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{{Fibroadenoma}}
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==Overview==
==Overview==
The definitive diagnosis of fibroadenoma is confirmed by an ultrasound guided [[biopsy]]. Characteristic findings for fibroadenoma on microscopic histopathological analysis can be found [[Fibroadenoma pathophysiology|'''here''']].<ref name="radio">Fibroadenoma. Radiopaedia (2015) http://radiopaedia.org/articles/fibroadenoma-of-the-breast-1 Accessed on January, 29 2016</ref>
The definitive diagnosis of fibroadenoma is confirmed by an [[ultrasound]] guided [[biopsy]]. This is usually done if patients presents with a rapidly enlarging mass, mass >3 cm in size and some other features.  
==Other Diagnostic Studies==
==Other Diagnostic Studies==
* The definitive diagnosis of fibroadenoma is confirmed by an ultrasound guided [[biopsy]]. Characteristic findings for fibroadenoma on microscopic histopathological analysis can be found [[Fibroadenoma pathophysiology|'''here''']].<ref name="radio">Fibroadenoma. Radiopaedia (2015) http://radiopaedia.org/articles/fibroadenoma-of-the-breast-1 Accessed on January, 29 2016</ref>
===Aspiration Cytology===
* Indications for an ultrasound guided biopsy include:
* The definitive diagnosis of fibroadenoma is confirmed by an [[ultrasound]] guided [[biopsy]].
* In combination with clinical diagnosis of fibroadenoma, [[fine needle aspiration]] ([[FNA]]) can improve the [[sensitivity]] of the diagnosis to 86%, with a specificity of 76%.<ref name="pmid9754521">{{cite journal |vauthors=Greenberg R, Skornick Y, Kaplan O |title=Management of breast fibroadenomas |journal=J Gen Intern Med |volume=13 |issue=9 |pages=640–5 |date=September 1998 |pmid=9754521 |pmc=1497021 |doi= |url=}}</ref>
*[[Aspiration]] [[cytology]] may confuse fibroadenomas with other benign [[breast]] lesions, false diagnosis of a [[malignant]] process is uncommon.<ref name="pmid9754521">{{cite journal |vauthors=Greenberg R, Skornick Y, Kaplan O |title=Management of breast fibroadenomas |journal=J Gen Intern Med |volume=13 |issue=9 |pages=640–5 |date=September 1998 |pmid=9754521 |pmc=1497021 |doi= |url=}}</ref>
* Indications for an [[ultrasound]] guided [[biopsy]] include:<ref name="pmid30174488">{{cite journal| author=Lee EJ, Chang YW, Oh JH, Hwang J, Hong SS, Kim HJ| title=Breast Lesions in Children and Adolescents: Diagnosis and Management. | journal=Korean J Radiol | year= 2018 | volume= 19 | issue= 5 | pages= 978-991 | pmid=30174488 | doi=10.3348/kjr.2018.19.5.978 | pmc=6082765 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30174488  }} </ref>
 
:* Rapidly enlarging mass
:* Rapidly enlarging mass
:* Atypical findings on ultrasound
:* Atypical findings on [[ultrasound]] such as non-circumscribed margins, complex solid and cystic components, posterior acoustic shadowing
:* A lesion greater than 2.5 cm in size, with no previous studies for comparison
:* Lesion greater than 3 cm in size, with no previous studies for comparison
:* Patients preference  
:* Patients preference
:* History of a [[risk factor]] for [[malignancy]] regardless of the [[lesion]] having a [[benign]] appearance on ultrasonography. Examples include a prior chest [[irradiation]], known concurrent [[cancer]] not involving the [[breast]], family history of [[breast cancer]].
 
