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1.  Bilateral Giant Juvenile Fibroadenomas of Breasts:A Case Report 
Juvenile fibroadenoma constitutes only 4% of the total fibroadenomas. The incidence of giant juvenile fibroadenomas is found to be only 0.5% of all the fibroadenomas. Bilateral giant juvenile fibroadenomas are extremely rare, and only four cases have been reported in the literature. To the best of our knowledge, we are presenting the fifth case of bilateral giant juvenile fibroadenomas in a 12-year-old prepubertal girl. The diagnosis was made on fine-needle aspiration cytology which was confirmed on histopathology. In this paper, we present this rare case to illustrate the diagnosis and management of this tumour and to emphasize that these tumours are almost always benign and should be treated with breast-conserving surgery to provide a healthy physical and social life to the patient.
doi:10.4061/2011/482046
PMCID: PMC3108471  PMID: 21660274
2.  An Ectopic Breast Tissue Presenting with Fibroadenoma in Axilla 
Case Reports in Surgery  2013;2013:947295.
Introduction. The congenital anomalies of breast, especially the polymastia (supernumerary breast) and polythelia (supernumerary nipple), always do not fail to amuse the clinicians because of their varied presentations, associated renal anomalies, and pathologies arising from them. The axillary polymastia is a variant of ectopic breast tissue (EBT). Ectopic breast tissue can undergo the same physiological and pathological processes as the normally located breast. The incidence of fibroadenoma developing in ectopic breast is reported as a rare entity, the most common being the carcinoma. Case Presentation. A 31-year-old Dravidian female presented with a lump of 4 cm in the right axilla for the past year which gradually increased in size, giving discomfort. Our initial differential diagnosis was fibroadenoma, lipoma, and lymphadenopathy. Further investigation and histopathological report of excision biopsy confirmed it as a fibroadenoma on ectopic breast tissue in the axilla. Patient has no associated urological or cardiac anomaly. Conclusion. This case has been reported for its rarity and to reemphasise the importance of screening of EBT for any pathology during routine screening of breast.
doi:10.1155/2013/947295
PMCID: PMC3623429  PMID: 23607040
3.  Vulvar lactating adenoma associated to a fibroadenoma: common neoplasms in an uncommon site 
Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating adenoma in the vulva are extremely rare. Only four cases have been reported. We report a case of a young woman who presented with vulvar mass during her lactation. The mass was excised, and histology confirmed vulvar lactating adenoma associated with fibroadenoma. This is the first case of vulvar heterotopic breast lesion associating lactating adenoma and fibroadenoma.
PMCID: PMC3542777  PMID: 23330038
Ectopic breast tissue; vulva; lactating adenoma; fibroadenoma; pathology
4.  Carcinoma developing in a fibroadenoma in a woman with a family history of breast cancer: a case report and review of literature 
Cases Journal  2009;2:9348.
Introduction
Malignant transformation of a fibroadenoma is rare with only about 100 cases reported in the world literature. Fibroadenoma occurring in middle aged woman with a strong family history of breast or ovarian cancer should be investigated with a high suspicion for malignancy.
Case presentation
A 35-year- old Indian lady operated previously for fibroadenoma of the right breast presented with a recurrent lump at the same site. She had a strong family history of breast carcinoma. Mammography and trucut biopsy was suggestive of infiltrating duct carcinoma. She was managed by lumpectomy and axillary lymph node dissection with a satisfactory outcome. There was no evidence of BRCA-1, BRCA-2 mutation on immunohistochemistry.
Conclusion
Malignant change in a pre-existing fibroadenoma is rare, however in a middle aged woman with a family history of breast cancer it should be suspected. In the absence of any definite clinical and radiological criteria of diagnosing malignant change in a fibroadenoma, high suspicion index is mandatory. The management and outcome depends on the stage and grade of presentation.
doi:10.1186/1757-1626-2-9348
PMCID: PMC2806393  PMID: 20072677
5.  Multiple fibroadenomas harbouring carcinoma in situ in a woman with a family history of breast/ovarian cancer 
Journal of Clinical Pathology  2002;55(10):795-797.
