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Management of breast fibroadenomas

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Abstract

OBJECTIVE: To identify from the literature and clinical experience a rational approach to management of fibroadenomas of the breast.

METHOD: Recent literature on detection, diagnosis, and natural history of fibroadenomas was reviewed. Experience with over 4,000 women evaluated in the breast clinic at the Tel-Aviv Medical Center contributed to the management strategies suggested by review of the literature.

RESULTS: Fibroadenomas of the breast are common, accounting for 50% of all breast biopsies performed. Physical examination, sonography, and fine needle aspiration are effective in distinguishing fibroadenomas from breast cancer. Transformation from fibroadenoma to cancer is rare; regression or resolution is frequent, supporting conservative approaches to follow-up and management.

CONCLUSION: Age-based algorithms that allow for conservative management and that limit excision to patients whose fibroadenomas fail to regress are presented.

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References

  1. Dent DM, Hacking EA, Wilkie W. Benign breast disease clinical classification and disease distribution. Br J Clin Pract. 1988;42(suppl 56):69–71.

    Google Scholar 

  2. Franyz VK, Pickern JW, Melcher GW, Auchincoloss JR. Incidence of chronic cystic disease in so-called normal breast: a study based on 225 post mortem examinations. Cancer. 1951;4:762–7.

    Article  Google Scholar 

  3. Schuerch C, Rosen PP, Hirota T, Itabashi M. A pathologic study of benign breast disease in Tokyo and New York. Cancer. 1982;50:1899–902.

    Article  PubMed  Google Scholar 

  4. Onuigb WIB. Adolescent mass in Nigerian igbos. Am J Surg. 1979;137:367–71.

    Article  Google Scholar 

  5. Brinton LA, Vajsey MP, Flavel R. Risk factors for benign breast disease. Am J Epidemiol. 1981;113:203–14.

    PubMed  CAS  Google Scholar 

  6. Soini I, Aine R, Lauslthti K. Independent risk factor of benign and malignant breast lesion. Am J Epidemiol. 1981;114:507–14.

    PubMed  CAS  Google Scholar 

  7. Yu H, Rohan TE, Cook MG, Howe GR. Risk factor for fibroadenoma: a case control study in Australia. Am J Epidemiol. 1992;135:247–58.

    PubMed  CAS  Google Scholar 

  8. Funder Burk WW, Rosero E, Leffall LD. Breast lesions in blacks. Surg Gynecol Obstet. 1972;135:58–61.

    CAS  Google Scholar 

  9. Ravnihar B, Segel DG, Lindther J. An epidemiologic study of breast cancer and benign breast neoplasm in relation to the oral contraceptive and estrogen use. Eur J Cancer. 1979;15:395–405.

    PubMed  CAS  Google Scholar 

  10. Canny PF, Berkowitz GS, Kelsey JL. Fibroadenoma and the use of exogenous hormones: a case control study. Am J Epidemiol. 1988;127:454–61.

    PubMed  CAS  Google Scholar 

  11. Parazzini F, La Vecchia C, Franceshi S. Risk factors for pathologically confirmed benign breast disease. Am J Epidemiol. 1984;120:115–22.

    PubMed  CAS  Google Scholar 

  12. Berkowitz GS, Canny PF, Vivolsy VA. Cigarette smoking and benign breast disease. J Epidemiol Community Health. 1985;39:308–13.

    Article  PubMed  CAS  Google Scholar 

  13. Rohan TE, Cook MG, Potter JD. A case control study of diet and benign proliferative epithelial disorder of the breast. Cancer Res. 1990;50:3176–81.

    PubMed  CAS  Google Scholar 

  14. Dupont WD, Page DL, Park FF. Long-term risk for breast cancer in women with fibroadenoma. N Engl J Med. 1994;331:10–15.

    Article  PubMed  CAS  Google Scholar 

  15. Haagensen CD. Disease of the breast. 3rd ed. Philadelphia, Pa; W.B. Saunders; 1996:267–83.

    Google Scholar 

  16. Hughes LE, Mansel RE, Webster DJT. Aberration of normal development and involution: a new perspective on pathogenesis and nomenclature of benign breast disorders. Lancet. 1987;11:1316–9.

