Breast hemangioma: The luminous innocuity

Hemangiomas are rare benign vascular tumors of the breast and can occur across a wide age range, and are typically located superficially. They are usually circumscribed masses with phleboliths and complex internal echotexture on ultrasound. Color Doppler often reveals hypovascularity or, in some instances, a complete absence of vascularity. Contrast-enhanced mammography shows early, diffuse, homogenous enhancement, which can mimic malignancy. However, despite potentially suspicious imaging findings, when core needle biopsy confirms a benign hemangioma without atypia with strong rad-path correlation, surgical excision is not indicated. A thorough understanding of the imaging characteristics of hemangiomas, combined with clinicopathologic correlation, is essential for accurate diagnosis and appropriate management. Differentiating from aggressive vascular malignancies such as angiosarcoma is critical to prevent unnecessary delays and ensure prompt treatment.