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Zhu Y, Yu H, Zheng Z, Liu Z, Li Q, Wu X. Imaging manifestations of ductal adenoma of the breast: A case report. Open Life Sci 2024; 19:20220917. [PMID: 39022161 PMCID: PMC11252727 DOI: 10.1515/biol-2022-0917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/23/2024] [Accepted: 06/11/2024] [Indexed: 07/20/2024] Open
Abstract
Tubular adenomas of the breast are rare benign epithelium-derived tumours, and so few cases have been reported. Most often, the tumours are palpable, well-circumscribed masses in women of childbearing age and are commonly diagnosed as fibroadenomas both clinically and radiographically. We describe the case of a premenopausal patient with tubular adenoma of the breast who presented with small nipple discharge and a palpable breast mass. On imaging, tubular adenomas are practically indistinguishable from fibroadenomas and most commonly present as oval, circumscribed masses that are hypoechoic on ultrasound. On magnetic resonance imaging (MRI), tubular adenomas may present as lobulated or oval masses with a hyperintense signal on T2-weighted imaging and inhomogeneous internal enhancement on dynamic contrast-enhanced MRI. Pathologic findings after resection of the mass confirmed the diagnosis of tubular adenoma.
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Affiliation(s)
- Yaning Zhu
- Department of Radiology, WeiFang Traditional Chinese Hospital, No. 1055 Weizhou Road, Weifang261041, China
| | - Haitong Yu
- Department of Radiology, WeiFang Traditional Chinese Hospital, No. 1055 Weizhou Road, Weifang261041, China
| | - Zhaolong Zheng
- Department of Radiology, WeiFang Traditional Chinese Hospital, No. 1055 Weizhou Road, Weifang261041, China
| | - Zewen Liu
- Medical Imaging Department, Weifang Medical University, Weifang261053, Shandong, People’s Republic of China
| | - Qin Li
- Department of Radiology, WeiFang Traditional Chinese Hospital, No. 1055 Weizhou Road, Weifang261041, China
| | - Xiqing Wu
- Department of Radiology, WeiFang Traditional Chinese Hospital, No. 1055 Weizhou Road, Weifang261041, China
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2
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Muacevic A, Adler JR. Tubular Adenoma of the Breast Mimicking Fibroadenoma. Cureus 2022; 14:e31002. [PMCID: PMC9627861 DOI: 10.7759/cureus.31002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 11/07/2022] Open
Abstract
Tubular adenomas of the breast are rare benign epithelial neoplasms and not many cases have been reported. Predominantly, the tumor is described as a palpable, well-circumscribed mass. Most often confused with fibroadenomas clinically and radiologically. Surgical excision is mandatory for diagnosis and to prevent the growth of the mass. Here, we presented a case of these rare tumors. Our case describes a large mass measuring 4.5 × 2.0 × 3.7 cm with tubular adenoma pathology. We elected to document this case to aid in the management of this rare neoplasm. Our aim is to allow physicians to get better identification and treatment for such tumors and improve the outcome for the patients.
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3
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Miles B, Zeinoddini A, Lahiji AP, Eyzaguirre E, Nguyen QD. Postmenopausal Tubular Adenoma of the Breast: A Case Report. Cureus 2022; 14:e27076. [PMID: 36000143 PMCID: PMC9390948 DOI: 10.7759/cureus.27076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/06/2022] Open
Abstract
Tubular adenoma (TA) of the breast is a rare, benign proliferative breast lesion that is predominantly composed of closely compacted tubules with an inner layer of epithelial cells and an outer layer of myoepithelial cells. They are regarded as residing on the opposite end of a spectrum of proliferative breast lesions from fibroadenomas, which are predominantly stromal. The majority of TAs are found in premenopausal women and the reason for this demographic predilection is not yet known. It is generally not possible to distinguish between TA and other, higher-risk breast lesions prior to biopsy or resection because the clinical and radiographic findings overlap. In this article, we present the case of a TA in a postmenopausal patient and review the epidemiology, histology, carcinogenic potential, and management of such lesions.
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4
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Imaging Features of Rare Breast Lesions in Young Women. CURRENT HEALTH SCIENCES JOURNAL 2021; 47:314-321. [PMID: 34765255 PMCID: PMC8551907 DOI: 10.12865/chsj.47.02.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 06/26/2021] [Indexed: 11/18/2022]
Abstract
Rare breast tumors, such as, pseudoangiomatous stromal hyperplasia, granulomatous mastitis, tubular adenoma, myofibroblastoma and xanthogranulomatous mastitis, sarcomas, neuroendocrine tumors can sometimes be misdiagnosed because of the similarities in their imagistic characteristics. The main objective of our report is to emphasize the importance of performing ultrasound-guided breast biopsies of suspect lesions in young patients. We performed an US-guided breast biopsy instead of an excisional biopsy because breast surgery has a huge psychological impact. We selected 3 atypical breast tumors in young women, with different clinical signs and symptoms, some of which similar to other breast lesions, but with rapid growth, which needed a different and multiple imaging approach.
