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What Causes A Lump In The Breast?
Question: My mother is 52 years old and has regular yearly mammogram and ultrasound. This year she did it in a different facility and with a different radiologist.
The radiologist said everything was normal, she noticed an isolated lesion on ultrasound (not palpable) and she said it is either a fat lobule or lipoma.
From what I have read, fat lobule can easily be identified when looked at a different plane as it will always merge or surrounding fat. Is this true ?
And how commonly are isolated fat lobules seen on ultrasound ?
Also, would a lipoma always show on mammogram as a fatty lesion with thin capsule ? Nothing was seen on mammogram at the same location of the lipoma/fat lobule see on ultrasound.
The radiologist said everything was normal, she noticed an isolated lesion on ultrasound (not palpable) and she said it is either a fat lobule or lipoma.
From what I have read, fat lobule can easily be identified when looked at a different plane as it will always merge or surrounding fat. Is this true ?
And how commonly are isolated fat lobules seen on ultrasound ?
Also, would a lipoma always show on mammogram as a fatty lesion with thin capsule ? Nothing was seen on mammogram at the same location of the lipoma/fat lobule see on ultrasound.
Brief Answer:
Imaging visualisation depends on fat concentration and arrangement of cell
Detailed Answer:
Hi,
Thanks for writing in to us.
The breast is made of fatty and glandular elements. In younger women there is more glandular tissue and with aging the fatty tissue increases.
At age above 50 years a fatty breast is usually seen with less glandular areas.
Answering your questions in detail.
1. It is the distribution of fat cells which help in visualisation of fat. If the fat density is the same then it will merge with surrounding areas.
2. In elderly women fat lobules are commonly visualised because of sparse glandular tissue.
3. Lipoma might not have a capsule every time. Therefore though a thin capsule can be visualised in most lipomas, it is not seen in every case.
4. Fat is radiolucent and does not usually form a density which can be visualised on mammography. Occasionally a dense lipoma can be seen due to concentration of fat and arrangement of cells.
Hope your query is answered.
Please do write back if you have any doubts.
Regards.
Imaging visualisation depends on fat concentration and arrangement of cell
Detailed Answer:
Hi,
Thanks for writing in to us.
The breast is made of fatty and glandular elements. In younger women there is more glandular tissue and with aging the fatty tissue increases.
At age above 50 years a fatty breast is usually seen with less glandular areas.
Answering your questions in detail.
1. It is the distribution of fat cells which help in visualisation of fat. If the fat density is the same then it will merge with surrounding areas.
2. In elderly women fat lobules are commonly visualised because of sparse glandular tissue.
3. Lipoma might not have a capsule every time. Therefore though a thin capsule can be visualised in most lipomas, it is not seen in every case.
4. Fat is radiolucent and does not usually form a density which can be visualised on mammography. Occasionally a dense lipoma can be seen due to concentration of fat and arrangement of cells.
Hope your query is answered.
Please do write back if you have any doubts.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I would appreciate the use of simpler terms and phrasing to understand.
So I still did not understand, would a fat lobule always merge with surrounding fat on ultrasound?
Is it commonly difficult to distinguish a lipoma
from fat lobule on ultrasound ?
My mother's report says her breast is 50-75% fibroglandular tissue.
So I still did not understand, would a fat lobule always merge with surrounding fat on ultrasound?
Is it commonly difficult to distinguish a lipoma
from fat lobule on ultrasound ?
My mother's report says her breast is 50-75% fibroglandular tissue.
Brief Answer:
A fat lobule will likely merge with surrounding fat in a fatty breast
Detailed Answer:
Hi,
Thanks for writing back with an update.
In simple terms, the breast in a young women contains fat and glands which secrete milk when a child is born.
The glands usually decrease in number with increasing age and after 60 years the glands are very few in number.
In your mothers report it is written that the breast contains a normal amount of glandular tissue of 50 to 75 percent and this is normal in some women.
A lipoma is a focal area of fat and lobules are normal structures.
In ultrasound we see in gray scale and make out different structures. Therefore a lipoma can be similar or brighter than a lobule. When a lipoma is brighter than a lobule then it is easy to tell the difference between a lipoma and lobule. When the lipoma and lobule is of same gray shade then it is difficult to tell it apart form a lipoma.
In many cases a lipoma is brighter than a lobule and therefore can be differentiated from each other. Rarely a lipoma can have septations and this can also help to make out a lipoma.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
A fat lobule will likely merge with surrounding fat in a fatty breast
Detailed Answer:
Hi,
Thanks for writing back with an update.
