Breast Imaging Society, India

Contributed By:

Dr.Sabita Subhash Desai
Breach Candy Hospital Bhulabhai Desai Road

Case History:

40-year-old lady came for a routine mammogram. Previous history of a lump in the left axillary region which she noticed during lactation.

Quiz Question:

What BI-RADS assessment category will you assign for this mass?

Answer

BI-RADS 2 Benign Pseudohamartoma appearance of a Chronic Galactocele within the accessory breast tissue

Discussion

Galactocele is a milk-filled retention cyst caused by the obstruction of the lactiferous duct. It is the most common benign breast mass in women who are or who recently stopped lactating. Clinically, it manifests as one or multiple painless palpable masses On mammography, galactocele can exhibit various imaging features depending on the proportion of fat and protein in the individual's breast milk. When completely radiolucent with a relatively high fat content, it is known as pseudolipoma. A cystic mass with a fat-fluid level is a diagnostic indicator of a galactocele, with the fat content above and the water content remaining at the bottom. Alternatively, when the high viscosity of breast milk does not allow the separation of the fat and water contents, a galactocele can resemble a hamartoma; this condition is known as pseudohamartoma

Findings

Mammography Accessory breast tissue in the left axillary region. Fat containing oval mass with circumscribed margins and a thin capsule around it. Additional left axillary tail view done . Ultrasound Oval mass with circumscribed margin,complex solid and cystic with no vascularity on color doppler.

References

Lee SE, Bae YK. Breast lesions during pregnancy and lactation: a pictorial essay. Ultrasonography. 2020 Jul;39(3):298-310. doi: 10.14366/usg.19070. Epub 2020 Jan 23. PMID: 32114749; PMCID: PMC7315302.

January 2023