A 46 year old woman with a family history of breast and ovarian cancer presented with multiple fibroadenomas in both breasts. From three fibroadenomas removed from the left breast carcinoma in situ (CIS) had developed. One fibroadenoma gave rise to ductal CIS, whereas the other two harboured lobular CIS. This is the first report of three fibroadenomas simultaneously giving rise to CIS. In addition, synchronous fibroadenomas harbouring different types of CIS from one fibroadenoma to the other have never been described. Direct sequencing revealed a mutation (5075G→A) in the BRCA1 gene, but retention of BRCA1 immunohistochemical staining and no loss of heterozygosity at the BRCA1 locus by polymerase chain reaction made a pathogenic mutation in BRCA1 unlikely. Furthermore, in this family no cosegregation of breast cancer with this BRCA1 mutation was seen. Indeed, this mutation is now regarded as a polymorphism. This case stresses the need for histological evaluation of all breast masses in women with a strong positive family history for breast and/or ovarian cancer.
PMCID: PMC1769772  PMID: 12354814
breast; fibroadenoma; carcinoma in situ; BRCA1
6.  Intraductal fibroadenoma under the nipple in an 11-year-old female 
Diagnostic Pathology  2014;9:32.
Recently, Chung et al. have reported the detailed clinicopathological features of an extremely rare case sharing similar histopathological characteristics with fibroadenomas, phyllodes tumours, intraductal papillomas or ductal adenomas, given the name of intraductal fibroadenomatosis, as an unusual variant of intracanalicular fibroadenoma. Herein we demonstrated a very unusual case of intraductal fibroadenoma of the breast with admixture of components of intracanalicular type fibroadenoma or benign phyllodes tumour and a smaller amount of intraductal papilloma, occupying the one duct and some adjacent ductules, presenting as a well-demarcated nodule.
doi:10.1186/1746-1596-9-32
PMCID: PMC3922281  PMID: 24512699
Intraductal fibroadenoma; Intracanalicular type fibroadenoma; Phyllodes tumour; Breast
7.  Myoid hamartoma of the breast that proved difficult to diagnose: a case report 
Myoid hamartomas of the breast are extremely rare breast lesions, with a poorly understood pathogenesis. We describe the case of a 38-year-old premenopausal woman who presenting with a mass in the left breast. Mammography revealed an oval mass that was partly indistinct, and ultrasonography showed a hypoechoic mass with a slightly irregular margin. Bilateral breast dynamic magnetic resonance imaging was performed for a more detailed evaluation. The images showed rapid initial enhancement and a microlobulated margin. Because the suspicion of malignancy was strong at that time, core needle biopsy was performed. Histologically, the tumor was identified as fibroadenoma. A case of myoid hamartoma of the breast that proved difficult to diagnose is reported, and discussed with reference to the literature.
doi:10.1186/1477-7819-10-12
PMCID: PMC3271982  PMID: 22248347
myoid hamartoma; breast tumor; smooth-muscle actin
8.  Fibroadenoma in women in Ghana 
Background:
Fibroadenoma is the commonest benign tumor of female breast. It is particularly common in young women in Africa.
Method:
This paper describes the clinicopathologic features of fibroadenoma of breast in African women from central Ghana and compares them to the data from African-American women.
Results:
Fibroadenomas constituted 47.7% of all palpable breast masses. The median age of women was 22 years (range 14-49). Almost a third of the cases occurred in teenager. The mean size of masses was 3.8 cm (range 1-9 cm), with 22.5% showing larger sizes. A total of 16.1% had multiple and/or bilateral lesions.
Conclusion:
Women from Central Ghana tend to have proportionately more fibroadenomas and larger (>5 cm) variants compared to published data from African-American women, however, the average age, size, multifocality and bilaterality do not differ significantly between these two groups of women.
PMCID: PMC2984278  PMID: 21532907
9.  Juvenile fibroadenoma of the breast: Treatment and literature review 
A fibroadenoma is a benign breast lump that occurs mainly in females, and is a major cause of unilateral breast masses in adolescents. Juvenile fibroadenoma may double in size, reaching 15 cm to 20 cm, within three to six months. Because it is a rapidly growing mass and distorts overlying skin, it can be very traumatic to the young patient. This article presents such a fibroadenoma in a 17-year-old girl, and discusses its treatment and management.
It is uncommon to find palpable breast masses in young patients. Generally, such masses are benign. Juvenile fibroadenoma is the most frequent benign tumour of the breast. The present report describes a case involving a 17-year-old girl with unilateral right breast hypertrophy, for whom resection and breast reduction was effectively achieved.
