Coexistence of lactating adenoma and invasive ductal adenocarcinoma of the breast in a pregnant woman

Abstract

A 36 year old pregnant woman was admitted to hospital complaining of an enlarging mass in her left breast. Histopathological examination of the mastectomy specimen revealed a high grade infiltrating ductal adenocarcinoma intermixed with a lactating adenoma. Lactating adenomas are rare entities but are the most common masses that occur during pregnancy. Although they are not thought to carry an increased risk of cancer there are two other case reports in the literature of a lactating adenoma associated with an infiltrating carcinoma. In this case, areas where the lactating adenoma and the infiltrating carcinoma were intermixed could be identified. This case could simply be a collision tumour, although the possibility of an invasive carcinoma arising within a lactating adenoma cannot be ruled out. Because of the relative lack of experience with lactating adenomas, the question of an increased association with carcinoma development remains unclear.

Concurrent Lactating Adenoma and Infiltrating Ductal Carcinoma: A Case Report

“…Microscopically lactating adenomas are characterized by hyperplastic lobules showing proliferated acini lined by actively secreting cuboidal cells [6]. In present case we did have similar picture but the other interesting feature seen in our case was the presence of infiltrating ductal carcinoma showing single file pattern along with in-situ carcinoma with central necrosis (comedo carcinoma).…”

Radiologic Evaluation of Breast Disorders Related to Pregnancy and Lactation

“…At gross examination, they are well circumscribed but noncapsulated. Secretory hyperplasia in the lesion is histologically similar to the physiologic changes found in the surrounding parenchyma (63)(64)(65). Lactating adenomas characteristically regress spontaneously after pregnancy and lactation.…”

“…The true nature of the tumor remains controversial. Some authors suggest that lactating adenoma is simply a variant of fibroadenoma, tubular adenoma, or lobular hyperplasia that has undergone certain histologic changes owing to the physiologic state (63)(64)(65). At histologic analysis, lactating adenomas are composed of compact aggregates of lobules that exhibit secretory hyperplasia and are separated by delicate connective tissue.…”

“…Like fibroadenomas, lactating adenomas are prone to develop infarction (66). Curiously, the coexistence of lactating adenoma and malignancy has recently been reported (65).…”

Fine Needle Aspiration Cytologic Diagnosis of Lactating Adenoma: Report of two Cases

“…The clue to the diagnosis in these cases lay in the observation of the background foaminess of the cells and the scattered and few dispersed bipolar cells [Table/ Fig-1,2,3 Hence, I would like to conclude that an accurate diagnosis of lactating adenoma is possible on cytology, with a clinical correlation. FNA plays an important role in the appropriate management of patients with lactating adenoma; it thus helps in avoiding invasive procedures [1][2][3][4].…”