Breast amyloidosis

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Amyloid deposition in the breast occurs predominantly in two forms

  • breast involvement in primary amyloidosis - commoner
  • in association with other conditions like multiple myeloma, plasmacytosis and rheumatoid arthritis and another in the localized form which is rarer. 

Clinical presentation

  • usually seen in elderly patients
  • painless, solitary firm or hard mass (amyloidoma)

Pathology

Amyloidosis is a systemic disease which is characterized by extracellular deposition of various insoluble proteins which may get deposited in any part of the body including breast.

The mass (or amyloidoma) is composed of amyloid deposits which are found predominantly around the ducts and blood vessels. The amyloid deposits are clearly demonstrated with Congo red staining.

Disease can be unilateral or bilateral.

Radiographic features

Mammography

Breast amyloidosis may be seen as:

  • spiculated high density area
  • amorphous microcalcifications

History and etymology

Amyloidosis in the breast was first reported by BB Fernandez and FJ Hernandez in 1973 .