Resection was combined with an aesthetically pleasing outcome through breast reduction, via a wise pattern of reduction with a superior pedicle.
While young patients rarely present with breast masses, the consideration of fibroadenoma in these cases is always warranted. The disconcerting appearance of the breasts for adolescents afflicted by such benign masses underscores the importance of achieving aesthetically optimal outcomes and attaining adequate tumour resection for diagnostic purposes through pathological specimens. In the present case, the young patient underwent a procedure that fulfilled both of these valuable goals through careful pre-operative planning, pedicle selection and skin resection patterns.
PMCID: PMC3269333  PMID: 22942662
Breast reduction; Breast tumours; Juvenile fibroadenoma
10.  Fibroadenoma of the ectopic breast of the axilla 
The Indian Journal of Surgery  2010;72(2):143-145.
Polymastia is a term that is used to describe the presence of more than two breasts in human beings. It is synonymous with supernumerary or accessory breast tissue. Ectopic breast tissue (EBT) may occur any where along the primitive embryonic milk lines, which extend from the axilla to the groin, and may occur unilaterally or bilaterally. In the EBT any disease can develop that affects the normal breast, including fibroadenoma. Since publications describing this anomaly are rare, we decided to report a case of fibroadenoma in axillary breast tissue.
doi:10.1007/s12262-010-0024-5
PMCID: PMC3452521  PMID: 23133228
Fibroadenoma; Axilla; Ectopic breast tissue
11.  Spontaneous Infarction in a Fibroadenoma of the Breast 
Breast Care  2011;6(1):54-55.
Summary
Background
Fibroadenomas are common neoplasms in young women but occur in a wide age range from adolescent females to octogenians.
Case Report
A 21-year-old female patient presented with a 10-week history of a mass in her breast. Ultrasound examination demonstrated a 3.5 × 3 cm, well-circumscribed, semisolid mass. An excisional biopsy but no fine needle aspiration was performed. The patient had no history of pregnancy or lactation, or trauma or infection to the area of the lesion. The histopathological examination showed a spontaneously infarcted fibroadenoma.
Conclusions
Spontaneous infarction is an uncommon complication in fibroadenoma of the breast, and there are very few reported cases in the literature.
doi:10.1159/000324047
PMCID: PMC3083272  PMID: 21547027
Fibroadenoma; Infarction; Breast
12.  Infarcted fibroadenoma of the breast: report of two new cases with review of the literature 
Diagnostic Pathology  2013;8:38.
Introduction
Fibroadenomas 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 methods
Retrospective 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%).
Results
Two 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.
Conclusion
Spontaneous 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 Slides
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1556060549847356
doi:10.1186/1746-1596-8-38
PMCID: PMC3598275  PMID: 23445683
Breast tumors; Benign tumors; Fibroadenoma; Infarction; Necrosis
13.  Tubular Adenoma of the Breast: A Rare Presentation and Review of the Literature 
Tubular adenomas, also known as pure adenomas, are rare epithelial tumors of the breast. Only a few cases have been reported in the literature, especially in young women of reproductive age. Postmenopausal women are very rarely affected. We describe here a very rare case of tubular breast adenoma in a postmenopausal woman who presented with a gradually enlarging breast lump. Clinical examination and imaging studies revealed a non-tender well circumscribed left breast tumor suggestive of a fibroadenoma. Due to the history of progressive enlargement of the breast lump, a surgical excision was performed. Histological findings were suggestive of a tubular breast adenoma. We conclude that although tubular breast adenoma is rare, it should always be considered in the differential diagnosis in postmenopausal patients presenting with a gradually enlarging breast mass. Preoperative diagnosis is difficult because tubular adenoma is indistinguishable from a fibroadenoma on physical examination and breast imaging. Surgical excision is necessary to establish a definitive diagnosis. Clinical presentation and management of our patient are discussed along with a review of the literature.
Keywords
Tubular adenoma; Breast; Breast mass.
doi:10.4021/jocmr746w
PMCID: PMC3279505  PMID: 22383931
14.  Synchronous Bilateral Male Breast Cancer: A Case Report 
Journal of Breast Cancer  2012;15(2):248-251.