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5
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A case report of the breast tubular adenoma in the perimenopausal age group. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.709994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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6
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Guirguis MS, Adrada B, Santiago L, Candelaria R, Arribas E. Mimickers of breast malignancy: imaging findings, pathologic concordance and clinical management. Insights Imaging 2021; 12:53. [PMID: 33877461 PMCID: PMC8058137 DOI: 10.1186/s13244-021-00991-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/23/2021] [Indexed: 12/18/2022] Open
Abstract
Many benign breast entities have a clinical and imaging presentation that can mimic breast cancer. The purpose of this review is to illustrate the wide spectrum of imaging features that can be associated with benign breast diseases with an emphasis on the suspicious imaging findings associated with these benign conditions that can mimic cancer. As radiologic-pathologic correlation can be particularly challenging in these cases, the radiologist’s familiarity with these benign entities and their imaging features is essential to ensure that a benign pathology result is accepted as concordant when appropriate and that a suitable management plan is formulated.
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Affiliation(s)
- Mary S Guirguis
- Breast Imaging Department, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1350, Houston, TX, 77030-4009, USA.
| | - Beatriz Adrada
- Breast Imaging Department, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1350, Houston, TX, 77030-4009, USA
| | - Lumarie Santiago
- Breast Imaging Department, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1350, Houston, TX, 77030-4009, USA
| | - Rosalind Candelaria
- Breast Imaging Department, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1350, Houston, TX, 77030-4009, USA
| | - Elsa Arribas
- Breast Imaging Department, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1350, Houston, TX, 77030-4009, USA
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7
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Rodrigues RA, Azevedo CLAP, Djahjah MCR, Pereira TSS. Tubular adenoma of the breast: radiological and ultrasound findings. Radiol Bras 2018; 51:341-342. [PMID: 30369669 PMCID: PMC6198833 DOI: 10.1590/0100-3984.2017.0012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Rodrigo Amaral Rodrigues
- Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro (HUCFF-UFRJ), Rio de Janeiro, RJ, Brazil
| | | | - Maria Célia Resende Djahjah
- Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro (HUCFF-UFRJ), Rio de Janeiro, RJ, Brazil
| | - Talita Siemann Santos Pereira
- Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro (HUCFF-UFRJ), Rio de Janeiro, RJ, Brazil
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8
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Miller MC, Johnson P, Kim S, Choi L. Tubular adenomas of the breast: a rare diagnosis. BMJ Case Rep 2018; 2018:bcr-2018-224631. [PMID: 30150335 DOI: 10.1136/bcr-2018-224631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Tubular adenomas of the breast are rare benign tumours and few cases have been reported. Most often, the tumours are described as palpable, well-circumscribed masses in women of childbearing age and are commonly diagnosed as fibroadenomas both clinically and radiographically. Surgical excision is required for diagnosis and to prevent continuing growth. Here, we present two cases of these rare tumours, both with unusual presentations. The first case describes a very large specimen (10 cm × 9.5 cm × 4 cm mass) with tubular adenoma pathology, which is one of the largest reported in medical literature. The second case illustrates another rare specimen, a mixture of both tubular adenoma and fibroadenoma pathology. We elected to document these cases to assist in the management of these rare lesions. Our hope is that this will allow future physicians to better identify and treat the pathology with improved outcomes for these patients.
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Affiliation(s)
- Mia Colette Miller
- Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Pamela Johnson
- Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Steve Kim
- Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Lydia Choi
- Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
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9
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Efared B, Sidibé IS, Abdoulaziz S, Hammas N, Chbani L, El Fatemi H. Tubular Adenoma of the Breast: A Clinicopathologic Study of a Series of 9 Cases. Clin Med Insights Pathol 2018; 11:1179555718757499. [PMID: 29449780 PMCID: PMC5808954 DOI: 10.1177/1179555718757499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 01/10/2018] [Indexed: 11/15/2022] Open
Abstract
Tubular adenoma of the breast is one of the most rare benign neoplasms, accounting for only 0.13% to 1.7% of all breast benign tumors. Little is known about this rare neoplasm as the current literature offers only some case reports or a few number of small series. The aim of our study is to provide some clinicopathologic features of the breast tubular adenoma. We retrospectively analyzed at our department of pathology all cases of breast tubular adenomas confirmed by immunohistochemistry over a period of 9 years (2009-2017). Nine cases of breast tubular adenoma have been recorded, with an average age of 31.44 years. Five tumors were located at the right side (55.55%), and most cases had suspicious aspects on imaging techniques (6 cases out of 9). The diagnosis has been made on 5 resected specimens (lumpectomy) and on 4 core needle biopsies. The tumor size ranged from 0.9 to 7 cm (mean size of 3.08 cm) and had well-circumscribed margins with elastic consistency. The histopathologic analysis showed a typical pattern of proliferating round and uniform tubules lined by regular epithelial cells surrounded by myoepithelial cells, packed in a small amount of stroma, highlighted by CD34 immunostaining. Tubular adenoma is a rare breast benign neoplasm of young premenopausal women. The radiologic aspects are often worrisome and only the histopathologic analysis can achieve the correct definitive diagnosis by excluding all potential differential diagnoses.
