Fibroadenoma pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
Fibroadenoma is a common benign tumor of the breast. Fibroadenoma arises from connective tissue cells, which are cells that are normally involved in the functional and mechanical support of the surrounding tissues. Fibroadenoma demonstrate estrogen and progesterone sensitivity and may grow during pregnancy. The most common gene involved in the pathogenesis of fibroadenoma is mediator complex subunit 12 (MED12) gene. On gross pathology, a rubbery texture, tan color, and lobulated appearance are characteristic findings of fibroadenoma. On microscopic pathology, charectersitic findings of fibroadenoma include a biphasic proliferation of both stromal and epithelial components that can be arranged in two growth patterns; a pericanalicular growth pattern or an intracanalicular growth pattern.
Pathogenesis
- Fibroadenoma is a common benign tumor of the breast.
- Fibroadenoma arises from connective tissue cells, which are cells that are normally involved in the functional and mechanical support of the surrounding tissues.
- The majority of fibroadenomas are benign and do not demonstrate any malignant potential.
- Fibroadenomas typically contain both stromal and epithelial connective tissue cells.
- Fibroadenoma demonstrate estrogen and progesterone sensitivity and may grow during pregnancy.
- It is thought that the hormone-receptor mechanism mediates the excessive proliferation of epithelial and stromal cells.[1]
- Although fibroadenomas may be develop in any part of the breast, there is a significant predilection for the upper outer quadrant.
Genetics
- The most common gene involved in the pathogenesis of fibroadenoma is mediator complex subunit 12 (MED12) gene.
Gross Pathology
- On gross pathology, a painless, firm, solitary, mobile, and slowly growing breast lump is a characteristic finding of fibroadenoma.
- Other charectersitic findings on gross examination of fibroadenoma include:
- Rubbery texture
- Tan/white colored
- Lobulated appearance
- Short slit-like spaces present
- Calcifications
- Fibroadenomas are sometimes called a breast mouse owing to their high mobility through out the breast.
Microscopic Pathology
- On microscopic pathology, charectersitic findings of fibroadenoma include:
- Biphasic proliferation of both stromal and epithelial components that can be arranged in two growth patterns:
- Pericanalicular growth pattern: stromal proliferation around epithelial structures
- Intracanalicular growth pattern: stromal proliferation compressing the epithelial structures into clefts
- Hypovascular stroma
- The epithelial proliferation appears in a single terminal ductal unit
Gallery
References
- ↑ Sapino A, Bosco M, Cassoni P, Castellano I, Arisio R, Cserni G; et al. (2006). "Estrogen receptor-beta is expressed in stromal cells of fibroadenoma and phyllodes tumors of the breast". Mod Pathol. 19 (4): 599–606. doi:10.1038/modpathol.3800574. PMID 16554735.