Fibroadenoma other diagnostic studies: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Fibroadenoma}} | {{Fibroadenoma}} | ||
{{CMG}} {{AE}} {{HL}} | {{CMG}} {{AE}} {{IO}} {{HL}} | ||
==Overview== | ==Overview== | ||
The definitive diagnosis of fibroadenoma is confirmed by an | 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]]. | ===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 | ||
:* | :* 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|1}} | {{reflist|1}} | ||
{{Soft tissue tumors and sarcomas}} | {{Soft tissue tumors and sarcomas}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Breast]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
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
- 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%.[1]
- Aspiration cytology may confuse fibroadenomas with other benign breast lesions, false diagnosis of a malignant process is uncommon.[1]
- Indications for an ultrasound guided biopsy include:[2]
- 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]
References
- ↑ 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.
- ↑ 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.
- ↑ 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.