BREAST HAMARTOMA WITH INVASIVE DUCTAL CARCINOMA - REPORT OF 2 CASES AND REVIEW OF THE LITERATURE

Two cases of well-defined masses also containing clinical and radiogra phical abnormalities suggestive of malignancy, subsequently found to b e invasive ductal carcinomas in breast hamartomas are described. The p atients were 53 and 78 years old. Both presented with a generally soft palapble breast lump, containing a firm area which in one case invade d and ulcerated the skin. Mammography demonstrated two typical hamarto mas: one containing a spiculated opacity, the other irregular opacitie s with suspicious calcifications, suggesting the presence of carcinoma s in these benign lesions. The cut surface of these well-circumscribed masses measured 5cm and 7cm. The microscopic appearance was character istic of breast hamartoma (sharp circumscribed ''pseudocapsule'' surro unding breast fibrocystic changes with variable amounts of adipose tis sue) with the firm area in each case corresponding to invasive ductal carcinoma. In one case the invasive ductal carcinoma was confined to t he hamartoma, whereas in the other malignant tumor, cells extended bey ond the surrounding breast tissue and infiltrated the skin. These find ings raise the question of secondary involvement of a hamartoma by inv asive carcinoma. Breast hamartomas are probably underrecognized lesion s. In our view, these findings do not justify a more aggressive approa ch towards the management of breast hamartomas.