Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2014

Open Access 01-12-2014 | Research

Breast cancer arising within fibroadenoma: collective analysis of case reports in the literature and hints on treatment policy

Authors: Yu-Ting Wu, Shou-Tung Chen, Chih-Jung Chen, Yao-Lung Kuo, Ling-Ming Tseng, Dar-Ren Chen, Shou-Jen Kuo, Hung-Wen Lai

Published in: World Journal of Surgical Oncology | Issue 1/2014

Login to get access

Abstract

Background

Breast cancer arising within a fibroadenoma (BcaFad) is rare; the rate varies from 0.002% to 0.125% in fibroadenoma specimens. Owing to its rarity, the clinicopathologic feature and treatment principle of BcaFad is still not clear. Therefore, the aim of this study was to perform a collective analysis of case reports in the literature to identify the characteristics and optimal treatment for BcaFad.

Methods

We analyzed an aggregated sample of 30 patients with BcaFad from case reports in the literature (n =24 cases) and our present study (n =6 cases). We collected and analyzed the clinicopathologic features and prognoses of patients with BcaFad, as well as treatments they received.

Results

The patients’ mean age at diagnosis was 46.9 years. Twenty BcaFad patients (66.7%) received breast-conserving surgery (BCS), and nine other patients (30.0%) were treated with mastectomy. The rate of lymph node metastasis in BcaFad patients was 23.8%. The breakdown of the histological types of BcaFad was invasive ductal carcinoma (53.3%), followed by ductal carcinoma in situ (23.3%), lobular carcinoma in situ (16.7%) and invasive lobular carcinoma (13.3%). More than half of patients with positive hormone receptor status received hormone therapy. Most BcaFad patients with lymph node metastases received chemotherapy, and 20.0% of BcaFad patients treated with BCS received further radiotherapy. Only one patient had recurrence after surgery, and another had lung metastasis when diagnosed with BcaFad.

