Case 04

(continued)

Answer:

Enhancing masses should be worked up!

It shouldn't surprise you that this is an example of a fibroadenoma. It has some great features for a fibroadenoma -- it's round/oval, it's circumscribed AND it enhances. Cysts might be round and circumscribed, but they definitely do not enhance!

But don't forget that aggressive cancers can also have these benign features!

For this reason, it's really important to work-up these types of masses. The first step is a targeted ultrasound. Can you identify other features that can help you distinguish benign from malignant? If by ultrasound it looks like a fibroadenoma, then follow-up or biopsy is a reasonable option (as is the standard of care for fibroadenoma). If it has any suspicious features on ultrasound, then biopsy is the way to go!

Phillips J, Fein-Zachary VJ, Slanetz PJ. Pearls and Pitfalls of Contrast-Enhanced Mammography. Journal of Breast Imaging. 2019. 1(1):64-72.

Amir T, Hogan MP, Jacobs S, et al. Comparison of False-Positive Versus True-Positive Findings on Contrast-Enhanced Digital Mammography. AJR Am J Roentgenol. 2021 Nov 24

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