Clinical Image

A “Breast” Within the Breast

Despoina D Kakagia1 and Eleni I Effraimidou2*
1Department of Plastic Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
2Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece


*Corresponding author: Eleni I. Effraimidou, Department of Surgery, Democritus University of Thrace, First Surgical Department, University Hospital of Alexandroupolis, University Campus, Dragana, Alexandroupolis, 681 00, Greece


Published: 30 Nov, 2017
Cite this article as: Kakagia DD, Effraimidou EI. A “Breast” Within the Breast. Clin Surg. 2017; 2: 1787.

Clinical Image

A 31-year-old female presented with unilateral slowly progressing gigantomastia (Figure 1), without any further medical history. A circumscribed, painless, mobile mass was clinically evident, without palpable axillary lymph nodes. A single 22 cm × 13 cm solid tumor was measured by ultrasound and Magnetic Resonance Imaging (MRI) showed a “breast within the breast” subtly encapsulated, heterogeneous lesion, consisting of confluent fibroadenotic elements, sizable fat lobules and scattered cysts (Figure 2). Core biopsy was not performed to avoid local tumor spreading. Tumor excision via inverted “T” incision and nipple-areola free grafting achieved symmetry to the small contralateral breast. Histologically, layers of normal breast tissues, without epithelial atypia, cysts with focal apocrine epithelial metaplasia and foci of sclerosing adenosis confirmed breast hamartoma. Recovery was uneventful. Mammographic or MRI scans in conjunction with clinical and ultrasonographic evaluation are diagnostic of breast hamartomas. Essential management consists of tumor excision, while breast reduction techniques warrant optimal aesthetic outcomes.

Figure 1

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Figure 1
Clinical appearance of the patient with marked anisomastia.

Figure 2

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Figure 2
MRI feature of “a breast within the breast”, characteristic of breast hamartoma. Arrows circumscribe the lesion.