A clinicopathological study of fibroadenomas with epithelial proliferation including lobular carcinoma in-situ, atypical ductal hyperplasia, DCIS and invasive carcinoma

Article type: Research Article

Authors: Krishnamurthy, Kritika^a; | Alghamdi, Sarah^a | Gyapong, Sylvia^b | Kaplan, Stuart^b | Poppiti, Robert J.^{a; c}

Affiliations: [a] Arkadi Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami, FL, USA | [b] Radiology, Mount Sinai Medical Center, Miami, FL, USA | [c] FIU Herbert Wertheim College of Medicine, Miami, FL, USA

Correspondence: [*] Corresponding author: Kritika Krishnamurthy, Arkadi Rywlin Department of Pathology and Laboratory Medicine, 4300 Alton road, Suite 2400, Miami Beach, Florida 33140, USA. Tel.: +1 305 674 2277; Fax: +1 305 674 2999; E-mail: Kritika.Krishnamurthy@msmc.com

Abstract: BACKGROUND:Fibroadenoma is a benign mixed tumor composed of epithelial and non-epithelial components. The epithelial component of a fibroadenoma may exhibit proliferation, including lobular carcinoma in-situ, atypical ductal hyperplasia, DCIS and rarely, invasive breast carcinoma. OBJECTIVE:In this series of 30 cases of fibroadenoma with epithelial proliferation, we assessed the radiological and histopathological findings of each entity. METHOD:A retrospective review was performed to identify all fibroadenomas diagnosed at our institution between January 2012 and May 2018. RESULTS:In a total of 1523 consecutive cases of fibroadenomas, thirty cases had epithelial proliferations with an overall prevalence of 1.97%. Eight cases had fibroadenoma with lobular carcinoma in-situ, six cases had atypical ductal hyperplasia, ten cases had DCIS and six cases had invasive carcinoma. In cases of fibroadenomas with lobular carcinoma in-situ, 62.5% of the cases the neoplasia was confined to the fibroadenoma whereas only 10% of the cases with DCIS showed confinement to the fibroadenoma (p = 0.036). The most common radiological finding was the presence of a mass. The BI-RADS scores were 4 and above in all cases (p > 0.05). CONCLUSION:In our study population, the most common type of carcinoma arising in fibroadenomas was DCIS, followed by lobular carcinoma in-situ. Lobular carcinoma in-situ was more likely to be confined to the fibroadenoma while most DCIS involved surrounding breast tissue.

Keywords: Fibroadenoma with DCIS, fibroadenoma with lobular neoplasia, fibroadenoma with invasive carcinoma

DOI: 10.3233/BD-180368

Journal: Breast Disease, vol. 38, no. 3-4, pp. 97-101, 2019