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Breast, Fibroadenoma

eMedicine Radiology, 2014

Introduction Background Radiologists must be familiar with a variety of benign breast conditions to confidently distinguish malignant disease from benign disease.
Multiple or complex fibroadenomas may indicate a slightly increased risk for breast cancer; the relative risk of patients with such fibroadenomas is approximately twice that of patients of similar age without fibroadenomas.
Pathophysiology Fibroadenomas are benign tumors that represent a hyperplastic or proliferative process in a single terminal ductal unit; their development is considered to be an aberration of normal development.
Approximately 10% of fibroadenomas disappear spontaneously each year, and most stop growing after they reach 2-3 cm.
Conversely, fibroadenomas may grow rapidly during pregnancy, during hormone replacement therapy, or during immunosuppression, in which case they can simulate malignancy.
In immunosuppressed patients, the etiology of multiple or growing fibroadenomas appears to be related to Epstein-Barr virus infection.
Fibroadenoma variants include juvenile fibroadenomas, occurring in female adolescents, and myxoid fibroadenomas, occurring in persons with Carney complex.
Carney complex is an autosomal dominant neoplasia syndrome that includes skin and mucosal lesions, myxomas, and endocrine disorders.
Frequency United States Fibroadenomas are among the most common breast lesions, particularly in women younger than 40 years.
Mortality/Morbidity Fibroadenomas are benign lesions and are not considered to have malignant potential.
However, because they contain epithelium, a risk of neoplasia exists, as in other locations in the breast.