Breast Hemangiomas: Imaging Features With Histopathology Correlation

Breast hemangiomas are rare benign vascular lesions. In a previously performed review of approximately 10,000 breast surgical pathology results, roughly 0.15% (15/~10 000) were hemangiomas. Hemangiomas are more frequent in women and have a documented age distribution of 1.5 to 82 years. They are mos...

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Bibliographic Details
Published in:Journal of breast imaging 2024-05, Vol.6 (3), p.288-295
Main Authors: Dhami, Alysha, Hao, Meng, Waheed, Uzma, Dashevsky, Brittany Z, Bean, Gregory R
Format: Article
Language:English
Subjects:
Breast - diagnostic imaging
Breast - pathology
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - pathology
Female
Hemangioma - diagnostic imaging
Hemangioma - pathology
Humans
Magnetic Resonance Imaging
Mammography - methods
Ultrasonography, Mammary - methods
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Summary:Breast hemangiomas are rare benign vascular lesions. In a previously performed review of approximately 10,000 breast surgical pathology results, roughly 0.15% (15/~10 000) were hemangiomas. Hemangiomas are more frequent in women and have a documented age distribution of 1.5 to 82 years. They are most often subcutaneous or subdermal and anterior to the anterior mammary fascia but may rarely be seen in the pectoralis muscles or chest wall. On imaging, breast hemangiomas typically present as oval or round masses, often measuring less than 2.5 cm, with circumscribed or mostly circumscribed, focally microlobulated margins, equal or high density on mammography, and variable echogenicity on US. Calcifications, including phleboliths, can be seen. Color Doppler US often shows hypovascularity or avascularity. MRI appearance can vary, although hemangiomas are generally T2 hyperintense and T1 hypointense with variable enhancement. Pathologic findings vary by subtype, which include perilobular, capillary, cavernous, and venous hemangiomas. If core biopsy pathology results are benign, without atypia, and concordant with imaging and clinical findings, surgical excision is not routinely indicated. Because of histopathologic overlap with well-differentiated or low-grade angiosarcomas, surgical excision may be necessary for definitive diagnosis. Findings that are more common with angiosarcomas include size greater than 2 cm, hypervascularity on Doppler US, irregular shape, and invasive growth pattern.
ISSN:2631-6110
2631-6129
DOI:10.1093/jbi/wbae011