Breast lumps natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]
Overview
If benign breast lumps left untreated, those proved to be benign both by clinical examination and cytological diagnosis, do not become malignant and 68% of benign breast lumps resolve by time mostly after 2 years. Benign breast lumps should approved to be benign both clinically and cytologicaly. Because some of breast lumps which thought to be benign ones can turn to be malignant by cytological results. Breast lumps which approved to be benign both clinically and cytologicaly in women under 35 years can resolve over time if do not excised.
Natural History, Complications, and Prognosis
Natural History
- Natural history of breast lumps is not well-studied and the related information is limited. [1]
- In order to prevent missed malignancy and patient's reassurance, benign breast lumps may be excised.
- The symptoms of benign breast lumps, especially fibroadenomas, usually develop in the second and third decade of life, and discrete breast lumps are considered to be benign on the basis of clinical examination.
- If left untreated, 68% of patients with benign breast lumps may regress over 2 years.
- The histological mechanism for resolution of breast lumps is associated with the fact that lumps may merge into stroma and hyalinize.[2]
- The risk of malignancy in fibroadenoma is low.[3]
- No adenocarcinoma reported in fibroadenoma yet, only lobular neoplasia was seen in fibroadenoma.[4]
Complications
- Common complications of breast lumps include:
Prognosis
The relative risk (RR) of following breast cancer in different types of breast lumps:[5][6][7]
- Non-proliferative breast lesions have RR 1.2-1.4.
- Proliferative diseases (PD) have RR 1.7-2.1.
- Proliferative diseases (PD) with atypia have RR more than 4 for breast cancer.
- PD and PD with atypia may be considered as early stages of breast cancer.
References
- ↑ 1.0 1.1 Sainsbury JR, Nicholson S, Needham GK, Wadehra V, Farndon JR (1988). "Natural history of the benign breast lump". Br J Surg. 75 (11): 1080–2. PMID 3208039.
- ↑ Kern WH, Clark RW (1973). "Retrogression of fibroadenomas of the breast". Am J Surg. 126 (1): 59–62. PMID 4123521.
- ↑ Pick PW, Iossifides IA (1984). "Occurrence of breast carcinoma within a fibroadenoma. A review". Arch Pathol Lab Med. 108 (7): 590–4. PMID 6329129.
- ↑ Haagensen, C. D. Diseases of the breast. Philadelphia: Saunders, 1971. Print.
- ↑ Hartmann LC, Sellers TA, Frost MH, Lingle WL, Degnim AC, Ghosh K; et al. (2005). "Benign breast disease and the risk of breast cancer". N Engl J Med. 353 (3): 229–37. doi:10.1056/NEJMoa044383. PMID 16034008.
- ↑ Page DL, Dupont WD, Rogers LW, Rados MS (1985). "Atypical hyperplastic lesions of the female breast. A long-term follow-up study". Cancer. 55 (11): 2698–708. PMID 2986821.
- ↑ Neal L, Sandhu NP, Hieken TJ, Glazebrook KN, Mac Bride MB, Dilaveri CA; et al. (2014). "Diagnosis and management of benign, atypical, and indeterminate breast lesions detected on core needle biopsy". Mayo Clin Proc. 89 (4): 536–47. doi:10.1016/j.mayocp.2014.02.004. PMID 24684875.