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Elnahas W, Metwally IH, Bonna K, Youssef M, AbdAllah S, Bonna M, Ali Faried M, Atef Tira M, Hamdy O. Fibroadenoma of the breast; incidence of malignancy and indicators for surgical intervention: An analysis of 1392 patients. Breast Dis 2022; 41:421-426. [PMID: 36565097 DOI: 10.3233/bd-210074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Fibroadenomas are common among young females. The size of the lesion used to be an indication for further assessment or excision. With arising of the watch and see proponents, criteria for selecting patients are important to establish. METHODS This is a retrospective study of a prospectively maintained database where all patients having the clinical/radiological provisional diagnosis of fibroadenoma and attending our center - from January 2008 to March 2020 - were enrolled. The primary outcome was the incidence of malignancy and the secondary outcomes were the correlation of malignancy-risk with epidemiologic and radiologic criteria. RESULTS The study enrolled 1392 patients. The mean age of the patients was 35.7 + ∕- 13.1 years. The median of the longest diameter of the detected breast lesions was 25 mm. The incidence of malignancy was 188 (13.5%). The size of the lesion measured by largest diameter was insignificant (p = 0.99), while the patients' age, marital status, and imaging criteria as measured by BIRADS score were significant (<0.001). CONCLUSION Approaching patients with the age above 35 or with BIRADS 4 provisionally diagnosed with fibroadenomas should be cautious with biopsy and short-term follow-ups The size of the tumor alone should not be used as an indication for surgical intervention.
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Affiliation(s)
- Waleed Elnahas
- Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Mansoura, Egypt
| | - Islam H Metwally
- Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Mansoura, Egypt
| | - Khaled Bonna
- Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Mansoura, Egypt
| | - Marco Youssef
- Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Mansoura, Egypt
| | - Samar AbdAllah
- Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Mansoura, Egypt
| | - Mohamed Bonna
- Medical Students, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Mohamed Ali Faried
- Medical Students, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Mohamed Atef Tira
- Medical Students, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Omar Hamdy
- Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Mansoura, Egypt
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Granger CJ, Hogan AR, Neville HL, Thorson CM, Perez EA, Sola JE, Brady AC. The limited role of ultrasound in the surgical assessment of solid pediatric breast lesions. Clin Imaging 2021; 74:100-105. [PMID: 33465666 DOI: 10.1016/j.clinimag.2020.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/28/2020] [Accepted: 12/31/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Ultrasound (US) is an adjunct to history and clinical exam (CE) in the assessment of pediatric breast lesions. We sought to investigate the reliability of US and CE to predict final pathologic diameter (P). METHODS A single institutional retrospective analysis of patients aged ≤18 years who underwent breast mass resection was performed. Data was collected and analyzed using SPSS. RESULTS 88 patients met inclusion criteria with an average age at surgery of 16 ± 1.5 years. No malignancies were encountered. The largest mean diameter measured by final pathology (MPØ) for all lesions was 4.1 ± 2.6 cm. Pathology encountered were fibroadenoma (83%, MPØ 3.7 ± 1.7 cm), juvenile fibroadenoma (10%, MPØ 7.0 ± 5.4 cm), and low-grade phyllodes tumor (3%, MPØ 6.2 ± 3.8 cm). 67 patients had documented CE measurement with a mean diameter of 3.4 ± 1.8 cm. 62 patients underwent US with a mean diameter of 3.3 ± 1.6 cm. US and CE were accurate in determining P by Cronbach Alpha reliability testing. CONCLUSION US and CE are reliable measurements of P. The surgical utility of US when considering pediatric breast lesions is limited and should be individualized following pediatric surgical evaluation and CE.
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Affiliation(s)
- Caroline J Granger
- Leonard M. Miller School of Medicine, University of Miami, 1600 NW 10th Ave, Suite 1140, Miami, FL 33136, USA
| | - Anthony R Hogan
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA
| | - Holly L Neville
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA
| | - Chad M Thorson
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA
| | - Eduardo A Perez
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA
| | - Juan E Sola
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA
| | - Ann-Christina Brady
- Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450, Miami, FL 33136, USA.
