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What Is a Spiculated Mass?

By Synthia L. Rose
Updated Mar 06, 2024
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A spiculated mass is a cluster of barbed tissue that is one of the primary indicators of cancer. Rather than a smooth lump, it has spicules or thin, elongated pieces of tissue sticking out from its perimeter. These spiky tumors can appear anywhere inside the body, but are often found in the breasts or lungs. When found, these masses are typically biopsied to confirm whether they are malignant or benign. If cancerous, treatment ranging from excision to radiation can be used.

Of all the indications of cancer, which include calcified tissue, lesions and smooth masses, the spiculated mass is believed to have the highest incidence of malignancy. For breast cancer cases, one explanation for this might be that cell tissue in these masses has abnormally higher levels of progesterone and estrogen. Some studies have shown that a spiculated mass typically has at least 30 percent more progesterone receptors and estrogen receptors than normal breast tissue or non-spiculated lumps.

While usually cancerous, it is possible in rare cases for a spiculated mass to be benign, particularly in instances where there is scar tissue, granular tumors or the presence of foreign matter in the body. When present, these masses can appear singly or in multiples. Often, they occur with adjacent calcified tissue.

In cases of breast cancer, a spiculated mass usually exists on the periphery of the breast, not the center, and is typically discovered through ultrasonography or a mammogram, which is a screening that uses radiation to create images of breast tissue. A radiologist is able to use computer-aided diagnosis (CAD) software to magnify and highlight abnormalities in breast images with colored lines in order to evaluate whether a mass is spiculated. Spicules are difficult to discern. For lung cancer cases, a computerized tomography (CT) chest scan or magnetic resonance imaging (MRI) can detect a spiculated mass. In conjunction with those procedures, an invasive surgical screening of the chest known as mediastinoscopy might be used.

No other symptoms may accompany the presence of spiculated masses. Sometimes, however, pain, skin thickening and infection can be present. For some breast cancer patients, the inversion of nipples may accompany the presence of a mass of this kind. Smokers and people with cancer history in their families have a higher risk of suffering from spiculated masses.

Treatment for this type of mass located in the breast often includes lumpectomy or mastectomy. Radiotherapy and chemotherapy can be used for both breast and lung masses. Doctors often recommend lifestyle alterations, as well, such as abstinence from alcohol and smoking.

Can Spiculated Mass be Benign?

Breast cancer research shows that benign or malignant processes cause spiculated mass. Thus, tuberculosis, ductal carcinoma, and radial scar are the leading causes of spiculated mass. For instance, a study conducted in East Sussex indicates that about 4% of spiculated masses are benign.

Spiculated masses are often associated with malignancy. Differential diagnosis shows that malignancy has a high predictive value of 90%. If you have spiculated mass, there are higher chances it could be malignant.

Spicules represent several tumor cells in malignant lesions. However, spiculated mass caused by malignancy and benign has no difference in survival rate. In the lungs, round nodules are more likely benign, while irregularly shaped nodules are cancerous.

Benign nodules do not spread to local structures. Instead, they grow slowly and have unique borders. Benign nodules in the lungs are not mostly problematic but lead to extreme pain and other complications when they become significant.

The spiculation sign differentiates benign nodules and malignant ones. The spiculation sign extends from the pulmonary nodule to the pulmonary parenchyma. Diagnosis of benign nodules and malignant nodules are categorized into biopsy and imaging detection.

A biopsy is the most accurate way of detecting benign and malignant. In addition, a biopsy is a primary method of checking the trend of benign nodules from imaging. The doctor must collect samples of suspected spiculated mass in your lungs before a biopsy, and the doctor should check the suspected section in your lungs.

A biopsy is currently considered the standard for judging the presence of a spiculating mass in the breasts or lungs. Remember that doctors don’t need to do biopsies on all malignant nodules. Spiculation signs and cavity signs are the primary imaging features.

Unfortunately, biopsies don’t detect the development of nodules. Instead, it only shows the current benign and malignant spiculated masses. Modern computer imaging technology enables doctors to successfully detect if the spiculated mass is benign or malignant.

What Type of Breast Cancer is Spiculated?

Scientists believe that spiculated mass is common with luminal. Luminal is an invasive type of cancer with low protein levels, which controls how cancer spreads in the body. Luminal A breast cancer has a slower growth rate than other cancers. The difference between Luminal A and typical breast cancer is that normal breast cancer is higher grade.

However, both types of breast cancers have a good prognosis. Patients have five years of survival when diagnosed with either Luminal A or Luminal B type. Managing breast cancer subtypes is overwhelming, and the survival rate is lower at 50%.

If diagnosed with Luminal A breast cancer, you need surgery to remove the tumors through a mastectomy or a lumpectomy. Your surgeon will know which will yield the best outcomes, and reconstructive surgery is usually possible. 