In simple terms, the breast in a young women contains fat and glands which secrete milk when a child is born.
The glands usually decrease in number with increasing age and after 60 years the glands are very few in number.
In your mothers report it is written that the breast contains a normal amount of glandular tissue of 50 to 75 percent and this is normal in some women.
A lipoma is a focal area of fat and lobules are normal structures.
In ultrasound we see in gray scale and make out different structures. Therefore a lipoma can be similar or brighter than a lobule. When a lipoma is brighter than a lobule then it is easy to tell the difference between a lipoma and lobule. When the lipoma and lobule is of same gray shade then it is difficult to tell it apart form a lipoma.
In many cases a lipoma is brighter than a lobule and therefore can be differentiated from each other. Rarely a lipoma can have septations and this can also help to make out a lipoma.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I know what a normal breast contains and what a fat lobule is.
My question again, in a breast with 50-75% glandular tissue based on your experience as a radiologist, are fat lobules in such breasts like my my mother's commonly merged with fat or isolated ?
The lesion on ultrasound was isoechoic. Is lipoma or fat lobule likely to be isoechoic ? By brighter u mean hypoechoic ?
Is there a chance that it is a liposarcoma?
The radiologist also did color Doppler and said it is avascular.
My question again, in a breast with 50-75% glandular tissue based on your experience as a radiologist, are fat lobules in such breasts like my my mother's commonly merged with fat or isolated ?
The lesion on ultrasound was isoechoic. Is lipoma or fat lobule likely to be isoechoic ? By brighter u mean hypoechoic ?
Is there a chance that it is a liposarcoma?
The radiologist also did color Doppler and said it is avascular.
Brief Answer:
Fat lobules can be isolated or merged and do not follow any fixed pattern
Detailed Answer:
Hi,
Thanks for writing back with an update.
Fat lobules can be isolated or merged and do not follow any fixed pattern in a patient.
Both lipoma and lobule can be isoechoic on ultrasound.
By brighter I mean hyperechoic.
Liposarcoma chances are less but it cannot be ruled out 100 percent. A biopsy is the only confirmatory investigation.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Fat lobules can be isolated or merged and do not follow any fixed pattern
Detailed Answer:
Hi,
Thanks for writing back with an update.
Fat lobules can be isolated or merged and do not follow any fixed pattern in a patient.
Both lipoma and lobule can be isoechoic on ultrasound.
By brighter I mean hyperechoic.
Liposarcoma chances are less but it cannot be ruled out 100 percent. A biopsy is the only confirmatory investigation.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
If this is in fact a fat lobule and it was not reported on previous ultrasounds, what would make it be noticed now ?
Would the dispersion of fat and glandular tissue in the breast change with time to make some fat lobules suddenly isolated and more prominent ? Or perhaps this radiologist was looking too closely at this area specifically that she noticed this particular fat lobule ?
I have attached an ultrasound picture. Does it look like its merging with fat on one side ?
Would the dispersion of fat and glandular tissue in the breast change with time to make some fat lobules suddenly isolated and more prominent ? Or perhaps this radiologist was looking too closely at this area specifically that she noticed this particular fat lobule ?
I have attached an ultrasound picture. Does it look like its merging with fat on one side ?
Brief Answer:
There are features which might represent a merging with surrounding fat
Detailed Answer:
Hi,
Thanks for writing back with an update.
Ultrasound is a skilled technique and this lobule is too small. Therefore not every radiologist will highlight an isolated lobule unless there is a suspicion on careful visualisation. The picture you have sent shows that the structure is well defined and unlikely to be a malignancy.
There is constant change over weeks to months and fat lobules might become isolated and prominent over time. Yes the radiologist was looking at this too closely to pick it up.
There is a small area which might represent a merging of the fat lobule with surrounding fat.
Hope your query is answered.
Please do write back if you have an doubts,
Regards,
There are features which might represent a merging with surrounding fat
Detailed Answer:
Hi,
Thanks for writing back with an update.
Ultrasound is a skilled technique and this lobule is too small. Therefore not every radiologist will highlight an isolated lobule unless there is a suspicion on careful visualisation. The picture you have sent shows that the structure is well defined and unlikely to be a malignancy.
There is constant change over weeks to months and fat lobules might become isolated and prominent over time. Yes the radiologist was looking at this too closely to pick it up.
There is a small area which might represent a merging of the fat lobule with surrounding fat.
Hope your query is answered.
Please do write back if you have an doubts,
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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