{"id":210,"date":"2025-06-03T21:36:27","date_gmt":"2025-06-03T21:36:27","guid":{"rendered":"https:\/\/depts.washington.edu\/breast-imaging-teach\/?p=210"},"modified":"2025-06-30T10:22:22","modified_gmt":"2025-06-30T18:22:22","slug":"case-12","status":"publish","type":"post","link":"https:\/\/depts.washington.edu\/breast-imaging-teach\/?p=210","title":{"rendered":"Case 10"},"content":{"rendered":"<p>Contributed by: Steven J. Rockoff, MD and Diana L. Lam, MD &#8211; June 1, 2020<\/p>\n<div class=\"wp-block-pb-accordion-item c-accordion__item js-accordion-item no-js\" data-initially-open=\"false\" data-click-to-close=\"true\" data-auto-close=\"true\" data-scroll=\"false\" data-scroll-offset=\"0\">\n<h2 id=\"at-2100\" class=\"c-accordion__title js-accordion-controller\" role=\"button\">Question 1<\/h2>\n<div id=\"ac-2100\" class=\"c-accordion__content\">\n<p>A 37-year-old woman presents for evaluation of a right breast mass that was incidentally seen on a CT exam for an unrelated issue.<\/p>\n<p>Diagnostic ultrasound:<\/p>\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"188\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-2-375x235-1-300x188.png\" alt=\"\" class=\"wp-image-213\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-2-375x235-1-300x188.png 300w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-2-375x235-1.png 375w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"170\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-1-375x213-1-300x170.png\" alt=\"\" class=\"wp-image-214\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-1-375x213-1-300x170.png 300w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-1-375x213-1.png 375w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n<p>Diagnostic mammogram:<\/p>\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"225\" height=\"300\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/MLO-375x501-1-225x300.png\" alt=\"\" class=\"wp-image-215\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/MLO-375x501-1-225x300.png 225w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/MLO-375x501-1.png 375w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/figure>\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"214\" height=\"300\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/CC-375x526-1-214x300.png\" alt=\"\" class=\"wp-image-216\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/CC-375x526-1-214x300.png 214w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/CC-375x526-1.png 375w\" sizes=\"auto, (max-width: 214px) 100vw, 214px\" \/><\/figure>\n<p>What is your assessment?<br \/>A. BI-RADS 0 (Incomplete); Recommend diagnostic MRI<br \/>B. BI-RADS 1 (Negative); Recommend one year follow-up<br \/>C. BI-RADS 2 (Benign); Recommend one year follow-up<br \/>D. BI-RADS 3 (Probably Benign); Recommend six month follow-up<br \/>E. BI-RADS 4 (Suspicious); Recommend biopsy<\/p>\n<div class=\"wp-block-pb-accordion-item c-accordion__item js-accordion-item no-js\" data-initially-open=\"false\" data-click-to-close=\"true\" data-auto-close=\"true\" data-scroll=\"false\" data-scroll-offset=\"0\">\n<h3 id=\"at-2101\" class=\"c-accordion__title js-accordion-controller\" role=\"button\">Answer<\/h3>\n<div id=\"ac-2101\" class=\"c-accordion__content\">\n<p><strong>Explanation:&nbsp;<\/strong>The large mass in the right breast at 9:00 is a breast hamartoma, also known as a fibroadenolipoma. This benign mass has the characteristic \u201cbreast within a breast\u201d appearance on mammogram, which is a well-circumscribed oval mass composed of normal fibroglandular and adipose tissue. These are benign malformations and do not require biopsy.<\/p>\n<p>The yellows arrows in these ultrasound images demarcate the capsule of the hamartoma. The green stars denote the hypoechoic areas of fibroglandular tissue within the hamartoma and the red arrows denote the hyperechoic areas of fat within the hamartoma:<\/p>\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"188\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-4a-375x235-1-300x188.png\" alt=\"\" class=\"wp-image-217\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-4a-375x235-1-300x188.png 300w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-4a-375x235-1.png 375w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"170\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-3a-375x213-1-300x170.png\" alt=\"\" class=\"wp-image-218\" srcset=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-3a-375x213-1-300x170.png 300w, https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/US-3a-375x213-1.png 375w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n<p>Although not needed to make the diagnosis, the CT on which the breast hamartoma was partially visualized also demonstrates multiple internal fat elements within the mass:<\/p>\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"262\" height=\"300\" src=\"https:\/\/depts.washington.edu\/breast-imaging-teach\/wordpress\/wp-content\/uploads\/2025\/06\/CT-annot-262x300-1.png\" alt=\"\" class=\"wp-image-219\"\/><\/figure>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Contributed by: Steven J. Rockoff, MD and Diana L. Lam, MD &#8211; June 1, 2020<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-210","post","type-post","status-publish","format-standard","hentry","category-quiz"],"_links":{"self":[{"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/posts\/210","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=210"}],"version-history":[{"count":4,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/posts\/210\/revisions"}],"predecessor-version":[{"id":687,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=\/wp\/v2\/posts\/210\/revisions\/687"}],"wp:attachment":[{"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=210"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=210"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/depts.washington.edu\/breast-imaging-teach\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=210"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}