Conclusions

Most BcaFad patients could be managed by BCS. Adjuvant radiotherapy could be performed, but was not mandatory. Chemotherapy should be considered as a treatment option in the presence of lymph node metastasis.
Appendix
Available only for authorised users
Literature
1.
Carty NJ, Carter C, Rubin C, Ravichandran D, Royle GT, Taylor I: Management of fibroadenoma of the breast. Ann R Coll Surg Engl. 1995, 77: 127-130.PubMedCentralPubMed
2.
Foster ME, Garrahan N, Williams S: Fibroadenoma of the breast: a clinical and pathological study. J R Coll Surg Edinb. 1988, 33: 16-19.PubMed
3.
Cant PJ, Madden MV, Coleman MG, Dent DM: Non-operative management of breast masses diagnosed as fibroadenoma. Br J Surg. 1995, 82: 792-794. 10.1002/bjs.1800820624.CrossRefPubMed
4.
Gordon PB, Gagnon FA, Lanzkowsky L: Solid breast masses diagnosed as fibroadenoma at fine-needle aspiration biopsy: acceptable rates of growth at long-term follow-up. Radiology. 2003, 229: 233-238. 10.1148/radiol.2291010282.CrossRefPubMed
5.
6.
Deschênes L, Jacob S, Fabia J, Christen A: Beware of breast fibroadenomas in middle-aged women. Can J Surg. 1985, 28: 372-374.PubMed
7.
Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer WD, Rados MS, Schuyler PA: Long-term risk of breast cancer in women with fibroadenoma. N Engl J Med. 1994, 331: 10-15. 10.1056/NEJM199407073310103.CrossRefPubMed
8.
Buzanowski-Konakry K, Harrison EG, Payne WS: Lobular carcinoma arising in fibroadenoma of the breast. Cancer. 1975, 35: 450-456. 10.1002/1097-0142(197502)35:2<450::AID-CNCR2820350223>3.0.CO;2-R.CrossRefPubMed
9.
Fukuda M, Nagao K, Nishimura R, Matsuda M, Baba K, Ueno Y, Morinaga H, Omachi H, Hamada T: Carcinoma arising in fibroadenoma of the breast–a case report and review of the literature. Jpn J Surg. 1989, 19: 593-596. 10.1007/BF02471669.CrossRefPubMed
10.
Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thürlimann B, Senn HJ, Panel members: Strategies for subtypes—dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol. 2011, 22: 1736-1747. 10.1093/annonc/mdr304.PubMedCentralCrossRefPubMed
11.
Early Breast Cancer Trialists’ Collaborative Group (EBCTCG): Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005, 366: 2087-2106.CrossRef
12.
Early Breast Cancer Trialists’ Collaborative Group (EBCTCG): Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011, 378: 1707-1716.CrossRef
13.
14.
Kurosumi M, Itokazu R, Mamiya Y, Kishi K, Takayama S, Nagasawa M, Kurihara T, Suemasu K, Higashi Y: Invasive ductal carcinoma with a predominant intraductal component arising in a fibroadenoma of the breast. Pathol Int. 1994, 44: 874-877. 10.1111/j.1440-1827.1994.tb01687.x.CrossRefPubMed
15.
Sarela AI, Madvanur AA, Soonawala ZF, Shah HK, Pandit AA, Samsi AB: Carcinoma in a fibroadenoma. J Postgrad Med. 1995, 41: 19-20.PubMed
16.
Shah AK, Pathak R, Banerjee SN, Kaul A, Niazi M, Girishkumar HT: Lobular carcinoma-in-situ within a fibroadenoma of the breast. Postgrad Med J. 1999, 75: 293-294.PubMedCentralCrossRefPubMed
17.
Yano Y, Ueno E, Kamma H, Tsunoda H, Hara H, Yashiro T, Aiyoshi Y, Wu W, Hukazawa M: Non-invasive lobular carcinoma within a fibroadenoma, a preoperatively diagnosed case. Breast Cancer. 2001, 8: 70-73. 10.1007/BF02967481.CrossRefPubMed
18.
Kuijper A, Preisler-Adams SS, Rahusen FD, Gille JJP, van der Wall E, van Diest PJ: Multiple fibroadenomas harbouring carcinoma in situ in a woman with a family history of breast/ovarian cancer. J Clin Pathol. 2002, 55: 795-797. 10.1136/jcp.55.10.795.PubMedCentralCrossRefPubMed
19.
Abe H, Hanasawa K, Naitoh H, Endo Y, Tani T, Kushima R: Invasive ductal carcinoma within a fibroadenoma of the breast. Int J Clin Oncol. 2004, 9: 334-338. 10.1007/s10147-004-0401-9.CrossRefPubMed
20.
Stafyla V, Kotsifopoulos N, Grigoriades K, Kassaras G, Sakorafas GH: Lobular carcinoma in situ of the breast within a fibroadenoma: a case report. Gynecol Oncol. 2004, 94: 572-574. 10.1016/j.ygyno.2004.04.031.CrossRefPubMed