    Article  Google Scholar 

  17. Parks AG. The micro anatomy of the breast. Ann R Coll Surg Engl. 1959;25:235–51.

    PubMed  CAS  Google Scholar 

  18. Noquchi S, Motomura K, Inaji H, Imorka S. Clonal analysis of fibroadenoma and phylloides tumor of the breast. Cancer Res. 1993;53(17):4071–4.

    Google Scholar 

  19. Sawhney N, Garrahan N, Douglas Jones AG, Williams ED. Epithelial stromal interaction in tumors: a morphologic study of fibroepithelial tumors of the breast. Cancer. 1992;70(8):2115–20.

    Article  PubMed  CAS  Google Scholar 

  20. Van Agthoven T, Timmerans M, Foekens JA, Dorssers LC. Differential expression of estrogen, progesterone and epidermal growth factor receptors in normal, benign and malignant human breast tissues using dual staining immunohistochemistry. Am J Pathol. 1994;144(6):1238–46.

    PubMed  Google Scholar 

  21. Dent DM, Cant PJ. Fibroadenoma. World J Surg. 1989;13:706–10.

    Article  PubMed  CAS  Google Scholar 

  22. Foster ME, Garrahan N, Williams S. Fibroadenoma of the breast: a clinical and pathological study. J R Coll Surg Edinb. 1988;33:13–6.

    Google Scholar 

  23. Wilkinson S, Anderson TJ, Rifkind E, Chetty U. Fibroadenoma of the breast: a follow up of conservative management. Br J Surg. 1989;76:390–1.

    Article  PubMed  CAS  Google Scholar 

  24. Cant PJ, Learmonth GM, Dent DM. When can fibroadenoma be managed conservatively. Br J Clin Pract. 1988;42(suppl 56):62–6.

    Google Scholar 

  25. Carty NS, Carter C, Rubin C, Ravichandran D. Management of fibroadenoma of the breast. Ann R Coll Surg Engl. 1995;77:127–30.

    PubMed  CAS  Google Scholar 

  26. Williamson ME, Lyons K, Hyghes LE. Multiple fibroadenoma of the breast a problem of uncertain incidence and management. Ann R Coll Surg Engl. 1993;75:161–3.

    PubMed  CAS  Google Scholar 

  27. Gregg WI. Gallactorrhea after contraceptive hormones. N Engl J Med. 1966;274:1432–4.

    Article  PubMed  CAS  Google Scholar 

  28. Pike AM, Oberman HA. Juvenile cellular adenofibromas. Am J Surg Pathol. 1985;9:730–5.

    Article  PubMed  CAS  Google Scholar 

  29. Cale Beuglet C, Soriano RZ, Kurtz AB, Goldberg BB. Fibroadenoma of the breast sonomammography correlated with pathology in 122 patients. AJR. 1983;140:369–75.

    Google Scholar 

  30. Wilkinson S, Forrest APN. Fibroadenoma of the breast. Br J Surg. 1985;72:835–8.

    Article  Google Scholar 

  31. Jackson VP, Rothschild PA, Kreipke DL, Mal TJ. The spectrum of sonographic finding of fibroadenoma of the breast. Invest Radiol. 1986;21:34–9.

    Article  PubMed  CAS  Google Scholar 

  32. Bottels K, Chan JS, Holly EA. Cytologic criteria for fibroadenoma: a step wise logistic regression analysis. Am J Clin Pathol. 1988;89:707–13.

    Google Scholar 

  33. Cant PJ, Madden MV, Close PM, Learmonth GM. Case for conservative management of selected fibroadenoma of the breast. Br J Surg. 1987;74:857–9.

    Article  PubMed  CAS  Google Scholar 

  34. Cant PJ, Madden MV, Coleman MG, Dent DM. Nonoperative management of breast mass diagnosed as fibroadenoma. Br J Surg. 1995;82:792–4.

