E3416. Managing the Unexpected: Breast Cancer Mimics
  1. Michael Chan; Vanderbilt University Medical Center
  2. Tamarya Hoyt; Vanderbilt University Medical Center
Numerous breast conditions can present with unexpected and equivocal imaging findings, ranging from proliferative conditions such as fibromatosis to inflammatory conditions including diabetic mastopathy, and benign tumors such as granular cell tumors. Due to shared suspicious imaging characteristics found in these conditions and also in malignancy, tissue sampling is often necessary to confirm the diagnosis. It is essential for interpreting radiologists to be familiar with these entities and their classic features in order to preserve concordance with the underlying histopathological findings, and provide added value when developing a plan for management.

Educational Goals / Teaching Points
The purpose of this exhibit is to showcase uncommon breast pathologies and atypical presentations of various pathologies that pose unique diagnostic challenges, identify key clinical, demographic, and imaging characteristics, discuss management pathways, and share clinical pearls essential to effective decision-making based on recommendations from the current literature.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This educational exhibit consists of a series of cases with uncommon or atypical breast pathologies in the form of a curated discussion. Cases vary in presentation and include inflammatory breast conditions such as fat necrosis, diabetic mastopathy, and granulomatous mastitis, proliferative breast conditions such as breast hamartomas, and benign breast lesions including fibromatosis, pseudoangiomatous hyperplasia (PASH), tubular adenoma, and granular cell tumor. Mammography, sonography, and MRI will be utilized to demonstrate imaging characteristics of these entities with extensive discussion focused on management of these lesions and generation of a general framework to approach these lesions.

Uncommon breast pathologies and unexpected presentations of pathologies can pose unique diagnostic challenges to establishing a diagnosis and preserving radiologic-pathologic concordance, which will ultimately influence underlying management. This educational exhibit shares key diagnostic and management considerations to effectively approach these cases.