How is Spiculation Characterized in Ultrasound Lesions?

The existence of spiculation is crucial when characterizing malignant tumors. 

There are multiple mammographic methods used to detect a spiculated mass. It’s hard to see spiculation tumors with traditional two-dimensional ultrasound, as the spiculation mass will only appear parallel to the skin in this method.

Recently, medical engineers developed a three-dimensional ultrasound that helps determine the architectural distortion surrounding a breast tumor.

Does Spiculated Mass Always Mean Cancer?

Different types of cancer appear spiculated because of a previous invasion into the nearby tissue. It can also result from a desmoplastic reaction in the breast tissues. For instance, spiculated breast lesions can be differentiated in morphologic characteristics.

In benign cases, the leading causes of spiculation mass are fibrous tissues and lipid-filled spaces. Spiculation in malignant instances is caused by the desmoplastic response and excessive tumor inflation. Mammography is not a reliable method of diagnosing benign and malignant spicules. Patients must undergo frequent breast examination and surgical biopsy.

Radiolucent lines are a clear sign of benign etiology. It’s hard to differentiate spiculated lesions from carcinoma, especially when using the standard mammographic feature. In most cases, radiolucent lines in benign are 86.7 percent, while specificity stands at 61.5 percent.

Parting Shot

No doubt spiculated masses are the leading signs of cancer. However, not all spiculated masses are malignant, and at least 10% of spiculated masses are benign. Biopsy and other latest medical technologies detect if the spiculated mass is benign or malignant.

Frequently Asked Questions

What is a spiculated mass?

A spiculated mass is an irregular growth that may be seen in imaging tests such as a mammogram. The spiculated mass is characterized by a  pattern of radiating lines. Several conditions, including benign tumors, fibrocystic changes, and malignant tumors, can cause this mass. Although not all spiculated masses are cancerous, it is essential to get them checked out.

What are the symptoms of a spiculated mass?

Spiculated masses usually don't trigger any symptoms and are usually detected through imaging tests like mammograms. However, if the mass grows large enough, it may cause a sensation of fullness or the development of a lump in the surrounding region.

How is a spiculated mass diagnosed?

Medical professionals typically detect a spiculated mass by means of imaging procedures like mammography, ultrasound, or MRI. Sometimes, a biopsy may be required to verify the diagnosis and identify the type of mass.

What are the treatment options for a spiculated mass?

The treatment for a spiculated mass depends on the size and type of the mass. In general, non-cancerous masses can be kept under surveillance using imaging exams, while cancerous ones may necessitate surgery or alternative therapies. In some cases, hormone treatment, radiation, or chemotherapy might be advised depending on the circumstances.

Is a spiculated mass always cancerous?

It's not always the case that a spiculated mass signifies cancer. Sometimes, it can indicate a serious health problem, but other times, it may be due to non-cancerous conditions like fibrocystic changes or tumors. To get a better understanding of the situation, it's crucial to consult with a physician for a thorough assessment and diagnosis.

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Discussion Comments

By anon990810 — On May 11, 2015

My only son (43) was diagnosed with granulosis of the right lower lobe. thankful it is not cancer,but his wife continues to smoke around him. A biopsy was performed and the doctor stated "this is as good as your lungs will get." What is the outcome? Will the pain and symptoms of tiredness decrease? They have a family of small children and no insurance. His primary doctor is great, never pressures for all payments. Just what they can afford. God bless doctors who still heal first. Any insight to this and the progress to expect?

By JackWhack — On Aug 15, 2012

@feasting – My doctor told me that I will need to start getting mammograms when I'm forty. She said that before then, my breast tissue will be too dense for the scan to be useful.

Since it would be hard for anyone to see a spiculated mass on a mammogram of a thirty-year-old, there is an alternative. You can get an ultrasound of your breasts.

You probably only need to do this if you feel a lump or soreness, though. I doubt a doctor would recommend it for no reason.

By feasting — On Aug 14, 2012

Breast cancer runs in my family. My grandmother died of it, and I recall the dread that I felt when I heard that the doctor had found a spiculated mass in her breast.

She had a masectomy, but that wasn't enough. She died anyway, and she left me with the fear that I might have the gene for this.

I'm only thirty-three right now, and I'm wondering if I should go ahead and start having mammograms. My doctor hasn't recommended that I get one yet, but I feel like it might be a good idea.

By DylanB — On Aug 13, 2012

I worry a lot about my sister one day getting a spiculated mass in her lungs. She has been smoking for the past twenty-five years, and she has never even tried to quit.

She once told me that her philosophy is, “We've all got to go some way.” I think that she would change her outlook if her doctor told her that he had found a cancerous mass on her lungs, though.

I can't imagine how scary it would be to hear that. I just keep praying that she will quit smoking one day, and I hope that it won't be too late.

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