Infarcted fibroadenoma of the breast: report of two new cases with review of the literature

Abstract

IntroductionFibroadenomas are the most common benign breast tumors in young women. Infarction is rarely observed in fibroadenomas and when present, it is usually associated with pregnancy or lactation. Infarction can exceptionally occur as a complication of previous fine-needle aspiration biopsy or during lactation and pregnancy.Materials and methodsRetrospective review of 650 cases of fibroadenomas diagnosed at our institution during the 8-years period identified two cases of fibroadenomas with infarction (rate ~0.3%).ResultsTwo partially infarcted fibroadenomas were diagnosed on core biopsy and frozen section in an adolescent girl (13 years old) and in a young woman (25 years old), respectively. No preceding fine-needle aspiration biopsy was performed in these cases, nor were the patients pregnant or lactating at the time of the diagnosis.ConclusionSpontaneous infarction within fibroadenoma is a rare phenomenon in younger patients. The presence of necrosis on core biopsy or frozen section should be cautiously interpreted and is not a sign of malignancy.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1556060549847356

Clinical and histopathological correlation of breast lesions

“…9 Skenderi et al, reported case of spontaneous infarction in fibroadenoma not associated with pregnancy or lactation or fine needle aspiration. 10 In this case also the infarction was not related with pregnancy, lactation or FNAC. In this case the diagnosis of fibroadenoma with infarction was suggested on cytology.…”

Breast Necrosis after Chemotherapy for Recurrent Ovarian Cancer: Report of a Case and Review of the Literature

“…Spontaneous infarction can be seen in focal breast lesions such as fibroadenoma, phyllodes tumors, intraductal papilloma, and lactating adenoma . Spontaneous infarction of fibroadenomas can be associated with pregnancy, lactation, or recent FNA or core biopsy or without any inciting event .…”

Pleomorphic carcinoma of the breast associated with cyst formation: a unique surgical case focusing on cytological and immunohistochemical findings. Cystic breast PC

“…The cytological characteristic features of PC of the breast seem to reflect the histopathological ones, exhibiting numerous individual bizarre and giant malignant cells with pleomorphic irregular nuclei, coarse chromatin, conspicuous nucleoli, very high mitotic rate, and relatively abundant cytoplasm in the background of possible inflammation and/or necrosis [6-8]. Indeed, when extensive necrosis is present without evidence of viable PC cells on cytology specimens, cytopathologists should exclude out the possibility of benign breast tumors, e.g., infarcted fibroadenoma [13]. On the other hand, we for the first time indicate that cohesive, three-dimensional and/or sheet-like clusters of highly malignant cells coexist on PC cytology.…”