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Md Nasir ND, Ng CCY, Rajasegaran V, Wong SF, Liu W, Ng GXP, Lee JY, Guan P, Lim JQ, Thike AA, Koh VCY, Loke BN, Chang KTE, Gudi MA, Lian DWQ, Madhukumar P, Tan BKT, Tan VKM, Wong CY, Yong WS, Ho GH, Ong KW, Tan P, Teh BT, Tan PH, Rahman NA, Nahar Begum SMK, Cheah PL, Chen CJ, Dela Fuente E, Han A, Harada O, Kanomata N, Lee CS, Han Lee JY, Kamal M, Nishimura R, Ohi Y, Sawyer EJ, Teoh KH, Tsang AKH, Tsang JY, Tse GMK, Yamaguchi R. Genomic characterisation of breast fibroepithelial lesions in an international cohort. J Pathol 2019; 249:447-460. [DOI: 10.1002/path.5333] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 07/11/2019] [Accepted: 08/01/2019] [Indexed: 12/31/2022]
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Guillez K, Callec R, Morel O, Routiot T, Mezan de Malartic C. [Treatment of fibroadenomas by high-intensity focused ultrasound: What results? Review]. ACTA ACUST UNITED AC 2018; 46:524-529. [PMID: 29773521 DOI: 10.1016/j.gofs.2018.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Indexed: 10/14/2022]
Abstract
OBJECTIVES To assess benefits and adverse effects of high-intensity focused ultrasound (HIFU) as a treatment for fibroadenomas (FA). METHODS To ensure the quality of the methodology, the PRISMA criteria have been met at all stages of the development of this review. We searched MEDLINE from inception to May 2017, without any restriction. KEYWORDS fibroadenoma, focused ultrasound, HIFU and fibroadenomata were used. Data were extracted and the results were compared. Two reviewers independently extracted study characteristics and outcome data. RESULTS Of 20 identified abstracts, 5 primary studies met inclusion criteria. All studies reported a reduction in the size of FA treated with an increasing effect over time. Pain tolerance was most often assessed as moderate. Adverse effects of HIFU were not severe in all studies. CONCLUSIONS HIFU appears to be a promising technique in the treatment of fibroadenomas with a volume decrease of approximately 50 % at 6 months of therapy.
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Affiliation(s)
- K Guillez
- Département de chirurgie, maternité régionale universitaire de Nancy, CHU de Nancy, 10, avenue Dr-Heydenreich, 54000 Nancy, France.
| | - R Callec
- Département de chirurgie, maternité régionale universitaire de Nancy, CHU de Nancy, 10, avenue Dr-Heydenreich, 54000 Nancy, France
| | - O Morel
- Département de chirurgie, maternité régionale universitaire de Nancy, CHU de Nancy, 10, avenue Dr-Heydenreich, 54000 Nancy, France
| | - T Routiot
- Département de chirurgie, maternité régionale universitaire de Nancy, CHU de Nancy, 10, avenue Dr-Heydenreich, 54000 Nancy, France
| | - C Mezan de Malartic
- Département de chirurgie, maternité régionale universitaire de Nancy, CHU de Nancy, 10, avenue Dr-Heydenreich, 54000 Nancy, France
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Clauser P, Bazzocchi M, Marcon M, Londero V, Zuiani C. Results of Short-Term Follow-Up in BI-RADS 3 and 4a Breast Lesions with a Histological Diagnosis of Fibroadenoma at Percutaneous Needle Biopsy. Breast Care (Basel) 2017; 12:238-242. [PMID: 29070987 DOI: 10.1159/000477536] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To evaluate the usefulness of short-term (6 months) follow-up in patients with Breast Imaging Report and Data System (BI-RADS) 3 and 4a lesions, after a diagnosis of fibroadenoma at an image-guided biopsy. PATIENTS AND METHODS The data of 318 women with 349 biopsy-proven fibroadenomas, a 6-month follow-up, and a follow-up of ≥ 24 months were retrospectively reviewed. Information on clinical history, lesion characteristics on ultrasound (US), mammography, and magnetic resonance imaging (MRI), BI-RADS classification, and follow-up was collected. The false-negative (FN) rate and the negative predictive value (NPV) for the biopsy were calculated. RESULTS 43 patients (13.5%) presented with a palpable nodule; 18 (5.7%) had a history of breast cancer. There were 334 lesions visible on US (95.7%), 57 on US and mammography (16.3%), and 15 on mammography only (4.3%); 37 lesions were first detected on MRI. All lesions were stable at 6 months. After an at least 1-year follow-up, 4 lesions changed their features and were excised. Histology showed 1 invasive lobular cancer, 1 ductal carcinoma in situ, 1 phyllodes tumor, and 1 papilloma. The FN rate of the needle biopsy was 1.1% and the NPV was 98.9%. CONCLUSION For lesions initially described as BI-RADS 3 and 4a with a histological diagnosis of fibroadenoma after biopsy, short-term follow-up can be avoided.
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Affiliation(s)
- Paola Clauser
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Massimo Bazzocchi
- Institute of Diagnostic Radiology, University of Udine, Udine, Italy
| | - Magda Marcon
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Viviana Londero
- Institute of Diagnostic Radiology, University of Udine, Udine, Italy
| | - Chiara Zuiani
- Institute of Diagnostic Radiology, University of Udine, Udine, Italy
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