Hamartoma of the breast.

Mammary hamartomas are unusual lesions with distinctive radiologic and pathologic features. They are well circumscribed, mobile tumors showing no adherence to skin or muscle. Mammographic studies show a peripheral, luscent halo, and the mass is radiographically similar in pattern to a normal breast ("breast within a breast"). Calcification is not present. Histologically, these encapsulated lesions are composed of various breast tissue components such as ducts, lobules, stroma prominently adipose, and smooth muscle, without any particular arrangement. Local surgical resection is the treatment of choice. Hamartomas of the breast are benign lesions that need to be distinguished from other breast neoplasms such as fibroadenomas, lipomas, and cystosarcoma phyllodes.

[Conservative surgery after preoperative radiotherapy in the treatment of breast cancer. Indications and results]. / La chirurgie conservatrice après radiothérapie à doses préopératoires dans le traitement des cancers du sein. Indications et résultats.

From 1969 to 1983, 122 patients with unifocal breast cancer, equal or more than 3 centimeters in diameter, NON1a or N1b, were treated at the Institut Curie with conservative surgery after pre-operative external irradiation. Among them were 68% T2NON1a, and 26% N1b (with 21% T2N1b); 80% of the tumors were located in the upper part of the breast. Initial radiotherapy with a moderate dose (50 to 55 Gy for the breast and the lower axillary area) was followed 6 weeks later by a lumpectomy either alone (42 cases) or associated to an axillary node resection (80 cases). Five year survival rate with non evident disease T2NON1a cases is 79%, similar to the radical surgery rate in this group. We noted 8% local recurrences with no axillary recurrences. Post operative courses were a little more troubled than with initial lumpectomy. We noted 8% of upper limb oedema, only in patients who received both radiotherapy and surgery in the axilla. Cosmetic results are good in 65% of the cases, while they are good in 80% for initial lumpectomy. So this therapeutic method gives satisfactory results, but we need more cases with a longer follow-up to draw definitive conclusions.