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    Benign Involuted Fibroadenoma Notes

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    isensepanic
    Fibroadenomas are benign breast tumors that are most common in young women between ages 15-35. They are hormone-dependent and often regress after menopause. While generally considered benign, rare cases of carcinoma arising in fibroadenomas have been reported. Mammographic findings of characteristic popcorn-like calcifications within a well-circumscribed mass are considered diagnostic of a fibroadenoma.

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    Benign Involuted Fibroadenoma Notes

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    isensepanic
    401 views3 pages
    Fibroadenomas are benign breast tumors that are most common in young women between ages 15-35. They are hormone-dependent and often regress after menopause. While generally considered benign, rare cases of carcinoma arising in fibroadenomas have been reported. Mammographic findings of characteristic popcorn-like calcifications within a well-circumscribed mass are considered diagnostic of a fibroadenoma.

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    benign involuted fibroad

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    Fibroadenomas are benign breast tumors that are most common in young women between ages 15-35. They are hormone-dependent and often regress after menopause. While generally considered benign, rare cases of carcinoma arising in fibroadenomas have been reported. Mammographic findings of characteristic popcorn-like calcifications within a well-circumscribed mass are considered diagnostic of a fibroadenoma.

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    401 views3 pages

    Benign Involuted Fibroadenoma Notes

    Uploaded by

    isensepanic
    Fibroadenomas are benign breast tumors that are most common in young women between ages 15-35. They are hormone-dependent and often regress after menopause. While generally considered benign, rare cases of carcinoma arising in fibroadenomas have been reported. Mammographic findings of characteristic popcorn-like calcifications within a well-circumscribed mass are considered diagnostic of a fibroadenoma.

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    Guray 2006:

    Fibroadenoma is the most common lesion of the breast; it occurs in 25% of asymptomatic women
    [101]. It is usually a disease of early reproductive life; the peak incidence is between the ages of
    15 and 35 years. Conventionally regarded as a benign tumor of the breast, fibroadenoma is also
    thought to represent a group of hyperplastic breast lobules called aberrations of normal
    development and involution [10, 101, 102]. The lesion is a hormone-dependent neoplasm that
    lactates during pregnancy and involutes along with the rest of the breast in perimenopause
    [102]. A direct association has been noted between oral contraceptive use before age 20 and the
    risk of fibroadenoma [103]. The Epstein-Barr virus might play a causative role in the development
    of this tumor in immunosuppressed patients [104].
    BRANT:
    Fibroadenomas are the most common well-defi ned solid
    masses seen on mammography ( Fig. 20.13 ). They are homogenous,
    but frequently show large, coarse calcifi cations. They
    may have a lobulated contour, but there are usually only a few
    large lobulations. If a fi broadenoma is not calcifi ed, it cannot be
    distinguished from a cyst by mammography. Sonography will
    allow characterization of fi broadenomas as solid hypoechoic
    masses. The peak age of patients with clinically detected fi broadenomas
    is 20 to 30 years; however, fi broadenomas are seen into
    the eighth decade. They rarely appear or grow after menopause.
    Fibroadenomas can calcify in various patterns. Sometimes
    the calcifi cations are indeterminate, but the classic calcifi cations,
    associated with an atrophic fi broadenoma, are large,
    coarse, and irregular in shape

    FIGURE 20.26. Degenerated Fibroadenoma. Typical large, coarse,


    irregular calcifi cations are seen in a fi broadenoma.
    CASE:

    LIN et al, 2011:


    Fibroadenoma is a common cause of a palpable lump in young premenopausal
    women. The diagnosis is often made confidently when pathognomic popcorn-like
    calcifications are observed in a mammography. These tumors are traditionally
    believed not to be associated with malignancy. Carcinoma arising in a fibroadenoma
    is rare, with a reported prevalence of 0.02% in a screened population

    Mammographically, dense large calcifications of a benign involuting fibroadenoma,


    such as popcorn-like calcifications, when observed within a circumscribed mass, are
    diagnostic and do not require any biopsy.
    Pathology:

    Fibroadenomas usually form during menarche (15 25 years of age), a time at which
    lobular structures are added to the ductal system of the breast (Fig. 1). Hyperplastic
    lobules are common at that time, and may be regarded as a normal phase of breast
    development.16 Hyperplastic lobules were shown to be histologically identical with
    fibroadenomas.10, 17 Analyses of the cellular components of fibroadenomas by means
    of polymerase chain reaction demonstrated that both the stromal and the epithelial
    cells are polyclonal,18supporting the theory that fibroadenomas are hyperplastic
    lesions associated with aberration of the normal maturation of the breast, rather
    than true neoplasms

    Natural history:
    From their incidence in mastectomy specimens, it has been assumed that
    fibroadenomas tend to regress and loss their cellularity with age. The rare finding of
    fibroadenomas in the older age groups also supports the hypothesis of regression of
    fibroadenomas.48 The mechanisms offered to explain the regression of
    fibroadenomas are infarction, calcification, and hyalinization
    Pilnik 2003:
    Usually asmptomatic, however in cases in which an intratumoral hemorrhage has
    occurred, pain could be the initial presenting symptom - More common in pregnant
    or lactating women.

    Causes: unknown: but because fibroadeomas do not occur before menarche, relp
    with ovarian secretion of estrogen is likely. Peak incidence: women over 30.

    Do not change in size during menstrual cycle, but a preexisting fibroadenoma may
    increase in size during pregnancy

    Fibroadenomas may undergo involutional change, This degenerative change is due


    either to increased stromal growth or an unrecognized infarction with necrosis. The
    result is calcification or a hyalinized fibroadenoma. Calcified fibroadenomas,
    (popcorn lesions)

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