Discussion Author(s): ENS Elisabeth A. Pimentel
Approximately 90% of presentations related to the breast are benign conditions, despite the greater emphasis placed on breast cancer findings in mammography. But in order to know what findings to be concerned about, an appreciation for normal variants and benign conditions must be learned. In this case, the patient has a lipoma found incidentally on routine screening mammography. Lipoma is characterized mammographically by fatty tissue, lucent, surrounded by a thin fibrous capsule. If the lipoma were felt on physical exam, it would be expected to be soft, freely moveable and well delineated. Treatment for a lipoma can include surgical removal but often times is just left alone, especially in this case as the patient does not appreciate a mass. A galactocele is characterized mammographically as a radiolucent mass in a dense lactating breast. Obviously, this patient being 76 y/o is not lactating. However, in a younger patient, this diagnosis must be considered when a radiolucent mass is seen on mammography. Galactoceles can also present on mammography with a fluid level seen within the radiolucent mass. This patient has not experienced any trauma in the recent past therefore making less likely the possibility of a traumatic oil cyst.
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