Findings
Final histopathology was suggestive of Adenomyoepithelioma (AME). (Few foci of atypia were seen, however there was no malignancy)
Answer
We suggested for excision biopsy with good margin as lesion lesion showed features of invasion on imaging. It was discordant with pathological findings. Patient underwent excision biopsy with axillary sampling.
Discussion
Adenomyoepithelioma is a primary breast neoplasm of rare entity caused by proliferation of both epithelial and myoepithelial components, Benign to low grade malignant behavior and has a propensity for recurrence. Either epithelial or myoepithelial component can show malignant transformation so thorough evaluation recommended*. Overlap of histopathological features usually lead to misinterpretation as invasive carcinoma or intraductal papilloma or sclerosing adenosis. Complete wide excision with negative margins is standard treatment to prevent local recurrence. It is difficult to diagnose this on imaging alone, however familiarity with this rare entity to radiologist is essential to raise possibility.
Reference
*D. C. Howlett, C. H. Mason, S. Biswas, P. D. Sangle, G. Rubin, and S. M. Allan. Adenomyoepithelioma of the Breast: Spectrum of Disease with Associated Imaging and Pathology. American Journal of Roentgenology 2003 180:3, 799-803
