Invasive ductal carcinoma within a fibroadenoma of the breast

Abe, Hajime; Hanasawa, Kazuyoshi; Naitoh, Hiroyuki; Endo, Yuichi; Tani, Tohru; Kushima, Ryoji

doi:10.1007/s10147-004-0401-9

Cited by 39 publications

(35 citation statements)

References 9 publications

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“…Therefore, histological diagnosis is typically unexpected (1,8,9,13,14). The mean age of patients with carcinoma in FA has been reported as 42-44 years, ~20 years subsequent to the peak age of occurrence of FA (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…Malignant transformation within FA is unusual, reported to be 0.1-0.3% in a screened population. However, the number of real cases appears to be even rarer; histological diagnosis is typically unexpected following excision of a breast lesion, with only >100 cases reported in the literature thus far (8,9). Classic lobular carcinoma in situ (LCIS) is a type of lobular neoplasia and is diagnosed when >50% of the acini of a lobular unit are distended and distorted by a dyshesive proliferation of cells with small, and uniform nuclei (10).…”

Section: Introductionmentioning

confidence: 99%

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Fibroadenoma with an unexpected lobular carcinoma in situ: A case report and review of the literature

Bai

Jiang

et al. 2015

Oncology Letters

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Abstract. Fibroadenoma (FA) is the most common type of breast lesion in young female individuals. Although malignant transformation in FA is rare, there is evidence of an association with breast carcinoma, particularly in middle-aged females with associated risk factors, such as a strong family history and/or BRCA-1/2 mutations. The current study presents the case of a 44-year-old female exhibiting lobular carcinoma in situ (LCIS) arising within an FA. Over the previous 20 years, numerous lumps were detected in the patient's breasts, all of which were clinically diagnosed as FA and expectantly managed. One year prior to presentation, the patient's father was diagnosed with esophageal cancer, older sister with kidney cancer and the patient herself with a benign ovarian teratoma. The patient presented with one lump in each breast and monitoring was performed using ultrasonography (US). US detected an increase in the size of the two lumps and analysis of the images was used to propose a diagnosis of FA. Therefore, a lumpectomy was performed. Analysis of the frozen section indicated a diagnosis of FA in the right breast, however, a 5-mm LCIS was identified within the FA of the left breast. Subsequent to the identification of three additional lumps in the left breast, a left mastectomy was performed. During a five-year follow-up period, no local recurrence or contralateral breast carcinoma occurred. The present study showed that FAs containing foci of carcinoma in situ can be indistinguishable from benign lesions following imaging, therefore, despite the incidence of carcinoma within FA is estimated at 0.1-0.3%, it should be considered a long-term risk factor for invasive breast cancer. The present describes a case of LCIS arising within an FA and conducts a review of the relevant literature.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fibroadenoma with an unexpected lobular carcinoma in situ: A case report and review of the literature

Bai

Jiang

et al. 2015

Oncology Letters

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“…13 As described earlier, invasive and in situ carcinoma may rarely be seen associated with fibroadenoma ( Figure 4). [3][4][5][6]13,15 Although fibroadenomas are considered innocuous, a recent report showed that 22 of 172 PT patients (12.8%) had previous fibroadenoma excisions, 16 and 11 of 36 malignant PT cases (30.6%) had a history of fibroadenoma, 17 raising the possibility that some fibroadenomas may undergo malignant transformation to PTs. Therefore, any atypical epithelial proliferation or unusual stromal alterations within a fibroepithelial tumor on a core needle biopsy should warrant complete excision of the lesion for further evaluation and to rule out associated malignant transformation or PT.…”

Section: Pathology Of Fibroepithelial Tumors Fibroadenomamentioning

confidence: 99%

Fibroepithelial Tumors of the Breast: Pathologic and Immunohistochemical Features and Molecular Mechanisms

Yang

Kandil

Cosar

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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Context.—The 2 main prototypes of fibroepithelial tumors of the breast include fibroadenoma and phyllodes tumor (PT). Although both tumors share some overlapping histologic features, there are significant differences in their clinical behavior and management. Phyllodes tumors have been further divided into clinically relevant subtypes, and there is more than one classification scheme for PT currently in use, suggesting a lack of consistency within different practices. Accurate differentiation between fibroadenoma and PT, as well as the grading of PT, may sometimes be challenging on preoperative core needle biopsy. Some immunohistochemical markers have been suggested to aid in the pathologic classification of these lesions. Objective.—To discuss the salient histopathologic features of fibroepithelial tumors and review the molecular pathways proposed for the initiation, progression, and metastasis of PTs. Also, to provide an update on immunohistochemical markers that may be useful in their differential diagnosis and outline the practice and experience at our institution from a pathologic perspective. Data Sources.—Sources included published articles from peer-reviewed journals in PubMed (US National Library of Medicine). Conclusions.—Fibroepithelial tumor of the breast is a heterogenous group of lesions ranging from fibroadenoma at the benign end of the spectrum to malignant PT. There are overlapping histologic features among various subtypes, and transformation and progression to a more malignant phenotype may also occur. Given the significant clinical differences within various subtypes, accurate pathologic classification is important for appropriate management. Although some immunohistochemical markers may be useful in this differential diagnosis, histomorphology still remains the gold standard.

