E1104. Sanguis (Cruor) Pollicetur Gloriam: Hematologic Diseases of the Breast - Diagnostic Features and Morphologic Mimics
Authors
Ronald Rauch;
The University of Texas MD Anderson Cancer Center
Mary Guirguis;
The University of Texas MD Anderson Cancer Center
Megha Kapoor;
The University of Texas MD Anderson Cancer Center
Elsie Arribas;
The University of Texas MD Anderson Cancer Center
Beatriz Adrada;
The University of Texas MD Anderson Cancer Center
Gary Whitman;
The University of Texas MD Anderson Cancer Center
Tanya Moseley;
The University of Texas MD Anderson Cancer Center
Background
Hematological malignancies are extremely uncommon in the breast, accounting for less than 1% of all breast cancers, and can be either primary or secondary. Other than ipsilateral axillary and supraclavicular lymph nodes, there is no history of extramammary disease or evidence of concurrent malignancy in primary disease. The presence of concurrent hematological malignancy makes secondary hematological diseases of the breast more prevalent and easier to diagnose. Due to its rarity, nonspecific imaging findings, and radiological characteristics that may overlap with those of other breast tumors, diagnosing primary involvement is extremely challenging. It is crucial, however, to make an accurate diagnosis of hematological breast involvement, as its treatment differs from that of breast cancer in that it does not require surgery. Hematological breast diseases may also resemble benign breast lesions. The purpose of this educational exhibit is to review the clinical and imaging findings of breast hematological diseases and to discuss potential diagnostic pitfalls.
Educational Goals / Teaching Points
Review the clinical and imaging findings of primary and secondary hematological diseases of the breast. Discuss the differential diagnosis of primary and secondary hematological diseases of the breast and how to differentiate them from other breast lesions. Examine potential diagnostic pitfalls.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Hematological breast diseases are uncommon and have variable imaging appearances. When suspicious imaging findings are present, pathologic sampling can validate diagnostic suspicions. In addition, a prior history of hematological malignancy can aid in making an accurate diagnosis and averting unnecessary imaging and/or surgical interventions.
Conclusion
The imaging appearance of hematological diseases of the breast may overlap with those of other breast tumors, making an accurate diagnosis challenging but not impossible. An accurate diagnosis of primary hematological breast involvement is profoundly impactful to the patient's care, as the treatment of primary hematologic breast lesions does not require surgery. Since hematological breast diseases may also resemble benign breast lesions, differentiating benign breast lesions from hematological breast diseases may obviate the need for a needle biopsy.
