Fibroadenomas mimicking cancer in postmenopausal women.
Fibroadenomas FAD are benign breast lesions usually seen in late teens less so common in postmenopausal women. This is a case series of postmenopausal patients, where breast cancer looked like fibroadenoma on imaging. The aim of this study was to identify the important role of tissue diagnosis in FAD like lesions on imaging and highlight the deceiving imaging findings. MATERIALS AND
We retrospectively reviewed the medical records of patients at our Breast unit who were treated for breast cancer under one surgeon in the period of Feb 2009 to Jan 2010. Patients underwent triple assessment as per protocol of the breast screening unit. All had fine needle aspiration and core biopsy of the lesions. Appropriate surgery was offered and the size, grade and lymph node status was evaluated and Nottingham Prognostic Index (NPI) used to predict survival.
5 patients were identified with breast cancers that had initial radiological diagnosis of fibroadenoma. All patient lesions were screen detected on NHS screening programme. One patient out of five was discharged after triple assessment and represented with a lump 18 months later. The Median age was 56 years (range 50-66 years). The mammogram showed these to be benign looking lesions and ultrasound scans suggested fibroadenomas as reported by specialist breast radiologist. Seven lesions were identified in 5 patients. One patient had 3 lesions. Lesions size ranged between 8mm to 25mm on mammogram (median 14mm) and 8-20mm on ultrasound (range 8-20). Fine needle aspiration cytology was C5 in the two lesions, C4 in 2 and C3 in 1 lesion. Two patients had unifocal grade 3 tumours. One patient had multifocal cancer (3 cancers- in unilateral breast) all were grade 3 cancers with lymph node involvement. One patient had grade 2 cancer and 1 was found to have adenoid cystic adenocarcinoma and therefore the grade and NPI was not assessed. NPI was good in1, moderate in 2 and poor in 1 patient.
Our case series suggested that one should have a high index of suspicion for FAD in the postmenopausal ladies and triple assessment should include thorough tissue sampling in the form of FNA and core biopsy.
QueenElizabeth Hospital, Gateshead, UK.
This article was published in the following journal.
Name: International journal of surgery (London, England)
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20804869
- DOI: http://dx.doi.org/10.1016/j.ijsu.2010.08.005
Objective:To compare the safety and regression rates of conservative treatments for complex atypical hyperplasia (CAH) between pre- and postmenopausal women.Methods:Historical cohort study of pre- and...
Background: Results from prospective studies on the association between urinary levels of melatonin and risk of postmenopausal breast cancer have been mixed. Several although not all studies have foun...
Objectives- Complex fibroadenomas are fibroadenomas harboring 1 or more complex pathologic features: epithelial calcifications, apocrine metaplasia, sclerosing adenosis, and cysts larger than 3 mm. No...
Epilepsy in menopausal women presents several challenges in the treatment including an increased risk of seizures due to hormone replacement therapy. We investigated the hypothesis if raloxifene, a se...
Recent epidemiological as well as in vivo and in vitro studies collectively suggest that the metalloestrogen cadmium (Cd) could be a potential risk factor for hormone-related cancers in particularly b...
Aim of this study is the determination of a valid procedure for ischemia diagnositc in postmenopausal women.
RATIONALE: Citalopram may help relieve hot flashes in women who had or have not had breast cancer. It is not yet known which dose of citalopram is more effective in treating hot flashes in...
RATIONALE: Estrogen can relieve the symptoms of menopause, but can also cause the growth of breast cancer cells. Flaxseed may reduce the number of hot flashes and improve mood and quality ...
This randomized phase I trial studies the side effects and the best dose of letrozole in treating healthy postmenopausal women at high risk for breast cancer. Letrozole may prevent breast ...
RATIONALE: Screening tests may help doctors detect cancer cells early and plan more effective treatment for cancer. It is not yet known if ultrasound is more effective with or without meas...
Medical and Biotech [MESH] Definitions
A gonadal stromal neoplasm composed only of THECA CELLS, occurring mostly in the postmenopausal OVARY. It is filled with lipid-containing spindle cells and produces ESTROGENS that can lead to ENDOMETRIAL HYPERPLASIA; UTERINE HEMORRHAGE; or other malignancies in postmenopausal women and sexual precocity in girls. When tumors containing theca cells also contain FIBROBLASTS, they are identified as thecoma-fibroma tumors with less active hormone production.
A synthetic retinoid that is used orally as a chemopreventive against prostate cancer and in women at risk of developing contralateral breast cancer. It is also effective as an antineoplastic agent.
A nonhormonal medication for the treatment of postmenopausal osteoporosis in women. This drug builds healthy bone, restoring some of the bone loss as a result of osteoporosis.
Metabolic disorder associated with fractures of the femoral neck, vertebrae, and distal forearm. It occurs commonly in women within 15-20 years after menopause, and is caused by factors associated with menopause including estrogen deficiency.
An aromatized C18 steroid with a 3-hydroxyl group and a 17-ketone, a major mammalian estrogen. It is converted from ANDROSTENEDIONE directly, or from TESTOSTERONE via ESTRADIOL. In humans, it is produced primarily by the cyclic ovaries, PLACENTA, and the ADIPOSE TISSUE of men and postmenopausal women.