BREAST FIBROADENOMA
A 25-year-old woman visits the gynecologist for routine annual
examination. During the examination she has a palpable, rubbery breast
mass, which has been present and stable for the past two years. The
pathology report of fine-needle aspiration was consistent with
fibroadenoma.Diagnosis. Fibroadenomas are the most common breast tumors found in
adolescents and young women. In approximately 15% of patients they occur as
multiple lesions. Clinically, fibroadenomas are discrete, smoothly contoured,
rubbery, nontender, freely moveable masses. The most distinctive gross feature
of fibroadenomas that allows them to be distinguished from other breast lumps is
their mobility. Fibroadenomas arise from the epithelium and stroma of the
terminal duct lobular unit, most frequently in the upper outer quadrant of the
breast. An association of fibroadenomas with the development of breast cancer
has not been well established. Any associated increases in breast cancer risk
depends on the presence of proliferative changes in the fibroadenoma itself or in
the surrounding breast and on a family history of breast carcinoma.
Although cysts and fibroadenomas may be indistinguishable on palpation,
ultrasound examination easily distinguishes cystic from solid lesions. On fine-
needle aspiration, cysts typically collapse, whereas samples from a
fibroadenoma present a characteristic combination of epithelial and stromal
elements.
Management.