* The characteristic cytologic features of fibroadenomas include:<ref name="pmid9754521">{{cite journal |vauthors=Greenberg R, Skornick Y, Kaplan O |title=Management of breast fibroadenomas |journal=J Gen Intern Med |volume=13 |issue=9 |pages=640–5 |date=September 1998 |pmid=9754521 |pmc=1497021 |doi= |url=}}</ref>
 
:* Clusters of [[spindle cells]] without inflammatory or fat cells. This is found in 96% of all fibroadenomas.
:* Aggregates of cells with a papillary configuration resembling elk antler (antler horn clusters). Found in about 93%.
:* Uniform cells with well-defined [[cytoplasm]] lying in rows and columns (honeycomb sheets). Found in about 95%
 
* A "triple assessment approach" refers to the combination of clinical [[breast]] examination, imaging and [[percutaneous]] tissue study. This approach allows a 95% accurate differentiation between a [[benign]] and [[malignant]] lesion.<ref name="pmid12860764">{{cite journal| author=Sperber F, Blank A, Metser U, Flusser G, Klausner JM, Lev-Chelouche D| title=Diagnosis and treatment of breast fibroadenomas by ultrasound-guided vacuum-assisted biopsy. | journal=Arch Surg | year= 2003 | volume= 138 | issue= 7 | pages= 796-800 | pmid=12860764 | doi=10.1001/archsurg.138.7.796 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12860764  }} </ref>
[[File:Histology fibro 1.jpg|400px|thumb|left|H&E stain showing proliferation of intralobular stroma compressing and distorting the epithelium [https://commons.wikimedia.org/wiki/File:Fibroadenoma_10X.jpg#/media/File:Fibroadenoma_10X.jpg Source:Department of Pathology, Calicut Medical College]]]
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==References==
==References==
{{reflist|2}}
{{reflist|1}}


{{Soft tissue tumors and sarcomas}}
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Latest revision as of 21:45, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2] Haytham Allaham, M.D. [3]

Overview

The definitive diagnosis of fibroadenoma is confirmed by an ultrasound guided biopsy. This is usually done if patients presents with a rapidly enlarging mass, mass >3 cm in size and some other features.

Other Diagnostic Studies

Aspiration Cytology

  • Rapidly enlarging mass
  • Atypical findings on ultrasound such as non-circumscribed margins, complex solid and cystic components, posterior acoustic shadowing
  • Lesion greater than 3 cm in size, with no previous studies for comparison
  • Patients preference
  • History of a risk factor for malignancy regardless of the lesion having a benign appearance on ultrasonography. Examples include a prior chest irradiation, known concurrent cancer not involving the breast, family history of breast cancer.
  • The characteristic cytologic features of fibroadenomas include:[1]
  • Clusters of spindle cells without inflammatory or fat cells. This is found in 96% of all fibroadenomas.
  • Aggregates of cells with a papillary configuration resembling elk antler (antler horn clusters). Found in about 93%.
  • Uniform cells with well-defined cytoplasm lying in rows and columns (honeycomb sheets). Found in about 95%
  • A "triple assessment approach" refers to the combination of clinical breast examination, imaging and percutaneous tissue study. This approach allows a 95% accurate differentiation between a benign and malignant lesion.[3]
H&E stain showing proliferation of intralobular stroma compressing and distorting the epithelium Source:Department of Pathology, Calicut Medical College



References

  1. 1.0 1.1 1.2 Greenberg R, Skornick Y, Kaplan O (September 1998). "Management of breast fibroadenomas". J Gen Intern Med. 13 (9): 640–5. PMC 1497021. PMID 9754521.
  2. Lee EJ, Chang YW, Oh JH, Hwang J, Hong SS, Kim HJ (2018). "Breast Lesions in Children and Adolescents: Diagnosis and Management". Korean J Radiol. 19 (5): 978–991. doi:10.3348/kjr.2018.19.5.978. PMC 6082765. PMID 30174488.
  3. Sperber F, Blank A, Metser U, Flusser G, Klausner JM, Lev-Chelouche D (2003). "Diagnosis and treatment of breast fibroadenomas by ultrasound-guided vacuum-assisted biopsy". Arch Surg. 138 (7): 796–800. doi:10.1001/archsurg.138.7.796. PMID 12860764.

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