Breast Hamartoma: A Size Diversity with Psychosocial Impact Analysis of 20 Cases and an Exceptional Case Report Review

Abstract

Objectives: Breast hamartoma is a rare painless benign tumor with limited literature review due to underestimation by clinicians and pathologists. Though slowly growing, delay in diagnosis can lead to physical and psychological impact due to breast size discrepancy. Our study intend was to present breast hamartoma concerning size variance from hardly palpable to gross defacement and its psychosocial impact due to physical disfigurement, along with a case report. Method: We reviewed the demographic data, radiological imaging, and size variability of patients diagnosed with breast hamartoma between May 2006 and November 2019. Results: Overall, 37 cases of female breast hamartoma were operated from 2006 to 2019 but only 20 cases, whose data can be retrieved, in Liaquat National Hospital & Medical College, Karachi Department of General Surgery were included in the study. The mean age of patients was 35±11.92 years. The clinical and histopathological size was 6.12 ±4.44 and 7.88 ±4.23 respectively. Largest recorded size was 20x20cm. There are 65% of cases with less than 40 years and 35% cases with greater than 45 years. Breast ultrasound and Mammograms were performed below 40 years and greater than 40 years age of respectively. Furthermore, one case presented with skin necrosis and necrotizing wound infection underwent wound debridement and later on reduction mammoplasty with hamartoma excision of 2.5 kg. Conclusion: Breast hamartomas are rare benign lesions that may have rapid growth leading to breast disfigurement and must be addressed vigilantly either by close observation or early intervention. Ultrasound has a significant role in diagnosis whereas the role of fine-needle aspiration is questionable.