FIBROCYSTIC CHANGE

• Presents mammographically as dense breasts with scattered punctate calcifications and fluctuating cysts that may or may not contain milk of calcium. 

• Cysts are not dense are only rarely calcify

PHYLLODES TUMOR

• Can present as complex cystic and solid mass

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• 70-90% of sx IP occur in the subareolar breast with main duct/lactiferous sinus

• Most commonly central near the nipple

• Usually solitary, in large ducts, and may be intracystic (inside a dilated duct)

• There is usually some fluid evident surrounding at least a portion of a solid mass on sonography

• Most present with nipple discharge; usually clear but can be bloody

  • Suspicious discharge: unilateral spontaneous, uniductal clear or bloody nipple discharge

  • If US and mammography are unrevealing for suspicious nipple discharge, further evaluation with galactography or MR should be considered.

• 15-20% risk of upgrade to carcinoma or high-risk lesion (atypical ductal hyperplasia)

• Surgical excision is recommended when a benign papilloma is diagnosed via core needle bx

FAT NECROSIS

• Benign nonsuppurative process related to breast trauma/surgery.

• No malignant potential and no treatment is necessary

• Imaging findings can overlap with malignancy, thus proper clinical hx of trauma or surgery is helpful

• Calcium deposits in fat necrosis develops over 1.5-5 years or later after trauma and coarsen over time.

• Calcs seen within 1st year after surgery at lumpectomy site in a pt w/ prior CA are more likely residual carcinoma and may prompt bx.

LIPOMA

GALACTOCELE

HAMARTOMA

• AKA fibroadenolipoma

• More encapsulated appearance with bot hfat and glandular elements within.

• Has a breast within a breast mammographic appearance and would not have peripheral calcifications.

LACTATING ADENOMA