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Affiliation(s)
- Boubacar Efared
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
| | - Ibrahim S Sidibé
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
| | - Souley Abdoulaziz
- Department of Radiology, Hassan II University Hospital, Fès, Morocco
| | - Nawal Hammas
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Laila Chbani
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Hinde El Fatemi
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
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10
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Smith Iorfido SM, Shah M, Zaidi SY, Iorfido S. A novel presentation of tubular adenoma of the breast as an intraductal mass: Diagnostic considerations and pathologic correlation. Indian J Radiol Imaging 2017; 27:112-114. [PMID: 28515600 PMCID: PMC5385767 DOI: 10.4103/0971-3026.202958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Suzanne M Smith Iorfido
- Department of Diagnostic Radiology, Detroit Medical Centre, Wayne State University, Detroit, Michigan, USA. E-mail:
| | - Mahendra Shah
- Diagnostic Radiologist and Breast Imager, Detroit Medical Center, Sinai Grace Hospital, Detroit, Michigan, USA
| | - S Yasir Zaidi
- Department of Pathology, Detroit Medical Center, Sinai Grace Hospital, Detroit, Michigan, USA
| | - Stephen Iorfido
- Diagnostic Radiology Resident, Detroit Medical Center, Huron Valley Sinai Hospital, Detroit, Michigan, USA
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11
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Kalipatnapu S, Samuel V, Johnson M, Perookavil Daniel K. A Case Report of a Giant Tubular Adenoma With a Concurrent Fibroadenoma of the Breast. World J Oncol 2015; 6:502-503. [PMID: 28983355 PMCID: PMC5624680 DOI: 10.14740/wjon954e] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2015] [Indexed: 11/11/2022] Open
Abstract
Tubular adenomas are rare benign epithelial tumors of the breast. Only a handful of cases have been reported in literature. We describe a very rare case of a giant tubular adenoma with a concurrent fibroadenoma in a young woman.
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Affiliation(s)
- Sasank Kalipatnapu
- Department of General Surgery, Christian Medical College, Vellore, Tamilnadu, India
| | - Vimalin Samuel
- Department of General Surgery, Christian Medical College, Vellore, Tamilnadu, India
| | - Martha Johnson
- Department of Pathology, Christian Fellowship Hospital, Oddanchatram, Dindigul District, Tamilnadu, India
| | - Koshy Perookavil Daniel
- Department of Surgery, Christian Fellowship Hospital, Oddanchatram, Dindigul District, Tamilnadu, India
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12
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Huang Y, Zhang H, Zhou Q, Ling L, Wang S. Giant tubular adenoma of the accessory breast in the anterior chest wall occurred in a pregnant woman. Diagn Pathol 2015; 10:60. [PMID: 26040320 PMCID: PMC4455915 DOI: 10.1186/s13000-015-0286-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 04/28/2015] [Indexed: 11/20/2022] Open
Abstract
Background Tubular adenoma of the breast is a rare benign epithelial tumor and only a few literatures have been reported; so far, no cases of tubular adenoma occurred in the accessory breast have been reported in the English literature. Clinical presentation and management of our patient are discussed along with a review of the literature on accessory mammary and tubular adenoma. Case presentation We present a case of 26-year-old woman (gravid 4, para 1) at 37 weeks of pregnancy with rapid enlargement in left anterior chest wall during pregnancy. Physical examination showed the left accessory breast was obviously bigger than the right one that only had a light areola around a small nipple. An elastic, mobile well-circumscribed mass measuring approximately 15 cm × 15 cm was palpated. Moreover, it was edematous and congestive with an increase in local temperature. The breast ultrasound further demonstrated the mass was a relatively homogeneous solid with short stripe blood flow signal. A single live fetus of 37 weeks gestation was observed by abdominal ultrasound scan. After a 2850 g male neonate was delivered, the right accessory breast and the mass in left accessory breast were removed. The resected specimen appeared as a solid white elastic mass with a smooth surface and the cut surface was red-grayish. Microscopically, the lesion consisted of tightly packed homogenous glandular structures which are supported by a single layer of myoepithelial cells with sparse intervening stroma. Conclusions We describe a very rare case of giant tubular adenoma arising within an accessory breast in the anterior chest wall in a late pregnancy woman. The high concentrations of estrogen, progesterone and prolactin might account for the significant tumor enlargement during pregnancy. To our knowledge, this is the first case of giant tubular adenoma occurred within the accessory breast in the anterior chest wall. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/6210811191552106.