21.
Shin JH, Choi HY, Lee SN, Kim YJ: Microinvasive ductal carcinoma arising within a fibroadenoma: a case report. Acta Radiol. 2006, 47: 643-645. 10.1080/02841850600698838.CrossRefPubMed
22.
Yuen S, Uematsu T, Kasami M: Two cases of small infiltrating lobular carcinomas mimicking fibroadenoma on breast MRI. Breast J. 2007, 13: 616-617. 10.1111/j.1524-4741.2007.00494.x.CrossRefPubMed
23.
Borecky N, Rickard M: Preoperative diagnosis of carcinoma within fibroadenoma on screening mammograms. J Med Imaging Radiat Oncol. 2008, 52: 64-67. 10.1111/j.1440-1673.2007.01913.x.CrossRefPubMed
24.
25.
Khandelwal CR, Tandon M, Yashwant K, Kulshreshtha P, Aeron T, Bhatnagar D, Bansal A, Saxena S: Carcinoma developing in a fibroadenoma in a woman with a family history of breast cancer: a case report and review of literature. Cases J. 2009, 2: 9348-10.1186/1757-1626-2-9348.PubMedCentralCrossRefPubMed
26.
Iyengar KR, Peh SC, Yip CH, Vijayananthan A: Infiltrating duct carcinoma within a fibroadenoma. Indian J Cancer. 2009, 46: 244-246. 10.4103/0019-509X.52964.CrossRefPubMed
27.
Rao S, Latha S, Ravi A, Thanka J: Ductal carcinoma in a multiple fibroadenoma: diagnostic inaccuracies. J Cancer Res Ther. 2010, 6: 385-387. 10.4103/0973-1482.73350.CrossRefPubMed
28.
Petersson F, Tan PH, Putti TC: Low-grade ductal carcinoma in situ and invasive mammary carcinoma with columnar cell morphology arising in a complex fibroadenoma in continuity with columnar cell change and flat epithelial atypia. Int J Surg Pathol. 2010, 18: 352-357.CrossRefPubMed
29.
Kato F, Omatsu T, Matsumura W, Takahashi M, Hosoda M, Takahashi H, Kubota K, Oyama-Manabe N, Terae S, Shirato H: Dynamic MR findings of ductal carcinoma in situ within a fibroadenoma. Magn Reson Med Sci. 2011, 10: 129-132. 10.2463/mrms.10.129.CrossRefPubMed
30.
Ooe A, Takahara S, Sumiyoshi K, Yamamoto H, Shiba E, Kawai J: Preoperative diagnosis of ductal carcinoma in situ arising within a mammary fibroadenoma: a case report. Jpn J Clin Oncol. 2011, 41: 918-923. 10.1093/jjco/hyr075.CrossRefPubMed
31.
Tajima S, Kanemaki Y, Kurihara Y, Okamoto K, Shimamoto H, Okazaki H, Okuda I, Kawahara F, Nakajima Y, Fukuda M, Maeda I: A case of a fibroadenoma coexisting with an invasive lobular carcinoma in the breast. Breast Cancer. 2011, 18: 319-323. 10.1007/s12282-009-0122-z.CrossRefPubMed
32.
33.
Jahan F, Ghosh PK, Rahman S, Khanam R: Fibroadenoma with foci of infiltrating ductal carcinoma. JOM J Medicine. 2012, 13: 115-117.
34.
Butler R, Pinsky R, Jorns JM: Alveolar variant of invasive lobular carcinoma in a fibroadenoma. Breast J. 2012, 18: 613-614. 10.1111/tbj.12016.CrossRefPubMed
35.
Kuijper A, Mommers EC, van der Wall E, van Diest PJ: Histopathology of fibroadenoma of the breast. Am J Clin Pathol. 2001, 115: 736-742. 10.1309/F523-FMJV-W886-3J38.CrossRefPubMed
36.
Farrow DC, Hunt WC, Samet JM: Geographic variation in the treatment of localized breast cancer. N Engl J Med. 1992, 326: 1097-1101. 10.1056/NEJM199204233261701.CrossRefPubMed
37.
Bland KI, Menck HR, Scott-Conner CE, Morrow M, Winchester DJ, Winchester DP: The National Cancer Data Base 10-year survey of breast carcinoma treatment at hospitals in the United States. Cancer. 1998, 83: 1262-1273. 10.1002/(SICI)1097-0142(19980915)83:6<1262::AID-CNCR28>3.0.CO;2-2.CrossRefPubMed
38.
Rosen PP, Kosloff C, Lieberman PH, Adair F, Braun DW: Lobular carcinoma in situ of the breast: detailed analysis of 99 patients with average follow-up of 24 years. Am J Surg Pathol. 1978, 2: 225-251. 10.1097/00000478-197809000-00001.CrossRefPubMed
39.
Yoshida Y, Takaoka M, Fukumoto M: Carcinoma arising in fibroadenoma: case report and review of the world literature. J Surg Oncol. 1985, 29: 132-140. 10.1002/jso.2930290213.CrossRefPubMed
40.
Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N: Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002, 347: 1233-1241. 10.1056/NEJMoa022152.CrossRefPubMed
41.
Tiu CM, Chou YH, Chiou SY, Hsu CY, Chen SP, Chiang HR, Lai CR, Tseng LM, Wang HK, Chiou HJ: Development of a carcinoma in situ in a fibroadenoma: color Doppler sonographic demonstration. J Ultrasound Med. 2006, 25: 1335-1338.PubMed
42.
Sastre-Garau X, Jouve M, Asselain B, Vincent-Salomon A, Beuzeboc P, Dorval T, Durand JC, Fourquet A, Pouillart P: Infiltrating lobular carcinoma of the breast: clinicopathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patterns. Cancer. 1996, 77: 113-120. 10.1002/(SICI)1097-0142(19960101)77:1<113::AID-CNCR19>3.0.CO;2-8.CrossRefPubMed
43.
Zafrani B, Aubriot MH, Mouret E, De Crémoux P, De Rycke Y, Nicolas A, Boudou E, Vincent-Salomon A, Magdelénat H, Sastre-Garau X: High sensitivity and specificity of immunohistochemistry for the detection of hormone receptors in breast carcinoma: comparison with biochemical determination in a prospective study of 793 cases. Histopathology. 2000, 37: 536-545. 10.1046/j.1365-2559.2000.01006.x.CrossRefPubMed
44.
Kaptain S, Tan LK, Chen B: Her-2/neu and breast cancer. Diagn Mol Pathol. 2001, 10: 139-152. 10.1097/00019606-200109000-00001.CrossRefPubMed
45.
Bundred NJ: Prognostic and predictive factors in breast cancer. Cancer Treat Rev. 2001, 27: 137-142. 10.1053/ctrv.2000.0207.CrossRefPubMed
46.
Ravdin PM, Chamness GC: The c-erbB-2 proto-oncogene as a prognostic and predictive marker in breast cancer: a paradigm for the development of other macromolecular markers–a review. Gene. 1995, 159: 19-27. 10.1016/0378-1119(94)00866-Q.CrossRefPubMed
47.
Harrington SW, Miller JM: Malignant changes in fibroadenoma of the mammary gland. Surg Gynecol Obstet. 1940, 70: 615-619.
48.
Morimoto T, Tanaka T, Komaki K, Sasa M, Monden Y, Kumagai H, Otsuka H: The coexistence of lobular carcinoma in a fibroadenoma with a malignant phyllodes tumor in the opposite breast: report of a case. Surg Today. 1993, 23: 656-660. 10.1007/BF00311918.CrossRefPubMed
49.
Ben Hassouna J, Damak T, Ben Slama A, Chargui R, Ben Dhiab T, Khomsi F, Gamoud A, Boussen H, Rahal K: Breast carcinoma arising within fibroadenomas: report of four observations. Tunis Med. 2007, 85: 891-895.PubMed
50.
Pick PW, Iossifides IA: Occurrence of breast carcinoma within a fibroadenoma: a review. Arch Pathol Lab Med. 1984, 108: 590-594.PubMed
51.
Diaz NM, Palmer JO, McDivitt RW: Carcinoma arising within fibroadenomas of the breast: a clinicopathologic study of 105 patients. Am J Clin Pathol. 1991, 95: 614-622.PubMed
Metadata
Title
Breast cancer arising within fibroadenoma: collective analysis of case reports in the literature and hints on treatment policy
Authors
Yu-Ting Wu
Shou-Tung Chen
Chih-Jung Chen
Yao-Lung Kuo
Ling-Ming Tseng
Dar-Ren Chen
Shou-Jen Kuo
Hung-Wen Lai
Publication date
01-12-2014
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2014
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-12-335

Other articles of this Issue 1/2014

World Journal of Surgical Oncology 1/2014 Go to the issue

Research

Prognostic analysis of gastric gastrointestinal stromal tumor with synchronous gastric cancer

Case report

Desmoplastic small round cell tumor: a case report and review of the literature

Research

Evaluation of the benefit of using blue dye in addition to indocyanine green fluorescence for sentinel lymph node biopsy in patients with breast cancer

Research

Oncoplastic breast surgery with latissimus dorsi myocutaneous flap for large defect in patients with ptotic breasts: is it feasible when combined with local flaps?

Research

Risk factors for venous port migration in a single institute in Taiwan

Case report

Spontaneous rupture of a giant gastrointestinal stromal tumor of the jejunum: a case report and literature review