Generally Benign Breast Tumours

Generally Benign Breast Tumours

Fibroadenoma

·        Most common benign breast tumour – no malignant potential

·        Hypertrophy of a lobule, compressed by stroma (® sharply circumscribed), hard and very mobile – up to 2 – 3 cm diameter.

·        Common in 16 – 24 years.  Rapid growth for 6 months, 1/3 will regress.

·        Diagnosis by FNA if < 25 years, surgical enucleation if > 35 years

·        Histology: ­fibrous tissue surrounding normal ducts that are often crushed flat. Risk of subsequent cancer = 2.17

·         Cytology: cells clump together (cohesive) compared with malignancy which are normally non-cohesive

·        Giant fibroadenoma: Variant:

o   Two peaks of incidence: 14 – 18 years and 40 – 50 years

o   Large: 5 – 10 cm

o   Typically oriental and black races

o   Diagnosis: FNA

o   Treatment: surgical enucleation (no excision margin)

Phyllodes Tumour

·        Rare but „worrisome‟ mixture of stromal and epithelial cells

·        30 – 50 years

·        Shiny skin + vascular markings

·        Wide spectrum from benign to frankly malignant.  Grow rapidly

·        Diagnosis: FNA + core biopsy.  Cleft into the tumour on US is characteristic

·        Treatment: excision with 1 cm margin

·        Recur locally

Papilloma

·        < 1 cm epithelial proliferation in a major duct just below the nipple

·        Can ® bloody discharge and/or nipple retraction

·        1 in 100 is a papillary carcinoma