Benign Lesions

  • Ermanno Vanzi
  • Federica Di Naro
  • Chiara Bellini


Benign breast lesions deserve attention because of their high prevalence. Breast cancer is the most common malignancy in women in developed countries; however, the vast majority of lesions that occur in the breasts are benign. The majority of patients, who present with a clinical breast problem, usually have a benign lesion. Diagnosis of a benign disease of the breast is usually accomplished with mammography, ultrasound (US), magnetic resonance imaging (MRI) or needle biopsies, thereby eliminating the need for surgery [1–3].


  1. 1.
    Guray M, Sahin A. Benign breast diseases: classification, diagnosis, and management. Oncologist. 2006;11(5):435–49.CrossRefGoogle Scholar
  2. 2.
    Putti TC, Pinder SE, et al. Breast pathology practice: most common problems in a consultation service. Histopathology. 2005;47:445–57.CrossRefGoogle Scholar
  3. 3.
    Miltenburg DM, Speigths VO Jr. Benign breast disease. Obstet Gynecol Clin North Am. 2008;35:285–300.CrossRefGoogle Scholar
  4. 4.
    Neal L, Tortorelli CL, et al. Clinician’s guide to imaging and pathologic findings in benign breast disease. Mayo Clin Proc. 2010;85:274–9.CrossRefGoogle Scholar
  5. 5.
    Pearlman MD, Griffin JL. Benign breast disease. Obstet Gynecol. 2010;116:747–58.CrossRefGoogle Scholar
  6. 6.
    Santen RJ, Mansel R. Benign breast disorders. N Engl J Med. 2005;353:275–85.CrossRefGoogle Scholar
  7. 7.
    Goehring C, Morabia A. Epidemiol Rev. 1997;19:310–27.CrossRefGoogle Scholar
  8. 8.
    Runruang B, Kelleym J. Benign breast diseases: epidemiology, evaluation and management. Clin Obstet Gynecol. 2011;54:110–24.CrossRefGoogle Scholar
  9. 9.
    Hartmann LC, Sellers TA, et al. Benign breast disease and the risk of breast cancer. N Engl J Med. 2005;353:229–37.CrossRefGoogle Scholar
  10. 10.
    Bartow SA, Pathak DR, Black WC, et al. Prevalence of benign, atypical and malignant breast lesions in populations at different risk for breast cancer. A forensic autopsy study. Cancer. 1987;60:2751–60.CrossRefGoogle Scholar
  11. 11.
    Smith A. The principles of contrast mammography. Scholar
  12. 12.
    Lobbes MB, Smidt ML, et al. Contrast enhanced mammography: techniques, current results, and potential indications. Clin Radiol. 2013;68:935–44.CrossRefGoogle Scholar
  13. 13.
    Diekmann F, Freyer M, et al. Evaluation of contrast enhanced digital mammography. Eur J Radiol. 2011;78:112–21.CrossRefGoogle Scholar
  14. 14.
    Kamal R, Helal M, et al. Can we apply the MRI BI-RADS lexicon morphology descriptors on contrast-enhanced spectral mammography? Br J Radiol. 2016;89(1064):20160157.CrossRefGoogle Scholar
  15. 15.
    Jochelson MS, Dershaw DD, Sung JS, et al. Bilateral contrast enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MRI imaging in women with known breast carcinoma. Radiology. 2013;266:743–51.CrossRefGoogle Scholar
  16. 16.
    Dupont WD, Page DL. Risk factors for breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer. 1993;71:1258–65.CrossRefGoogle Scholar
  17. 17.
    Orr B, Kelley JL III. Benign breast diseases: evaluation and management. Clinical Obstet Gynecol. 2016;59(4):710–26.CrossRefGoogle Scholar
  18. 18.
    Goel NB, Knight TE, et al. Fibrous lesions of the breast: imaging-pathologic correlation. Radiographics. 2005;25:1547–59.CrossRefGoogle Scholar
  19. 19.
    Dupont WD, Dl P, et al. Long term risk of breast cancer in women with fibroadenoma. N Engl J Med. 1994;331:10–5.CrossRefGoogle Scholar
  20. 20.
    Houssami N, Irwig L, Ung O. Review of complex breast cysts: implications for cancer detection and clinical practice. ANZ J Surg. 2005;75:1080–5.CrossRefGoogle Scholar
  21. 21.
    Venta LA, Kim JP, Pelloski CE, et al. Management of complex breast cysts. AJR Am J Roentgenol. 1999;173:1331–6.CrossRefGoogle Scholar
  22. 22.
    Jensen RA, Page DL, Dupont WD, et al. Invasive breast cancer risk in women with sclerosing adenosis. Cancer. 1989;64:1977–83.CrossRefGoogle Scholar