Synchronous bilateral breast cancer is extremely rare in men and has not, up to date, been reported in Korea. A 54-year-old man presented with a palpable mass in the right breast. The right nipple was retracted and bilateral axillary accessory breasts and nipples were present. On physical examination, a 2 cm-sized mass was palpated directly under the right nipple, and, with squeezing, bloody discharge developed in a single duct of the left nipple. There was no palpable mass in the left breast, and axillary lymph nodes were not palpable. Physical examination of external genitalia revealed a unilateral undescended testis on the left side. Synchronous bilateral breast cancer was diagnosed using mammography, ultrasonography, and core-needle biopsy. Histopathological examination revealed invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast. Bilateral total mastectomy, sentinel lymph node biopsy, and excision of accessory breasts in the axilla were performed.
doi:10.4048/jbc.2012.15.2.248
PMCID: PMC3395751  PMID: 22807945
Breast; Male; Synchronous neoplasms
15.  Adenoid cystic carcinoma of female breast: A case report 
INTRODUCTION
Adenoid cystic carcinoma (ACC) of the breast is a rare neoplasm accounting for 0.1% of breast carcinomas.
PRESENTATION OF CASE
A 30 year old female patient presented with multiple lumps in the right breast. Excision biopsy of a lump in the lower outer quadrant revealed adenoid cystic carcinoma. A right sided modified radical mastectomy (MRM) was performed, with axillary clearance. Histopathology revealed a fibroadenoma accounting for one mass and adenoid cystic carcinoma in another, confirmed on Periodic acid Schiff (PAS) staining. Three out of the eight excised axillary lymph nodes contained malignancy. There was no evidence of recurrence or distant spread at follow-up 6 months postoperatively.
DISCUSSION
ACC of the breast is a rare neoplasm accounting for 0.1% of breast carcinomas and is of special interest because of its favourable prognosis and distinctive histological appearance. This tumor occurs predominantly in women in their sixth decade and usually presents as a tender breast mass, often in the subareolar area though in our case it was not tender and presented as multiple lumps in the right breast. The diagnosis can be made on fine needle aspiration cytology (FNAC), but in our case FNAC was inconclusive. We performed MRM with axillary clearance, and three out eight lymph nodes proved positive for malignancy.
CONCLUSION
ACC is a rare malignant neoplasm. Surgical treatment is the mainstay with little role for radiotherapy and chemotherapy according to the published literature.
doi:10.1016/j.ijscr.2013.01.025
PMCID: PMC3731693  PMID: 23562896
Adenoid cystic carcinoma; Axillary lymph nodes; Modified radical mastectomy
16.  Invasive ductal carcinoma within fibroadenoma: a case report 
Cases Journal  2009;2:174.
Introduction
Fibroadenoma is the most common benign tumor of the female breast with the highest incidence before age 30. Fibroadenoma may be associated with fibrocystic changes, proliferative epithelial changes, and extremely rarely, with non-invasive and invasive cancer.
Case presentation
We present a rare case of a 39 years old female with invasive ductal carcinoma arising within fibroadenoma.
Conclusion
There is a low percentage of fibroadenomas harboring carcinoma; however, all breast lumps should be seriously managed; extirpation and histological examination is recommended.
doi:10.1186/1757-1626-2-174
PMCID: PMC2783130  PMID: 19946485
17.  The utilization of an ultrasound-guided 8-gauge vacuum-assisted breast biopsy system as an innovative approach to accomplishing complete eradication of multiple bilateral breast fibroadenomas 
Background
Ultrasound-guided vacuum-assisted breast biopsy technology is extremely useful for diagnostic biopsy of suspicious breast lesions and for attempted complete excision of appropriately selected presumed benign breast lesions.
Case presentation
A female patient presented with 16 breast lesions (eight within each breast), documented on ultrasound and all presumed to be fibroadenomas. Over a ten and one-half month period of time, 14 of these 16 breast lesions were removed under ultrasound guidance during a total of 11 separate 8-gauge Mammotome® excision procedures performed during seven separate sessions. Additionally, two of these 16 breast lesions were removed by open surgical excision. A histopathologic diagnosis of fibroadenoma and/or fibroadenomatous changes was confirmed at all lesion excision sites. Interval follow-up ultrasound imaging revealed no evidence of a residual lesion at the site of any of the 16 original breast lesions.
