, January 2001, pp. 2-7(6)
2. Dianne Georgian-Smith, Bret Kricun, Grace McKee, et al. The Mammary Hamartoma. Appreciation of Additional Imaging Characteristics. J. Ultrasound Med 2004. 23:1267-1273
3. Sandra Hagen-Ansert. Sonographic Evaluation of the Breast. http://www.gehealthcare.com/inen/rad/us/education/msucmebr.html

Follow Up Core biopsy was performed with subsequent excisional biopsy. Pathology demonstrated a breast hamartoma.
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