Breast hamartoma: Ultrasound, elastosonographic, and contrast-enhanced ultrasound features

Aims: To present the ultrasound (US), shear-wave elastography (SWE), and contrast-enhanced ultrasonography (CEUS) features of breast hamartomas. Subjects and Methods: In this retrospective analysis, we included 36 breast hamartomas of 36 female patients who had been scheduled for US-guided vacuum-assisted biopsy (VAB) or surgical excision between May 2013 and October 2016. In the 36 patients, US, CEUS, and SWE were performed, and the pathology results from surgical or VAB were obtained. The US, SWE, and CEUS features of the lesions were analyzed. Results: All breast hamartomas had an oval-shaped and a circumscribed margin. Of the 36 hamartomas, 30 (83.3%) had heterogeneous echogenicity and 28 (77.8%) displayed no changes in posterior echogenicity. There were no significant differences in the maximum, mean, and minimum elasticity between the hamartomas and peripheral parenchyma (P = 0.885, 0.683, and 0.451, respectively). All hamartomas appeared with a clear edge on CEUS, and none showed lesion diameter expansion after the injection of contrast. Compared with the peripheral parenchyma, 10 hamartomas (27.8%) showed rapid perfusion mode, 23 (63.9%) showed equal perfusion mode, 24 (66.7%) showed equal enhancement, and 9 (25.0%) showed hyperenhancement. The mean peak intensity and area under the curve of hamartomas were significantly higher than those of peripheral parenchyma (P = 0.013 and P = 0.011, respectively). The peak time and increasing-start time were not significantly different between hamartomas and peripheral parenchyma (P = 0.321 and P = 0.215, respectively). Conclusions: Hamartomas have typical features on US, SWE, and CEUS. Applying multiple ultrasound techniques would be helpful for their diagnosis.