  23. 23.
    London SJ, Connolly JL, Schnitt SJ, et al. A prospective study of benign breast disease and the risk of breast cancer. JAMA. 1992;267:941–4.CrossRefGoogle Scholar
  24. 24.
    Hines N, Slanetz PJ, et al. Cystic masses of the breast. AJR. 2010;194:W122–33.CrossRefGoogle Scholar
  25. 25.
    Chen J, Nalcioglu O, et al. Fibrocystic change of the breast presenting as a focal lesion mimicking breast cancer in MR imaging. J Magn Reson Imaging. 2008;28(6):1499–505.CrossRefGoogle Scholar
  26. 26.
    Chen J, Liu H, et al. MR imaging features of fibrocystic change of the breast. Magn Reson Imaging. 2008;26(9):1207–14.CrossRefGoogle Scholar
  27. 27.
    Tse GM, Law BK, et al. Hamartoma of the breast: a clinical pathological review. J Clin Pathol. 2002;55:951–4.CrossRefGoogle Scholar
  28. 28.
    Linda A, Zuiani C, et al. The wide spectrum of hyperechoic lesions of the breast. Clin Radiol. 2011;66:559–65.CrossRefGoogle Scholar
  29. 29.
    Linda A, Zuini C, Lorenzon M, et al. Hyperechoic lesions of the breast: not always benign. AJR Am J Roentgenol. 2011;196:1219–24.CrossRefGoogle Scholar
  30. 30.
    Adrada B, Wu Y, Yang W. Hyperechoic lesions of the breast: radiologic-histopathologic correlation. AJR Am J Roentgenol. 2013;200:W518–30.CrossRefGoogle Scholar
  31. 31.
    Presazzi A, Di Giulio G, et al. Breast hamartoma: ultrasound, elastosonographic, and mammographic features. Mini pictorial essay. J Ultrasound. 2015;18:373–7.CrossRefGoogle Scholar
  32. 32.
    Knogler T, Homolka P, et al. Application of BI-RADS descriptors in contrast enhanced dual-energy mammography: comparison with MRI. Breast Care. 2017;12:212–6.CrossRefGoogle Scholar
  33. 33.
    Tuffarelli M, Pellegrini A, et al. Positive predictive value of brast lesions of uncertain malignant potential (B3): Can we identify high risk patients? The value of a multidisciplinary team and implications in the surgical treatment. Surg Oncol. 2016;25:119–22.CrossRefGoogle Scholar
  34. 34.
    Rakha EA, Ho BC, et al. Outcome of breast lesions diagnosed as lesion of uncertain malignant potential (B3) or suspicious of malignancy (B4) on needle core biopsy, including detaile review of epithelial atypia. Histopathology. 2011;56:626–32.CrossRefGoogle Scholar
  35. 35.
    Rageth CJ, O’Flynn EAM, et al. First International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions). Breast Cancer Res Treat. 2016;159:203–2013.CrossRefGoogle Scholar
  36. 36.
    Eiada R, Chong J, et al. Papillary lesions of the breast: MRI, ultrasound, and mammographic appearances. AJR Am J Roentgenol. 2012;198:264–71.CrossRefGoogle Scholar
  37. 37.
    Tan PH, Lai LM, et al. Fat necrosis of the breast: a review. Breast. 2006;15:313–8.CrossRefGoogle Scholar
  38. 38.
    Taboada J, Stephens T, et al. The many faces of fat necrosis in the breast. AJR Am J Roentgenol. 2009;192:815–25.CrossRefGoogle Scholar
  39. 39.
    Dromain C, Thibault F, Diekmann F, et al. Dual energy contrast-enhanced digital mammography: initial clinical result of a multireader, multicase study. Breast cancer Res. 2012;14:R94.CrossRefGoogle Scholar
  40. 40.
    Luczynka E, Heinze-Paluchowska S, et al. Contrast enhanced spectral mammography: comparison with conventional mammography and histopathology in 152 women. Korean J Radiol. 2014;15:689–96.CrossRefGoogle Scholar
  41. 41.
    Luczynka E, Niemiec J, et al. Degree of enhancement on contrast enhanced spectral mammography (CESM) and lesion type on mammography (MG): comparison based on histological results. Med Sci Monit. 2016;22:3886–93.CrossRefGoogle Scholar
  42. 42.
    Covington MF, Pizzitola VJ, et al. The future of contrast enhanced mammography. AJR Am J Roentgenol. 2018;210:1–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Ermanno Vanzi
    • 1
  • Federica Di Naro
    • 1
  • Chiara Bellini
    • 1
  1. 1.Diagnostic Senology Unit, Department of RadiologyAzienda Ospedaliero Universitaria CareggiFlorenceItaly

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