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Affiliation(s)
- Yaoyu Huang
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Hao Zhang
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Qian Zhou
- Department of Breast Surgery, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Lijun Ling
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Shui Wang
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
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Sengupta S, Pal S, Biswas BK, Bose K, Phukan JP, Sinha A. Evaluation of Clinico-Radio-Pathological Features of Tubular Adenoma of Breast: a Study of Ten Cases with Histopathological Differential Diagnosis. IRANIAN JOURNAL OF PATHOLOGY 2015; 10:17-22. [PMID: 26516321 PMCID: PMC4539785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 03/26/2014] [Indexed: 06/05/2023]
Abstract
BACKGROUND & OBJECTIVES Tubular adenomas are rare benign epithelial tumours of breast affecting predominantly females of child bearing age group. Till now, very small number of cases have been reported in the literature. Present study was carried out to evaluate the clinico-pathological features of tubular adenoma cases diagnosed during three years study period along with discussion of possible differential diagnoses. METHODS Overall, 346 female breast biopsies were diagnosed as benign lesions in three years (2010-2012), of which 10 cases of tubular adenomas were identified. Available clinical, radiological and cytological data of these cases were analysed retrospectively in detail. RESULT Tubular adenomas were identified from 16 to 48 years of age with a predilection to younger age group (60% within 30 years). Most of the tubular adenomas were small and circumscribed mimicking fibroadenoma in almost all the cases. Diagnosis of tubular adenoma in each case was possible only after histological examination. Pre-operative diagnosis of tubular adenoma was not established by cytological and radiological evaluation in any case. CONCLUSION Tubular adenomas are clinically indistinguishable from other benign breast neoplasms and it should be considered as potential differential diagnosis during histopathological evaluation of breast biopsies.
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Affiliation(s)
- Sanjay Sengupta
- Dept. of Pathology, Bankura Sammilani Medical College, Bankura, India
| | - Subrata Pal
- Dept. of Pathology, Bankura Sammilani Medical College, Bankura, India
| | - Biplab Kr Biswas
- Dept. of Pathology, Bankura Sammilani Medical College, Bankura, India
| | - Kingshuk Bose
- Dept. of Pathology, Bankura Sammilani Medical College, Bankura, India
| | - Jyoti P Phukan
- Dept. of Pathology, Bankura Sammilani Medical College, Bankura, India
| | - Anuradha Sinha
- Dept. of Pathology, Bankura Sammilani Medical College, Bankura, India
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14
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Sengupta S, Pal S, Biswas BK, Phukan JP, Sinha A, Sinha R. Preoperative Diagnosis of Tubular Adenoma of Breast - 10 years of experience. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2014; 6:219-23. [PMID: 24926447 PMCID: PMC4049055 DOI: 10.4103/1947-2714.132940] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: Tubular adenomas are rare benign neoplasms of female breast affecting women, predominantly of child-bearing age group. Definitive diagnosis of this tumor is usually achieved after histopathological study. Clinical, radiological, and even cytological features are often insufficient for accurate diagnosis. Aim: The aim of the present study was planned to analyze clinical and radiological features of histologically confirmed cases of tubular adenoma of breast to find out a clue for accurate preoperative cytological diagnosis. Materials and Methods: In our 10-year research program, all histologically confirmed tubular adenoma cases of breast were studied. Clinico-radio-cytological features, if available, were analyzed and tabulated. Results: Thirty-three cases of tubular adenoma of breast were studied. Radiological and cytological assessments are available for 12 and 26 cases, respectively. Tubular adenoma could be diagnosed in only two cases (7.7%) by cytological assessment, but in none by radiological assessment. Conclusions: Clinico-cyto-radiological assessment could identify the benign nature of the tumors in most cases, but final confirmation was possible only after histopathological study.
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Affiliation(s)
- Sanjay Sengupta
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Subrata Pal
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Biplab Kr Biswas
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Jyoti Prakash Phukan
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Anuradha Sinha
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Rajani Sinha
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
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