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

Wu YT, Chen ST, Chen CJ, Kuo YL, Tseng LM, Chen DR, Kuo SJ, Lai HW - World J Surg Oncol (2014)

Bottom Line: Only one patient had recurrence after surgery, and another had lung metastasis when diagnosed with BcaFad.Adjuvant radiotherapy could be performed, but was not mandatory.Chemotherapy should be considered as a treatment option in the presence of lymph node metastasis.

View Article: PubMed Central - PubMed

Affiliation: Endoscopic and Oncoplastic Breast Surgery Center, Comprehensive Breast Cancer Center, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua City, Changhua County 500, Taiwan. 143809@cch.org.tw.

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.

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Related in: MedlinePlus

Postoperative photograph of patient 26. This patient had centrally located breast cancer arising from a fibroadenoma diagnosed before surgery. She was treated with endoscopically assisted nipple-sparing mastectomy combined with immediate breast reconstruction with a gel implant. Photograph was taken 3 months after surgery.
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Fig2: Postoperative photograph of patient 26. This patient had centrally located breast cancer arising from a fibroadenoma diagnosed before surgery. She was treated with endoscopically assisted nipple-sparing mastectomy combined with immediate breast reconstruction with a gel implant. Photograph was taken 3 months after surgery.

Mentions: Twenty (66.7%) of thirty patients with BcaFad received breast-conserving surgery (BCS), and nine other patients (30.0%) received mastectomies. One (patient 26) of these nine mastectomy patients received immediate breast reconstruction (Figure 2). Furthermore, five (23.8%) of twenty-one patients with the diagnosis of lymph node status had lymph node metastasis. Most patients were diagnosed with IDC (16 cases, 53.3%), followed by DCIS (7 cases, 23.3%), LCIS (5 cases, 16.7%) and ILC (4 cases, 13.3%) (Table 2). Among these patients, only one patient (patient 2) had both LCIS and IDC and another (patient 5) had both DCIS and LCIS. The TNM stages recorded were major in TisN0M0, T1aN0M0 stage to T1bN0M0. A T1aN1M0 tumor was also noted.Figure 2


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

Wu YT, Chen ST, Chen CJ, Kuo YL, Tseng LM, Chen DR, Kuo SJ, Lai HW - World J Surg Oncol (2014)

Postoperative photograph of patient 26. This patient had centrally located breast cancer arising from a fibroadenoma diagnosed before surgery. She was treated with endoscopically assisted nipple-sparing mastectomy combined with immediate breast reconstruction with a gel implant. Photograph was taken 3 months after surgery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4289362&req=5

Fig2: Postoperative photograph of patient 26. This patient had centrally located breast cancer arising from a fibroadenoma diagnosed before surgery. She was treated with endoscopically assisted nipple-sparing mastectomy combined with immediate breast reconstruction with a gel implant. Photograph was taken 3 months after surgery.
Mentions: Twenty (66.7%) of thirty patients with BcaFad received breast-conserving surgery (BCS), and nine other patients (30.0%) received mastectomies. One (patient 26) of these nine mastectomy patients received immediate breast reconstruction (Figure 2). Furthermore, five (23.8%) of twenty-one patients with the diagnosis of lymph node status had lymph node metastasis. Most patients were diagnosed with IDC (16 cases, 53.3%), followed by DCIS (7 cases, 23.3%), LCIS (5 cases, 16.7%) and ILC (4 cases, 13.3%) (Table 2). Among these patients, only one patient (patient 2) had both LCIS and IDC and another (patient 5) had both DCIS and LCIS. The TNM stages recorded were major in TisN0M0, T1aN0M0 stage to T1bN0M0. A T1aN1M0 tumor was also noted.Figure 2

Bottom Line: Only one patient had recurrence after surgery, and another had lung metastasis when diagnosed with BcaFad.Adjuvant radiotherapy could be performed, but was not mandatory.Chemotherapy should be considered as a treatment option in the presence of lymph node metastasis.

View Article: PubMed Central - PubMed

Affiliation: Endoscopic and Oncoplastic Breast Surgery Center, Comprehensive Breast Cancer Center, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua City, Changhua County 500, Taiwan. 143809@cch.org.tw.

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.

Show MeSH
Related in: MedlinePlus