Conclusion
This report describes an innovative approach of utilizing ultrasound-guided 8-gauge vacuum-assisted breast biopsy technology for assisting in achieving complete eradication of multiple bilateral fibroadenomas in a patient who presented with 16 documented breast lesions. As such, this innovative approach is highly recommended in similar appropriately selected patients.
doi:10.1186/1477-7819-5-124
PMCID: PMC2147012  PMID: 17967193
18.  Cyclosporine-A therapy-induced multiple bilateral breast and accessory axillary breast fibroadenomas: a case report 
Introduction
Breast adenoma is common. However, in the setting of post-transplantation immune suppression it may be expressed differently.
Case presentation
A 35-year-old Sudanese woman, with a history of renal transplantation two and half years prior to presentation, was on a single immune suppression therapy in the form of cyclosporine-A since the transplantation. During a regular follow-up visit, she was noticed to have gingival hypertrophy and bilateral breast and axillary swellings. She underwent successful surgical resection of the bilateral fibroadenomas.
Conclusions
Cyclosporine-A therapy post renal transplantation is associated with an increased incidence of benign breast changes as fibroadenoma. Regular follow-up and appropriate selection of immunosuppressant therapy are essential in the post transplantation management of these patients.
doi:10.1186/1752-1947-4-267
PMCID: PMC2928248  PMID: 20701786
19.  A rare coexistence of concurrent breast hemangioma with fibroadenoma: a case report 
Cases Journal  2009;2:7005.
We report the case of a 38-year-old Asian, Indian female with capillary hemangioma breast in coexistence with the commonly occurring fibroadenoma. Clinical examination of the breast revealed a 4 cm diameter lump. Mammography revealed a well defined slightly hypoechoic lesion with smooth contours. A lumpectomy was performed. Histopathology confirmed the diagnosis of a completely encapsulated fibroadenoma coexistent with a capillary hemangioma in the adjacent breast tissue. The rarity of literature on breast hemangioma especially capillary type with coexisting fibroadenoma deserves mention.
doi:10.1186/1757-1626-2-7005
PMCID: PMC2740063  PMID: 19829893
20.  Male Breast Cancer Originating in an Accessory Mammary Gland in the Axilla: A Case Report 
Case Reports in Medicine  2012;2012:286210.
Carcinoma of an accessory mammary gland is an extremely rare tumor. A 61-year-old male patient presented with a hard mass measuring 85 mm × 51 mm in the left axilla. Incisional biopsy histopathologically showed an adenocarcinoma compatible with breast carcinoma originating in an accessory mammary gland. Systemic examinations revealed no evidence of malignant or occult primary lesion in the bilateral mammary glands or in other organs. Neoadjuvant chemotherapy was performed for the locally advanced axillary tumor and reduced the tumor to 55 mm in size, and, then, he could undergo complete resection with a negative surgical margin in combination with reconstructive surgery to fill the resulting skin defect with a local flap of the latissimus dorsi muscle. The patient has presented with no metastatic lesion in four years since the operation. This unusual case shows that neoadjuvant chemotherapy is an effective and tolerated therapy for advanced accessory breast cancer in the axilla.
doi:10.1155/2012/286210
PMCID: PMC3522500  PMID: 23251170
21.  Aberrant DNA methylation of cancer-related genes in giant breast fibroadenoma: a case report 
Introduction
Giant fibroadenoma is an uncommon variant of benign breast lesions. Aberrant methylation of CpG islands in promoter regions is known to be involved in the silencing of genes (for example, tumor-suppressor genes) and appears to be an early event in the etiology of breast carcinogenesis. Only hypermethylation of p16INK4a has been reported in non-giant breast fibroadenoma. In this particular case, there are no previously published data on epigenetic alterations in giant fibroadenomas. Our previous results, based on the analysis of 49 cancer-related CpG islands have confirmed that the aberrant methylation is specific to malignant breast tumors and that it is completely absent in normal breast tissue and breast fibroadenomas.
Case presentation
A 13-year-old Hispanic girl was referred after she had noted a progressive development of a mass in her left breast. On physical examination, a 10 × 10 cm lump was detected and axillary lymph nodes were not enlarged. After surgical removal the lump was diagnosed as a giant fibroadenoma. Because of the high growth rate of this benign tumor, we decided to analyze the methylation status of 49 CpG islands related to cell growth control. We have identified the methylation of five cancer-related CpG islands in the giant fibroadenoma tissue: ESR1, MGMT, WT-1, BRCA2 and CD44.
