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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, a breast hamartoma that remains unchanged often requires regular monitoring, but no treatment. In instances where the hamartoma changes shape or increases in size, a biopsy and surgical removal of the mass may be performed. Rarely does a hamartoma lead to the development of breast cancer, but, for some women, the presence of a fibroadenolipoma may increase the chance of breast cancer later in life.
There is no known cause for the development of a breast hamartoma. Made up of both connective and glandular tissues, it has been asserted that hormones contribute to the formation of a fibroadenolipoma. The hormonal connection is further supported evidentially by the frequency of diagnoses of hamartomas that occur in women of reproductive age.
The solid mass that forms within the breast tissue is palpable and may be easily moved and possesses distinct shape. Though many do not cause pain, if the hamartoma grows large enough it can compress the surrounding tissues or nerves and cause pain. Masses which measure up to 0.7 inches (about 2 cm) in size are considered normal, and those measuring 2 inches (about 5 cm) or more are classified as extremely large. Often, women with a breast hamartoma who are pregnant or breast-feeding may experience an enlargement of the mass, which should be monitored.
There are several tests that may be administered to evaluate a hamartoma. Commonly, a physician will initially ask a series of questions, such as when the lump first appeared and what types of symptoms the woman may be experiencing, and perform a clinical breast exam to check the lump and determine whether there are any additional abnormalities. Imaging tests, such as an ultrasound and mammography, may be administered to produce a clear picture of the location, size, and shape of the hamartoma. Additionally, a fine-needle aspiration and core needle biopsy may also be conducted.
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 During the procedure, a needle is inserted into the mass to draw out fluid; if no fluid is withdrawn, the mass is determined to be solid.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 the use of a large needle to collect tissue samples from the mass, which are sent to a laboratory for analysis. Because these tumors are made of of several types of cells, often the only way to definitively diagnose a lump as a breast hamartoma is after it has been removed.
The 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 with leaving the hamartoma in place may consider having the mass surgically removed. It is important for women to discuss the risks associated with a lumpectomy with their physician prior to opting for surgery. In some cases, removal of a fibroadenolipoma may result in the disfigurement of the breast and the creation of scar tissue.
An excisional biopsy, also known as a lumpectomy, is an invasive procedure that involves the removal of the fibroadenolipoma and part of the surrounding tissue; all of which is 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 on. Women who do not have the mass surgically removed should continue to be conscientious about having regular exams to monitor the mass for any changes that may occur.