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“…[1][2][3][4] They are the second most common tumours of the breast after carcinoma and the most common benign tumours of the breast in adolescent girls and young women. 1,3 Malignant transformation of fibroadenoma to carcinoma is very rare (equal or less than 0.5%), and the mean age is fifth decade.…”

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confidence: 99%

“…1,3 Malignant transformation of fibroadenoma to carcinoma is very rare (equal or less than 0.5%), and the mean age is fifth decade. 2,[4][5][6][7] The most common malignant histologic type coexistence with fibroadenoma is lobular carcinoma in situ (66.9%), followed by ductal carcinoma in situ (12.4%), invasive ductal carcinoma (11%), and invasive lobular carcinoma (3.4%). 4 Positive family history, complex fibroadenomas, proliferative disease adjacent fibroadenomas and BRCA mutation are associated with Turkiye Klinikleri J Case Rep 2015;23 (2) fibroadenomas mild increase risk of subsequent breast cancer.…”

mentioning

confidence: 99%

Invasive Breast Carcinoma Occuring Within Fibroadenoma: Case Report

Dandin¹,

Karakaş²,

Balta³

et al. 2015

Turkiye Klinikleri J Case Rep

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A AB BS ST TR RA AC CT T Fibroadenomas are the most common benign tumors of the breast. Carcinomas occuring within fibroadenoma are very rare. Fibroadenomas present in approximately 10% of women at autopsy, also occurs 20% of all the benign breast mass and usually identified as circumscribed masses at physical examination or mammography. The most common histologic type is lobular carcinoma in situ, followed by ductal carcinoma in situ, invasive ductal carcinoma and invasive lobular carcinoma. Positive family history, complex fibroadenomas, proliferative disease adjacent fibroadenomas and BRCA mutation are the risk factors for malign transformation within fibroadenomas. Histopathological examination should be performed routinely to rule out malignancy because of no definitive clinical or radiological criteria for diagnosing carcinoma occuring within fibroadenoma. We presented a case of invasive breast carcinoma occuring within fibroadenoma.K Ke ey y W Wo or rd ds s: : Fibroadenoma; carcinoma, ductal; carcinoma, lobular Ö ÖZ ZE ET T Fibroadenomlar memenin en sık benign tümörleridir. Fibroadenomadan kanser gelişimi oldukça nadirdir. Fibroadenoma, genellikle fizik muayene ve mamografide sınırlı kitleler olarak tanımlanıp, kadınların otopsisinde yaklaşık %10 oranında saptanırken tüm iyi huylu meme kitlelerinin % 20'sini oluşturur. En sık görülen histolojik tip lobular karsinoma in situdur, bunu duktal karsinoma in situ, invaziv duktal karsinom, invazif lobüler karsinom takip eder. Pozitif aile öyküsü, karmaşık fibroadenomalar, fibroadenomaya komşu proliferatif hastalık ve BRCA mutasyonu fibroadenomanın malign transformasyonu için risk faktörleridir. Fibroadenomadan karsinom gelişiminin tanısında kesin bir klinik ve radyolojik kriter olmadığından maligniteyi dışlamak için histopatolojik değerlendirme yapılmalıdır. Burada fibroadenomadan gelişen invaziv meme kanserli bir olguyu sunmaktayız.A An na ah ht ta ar r K Ke el li im me el le er r: : Fibroadenom; karsinom, duktal; karsinom, lobüler T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J C Ca as se e R Re ep p 2 20 01 15 5; ;2 23 3( (2 2) ): :1 14 49 9--5 52 2

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Invasive ductal carcinoma within a fibroadenoma of the breast

Cited by 39 publications

References 9 publications

Fibroadenoma with an unexpected lobular carcinoma in situ: A case report and review of the literature

Fibroadenoma with an unexpected lobular carcinoma in situ: A case report and review of the literature

Fibroepithelial Tumors of the Breast: Pathologic and Immunohistochemical Features and Molecular Mechanisms

Invasive Breast Carcinoma Occuring Within Fibroadenoma: Case Report

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