Conclusion
In this case report we show for the first time the methylation analysis of a giant fibroadenoma. The detection of methylation of these five cancer-related regions indicates substantial epigenomic differences with non-giant fibroadenomas. Epigenetic alterations could explain the higher growth rate of this tumor. Our data contribute to the growing knowledge of aberrant methylation in breast diseases. In this particular case, there exist no previous data regarding the role of methylation in giant fibroadenomas, considered by definition as a benign breast lesion.
doi:10.1186/1752-1947-5-516
PMCID: PMC3206866  PMID: 22011321
22.  Primary Well Differentiated Breast Liposarcoma with Divergent Cartilagenous Differentiation: A Case Report 
Oman Medical Journal  2013;28(2):138-140.
Primary liposarcomas of the female and male breasts are very rare. Heterologous differentiation in adipocytic tumors is also an exceedingly rare phenomenon, which is occasionally reported in the literature. We describe the case of a 22 year-old female who presented with a relatively large left breast mass which was clinically diagnosed as a case of giant fibroadenoma, but histologically showed a well differentiated liposarcoma with evidence of extensive chondroid differentiation. The mammographic and radiological features are presented and correlated with the histopathological appearances together with literature review and comparison with similar reported cases.
doi:10.5001/omj.2013.37
PMCID: PMC3628195  PMID: 23599887
Breast sarcomas; Liposarcoma; Chondroid/cartilaginous differentiation; Dedifferentiated liposarcoma
23.  Accessory Breast Cancer Occurring Concurrently with Bilateral Primary Invasive Breast Carcinomas: A Report of Two Cases and Literature Review 
Cancer Biology & Medicine  2012;9(3):197-201.
The development of accessory breast tissue, which is found anywhere along the milk line, is attributed to the failure of milk line remnants to regress during embryogenesis. Primary tumors may arise from any ectopic breast tissue. Accessory breast cancer occurring concurrently with primary invasive breast cancer is extremely rare. Two such cases were reported in this article. One was a 43-year-old Chinese female who exhibited bilateral breast cancer (invasive ductal carcinoma, not otherwise specified, IDC-NOS) and an accessory breast carcinoma (IDC-NOS) incidentally identified in her left axilla. The ectopic breast tissue in her right axilla presented with adenosis. The patient was surgically treated, followed by postoperative docetaxel epirubicin (TE) chemotherapy. The second case was a 53-year-old Chinese female with bilateral breast cancer (apocrine carcinoma) accompanied by an accessory breast carcinoma (IDC-NOS) in her right axilla that was also incidentally identified. The patient was surgically treated after three doses of cyclophosphamide epirubicin docetaxel (CET) neoadjuvant chemotherapy, followed by adjuvant chemotherapy of the same regimen.
doi:10.7497/j.issn.2095-3941.2012.03.008
PMCID: PMC3643663  PMID: 23691479
invasive breast cancer; bilateral; primary; accessory breast cancer; occurring concurrently
24.  Management of Breast Fibroadenomas 
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.
doi:10.1046/j.1525-1497.1998.cr188.x
PMCID: PMC1497021  PMID: 9754521
fibroadenoma; breast neoplasms; women
25.  Asymptomatic Primary Fallopian Tube Cancer: An Unusual Cause of Axillary Lymphadenopathy 
Primary Fallopian tube malignancy is considered a rare disease and is often mistaken histologically and clinically for ovarian cancer. The etiology is poorly understood, and it typically presents at an advanced disease stage, as symptoms are often absent in the initial period. As a result, primary fallopian tube cancer is generally associated with a poor prognosis. We present the case of a 45-year-old female who presents with a 5-day history of left axillary swelling and a normal breast examination. Mammogram and biopsy of a lesion in the left breast revealed a fibroadenoma but no other abnormalities. Initial sampling of the axillary node was suspicious for a primary breast malignancy, but histology of the excised node refuted this. PET-CT showed an area of high uptake in the right pelvis, and a laparoscopy identified a tumor of the left fallopian tube which was subsequently excised and confirmed as a serous adenocarcinoma.
doi:10.1155/2011/402127
PMCID: PMC3335533  PMID: 22567506

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