Breast fibroadenolipoma

Case contribution: Dr Radhiana Hassan


  • A 30 years old lady
  • Presented with right breast lump for 3 years
  • Slow increase in size, not painful
  • No family history of breast cancer
  • Clinically a palpable lump felt in the right breast
  • FNAC done told no malignant cell seen

Ultrasound findings:

  • There is a large lesion in the inner upper quadrant of right breast.
  • This lesion is seen oval in shape with heterogenous echogenicity.
  • The echogenicity is mainly following the normal breast tissue.
  • There is no increase in vascularity and no penetrating vessels.
  • The lesion is seen coursing along the plane of the breast tissue with no infiltration of the tissue anterior or posterior to it.
  • No posterior shadowing.
  • No dilated duct. No abnormal enlargement of axillary nodes.
Bilateral mammogram in CC and MLO views

Mammographic findings:

  • There is a well-defined lesion at right inner quadrant of right breast measuring about 8.0×6.0cm.
  • The lesion is showed heterogenous density main similar to rest of breast tissue.
  • There is compression and displacement of surrounding breast tissue seen with no obvious infiltration.
  • There is no suspicious clutered microcalcification.
  • There is no thickening of the overlying skin. No nipple retraction.
  • No abnormal axillary nodes.

Diagnosis: Benign breast lesions; fibroadenolipoma


  • Breast fibroadenolipomas are rare benign tumours.
  • It is also known as breast hamartomas.
  • It present as a soft, mobile, nodular lesion characterized by slow growth and vary in size from tiny masses to tumor-like formations measuring 10–12 cm in diameter, which may occupy almost the entire breast.
  • It represent 4–8 % of the benign breast lesions diagnosed in women.
  • They are extremely rare in males.
  • Ultrasound in most cases appear as solid, well-defined, oval lesion lying parallel to the skin plane. The echo structure is inhomogeneous with hypoechoic areas intermixed with hyperechoic band-like or nodular areas, reflecting the presence of adipose, epithelial, and fibrous connective tissues.
  • Hypervascularization is absent on color Doppler imaging.
  • On mammogram these lesions are typically seen as oval or round formations, which are inhomogeneous with radio-opaque and radiotransparent areas reflecting the presence of tissues that differ in density.
  • They are well defined by a thin radio-opaque pseudocapsule. The pseudocapsule is composed of breast parenchyma that has been displaced by the mass.
  • The appearance has been described as ‘breast within a breast’ sign.
Author: radhianahassan