    Article  PubMed  CAS  Google Scholar 

  35. Dupont W, Parl FF, Hartman WH. Breast cancer associated with proliferative breast disease and atypical hyperplasia. Cancer. 1993;71:125–30.

    Article  Google Scholar 

  36. Dupont WD, Page DL. Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med. 1985;312:146–51.

    Article  PubMed  CAS  Google Scholar 

  37. Hutchinson WB, Thomas DB, Hamlin WB, Roth GJ. Risk of breast cancer in women with benign breast disease. J Natl Cancer Inst. 1980;65:13–20.

    PubMed  CAS  Google Scholar 

  38. Moskowits M, Gartside P, Wirman JA, McLaughlin C. Proliferative disorder of the breast as risk factors for breast cancer in a self-selected screened population. Radiology. 1980;134:289–91.

    Google Scholar 

  39. Carter CL, Corle DK, Micozzi MS, Schatzkin A, Tailor PR. A prospective study of the development of breast cancer in 16,692 women with benign breast disease. Am J Epidemiol. 1988;128:467–77.

    PubMed  CAS  Google Scholar 

  40. McDivitt RW, Stevens JA, Lee MC, Wingo PA. Histologic types of benign breast disease and the risk for breast cancer. Cancer. 1992;69:1408–14.

    Article  PubMed  CAS  Google Scholar 

  41. Krieger N, Hiatt RA. Risk of breast cancer after benign breast diseases: variation by histologic type, degree of atypia, age at biopsy, and length of follow up. Am J Epidemiol. 1992;135:619–31.

    PubMed  CAS  Google Scholar 

  42. Deschenes L, Jacob S, Fobia J, Christen A. Beware of breast fibroadenoma in middle aged women. Can J Surg. 1985;28:372–3

    PubMed  CAS  Google Scholar 

  43. Bazanowski Konarky K, Harrison EG, Payne WS. Lobular carcinoma arising fibroadenoma of the breast. Cancer. 1975;35:450–6.

    Article  Google Scholar 

  44. Pick PW, Iossifide IA. Occurrence of breast carcinomas within a fibroadenoma: a review. Arch Pathol Lab Med. 1984;108:590–3.

    PubMed  CAS  Google Scholar 

  45. Oyyello L, Gump PE. The management of patients with carcinomas in fibroadenomatous tumors of the breast. Surg Gynecol Obstet. 1985;160:99–104.

    Google Scholar 

  46. Diaz NM, Palmer JO, McDivitt RW. Carcinoma arising within fibroadenoma of the breast: a clinicopathological study of 105 patients. Am J Clin Pathol. 1991;95:614–22.

    PubMed  CAS  Google Scholar 

  47. Smallwood JA, Roberts A, Guyer DP, Taylor I. The natural history of fibroadenoma. Br J Clin Pract. 1988;56(suppl):86–7.

    Google Scholar 

  48. Sainsbury JRL, Nicholson S, Needham GK, Wadehra V. Natural history of benign breast lumps. Br J Surg. 1988;75:1080–2.

    Article  PubMed  CAS  Google Scholar 

  49. Kerm WH, Clark RW. Retrogression of fibroadenoma of the breast. Am J Surg. 1973;126:59–62.

    Article  Google Scholar 

  50. Naraynsingh V, Raju GC. Familial bilateral fibroadenoma of the breast. Postgrad Med J. 1985;64:430–40.

    Google Scholar 

  51. Mies C, Rosen PP. Juvenile fibroadenoma with atypical epithelium. Am J Surg Pathol. 1987;11:184–7.

    Article  PubMed  CAS  Google Scholar 

  52. Dixon JM, Dobie V, Lamb J, et al. Assessment of the acceptability of conservative management fibroadenoma of the breast. Br J Surg. 1996;83:264–5.

    Article  PubMed  CAS  Google Scholar 

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Greenberg, R., Skornick, Y. & Kaplan, O. Management of breast fibroadenomas. J GEN INTERN MED 13, 640–645 (1998). https://doi.org/10.1046/j.1525-1497.1998.cr188.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.1998.cr188.x

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