Fibroadenomas are benign tumors
composed of stromal and epithelial elements. These tumors are commonly seen in
young women; less than 25 years old according Lee (2011). 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 (Roubidoux,
2011) ,
although other authors do not consider a breast cancer precursor (Lee, Bushan,
Tolles, & Hofmann, 2011) .
Intraductal
papilloma is a small benign proliferative tumor that grows in lactiferous
ducts, consists of a branching fibrovascular core with overlying epithelial and
myoepithelial layers. These lesions can occur anywhere in the ductal system,
and may be solitary or multiple (Warrick, 2011) . It is founds
typically beneath areola as mentioned by Lee at el (2011), and presents like a
serous or bloody nipple discharge.
The
risk of developing cancer from Intraductal papilloma is not well established, Azzopardi
did not consider papilloma to be a direct precursor based on what he believed
to be a false association between papilloma and breast cancer in studies
available during his time, which he thought were confounded by an overdiagnosis
of "pseudo-infiltration" in benign papilloma and the misdiagnosis of
papilloma as papillary carcinoma. (Azzopardi, 1979) . In the other hand,
Haagensen believed "multiple papillomas" was a precancerous lesion;
because all 6 women in his study who developed breast cancer, in the same area
where the initial papilloma had been diagnosed. (Haagensen, 1986).
Phyllodes
tumor is the most commonly occurring nonepithelial neoplasm of the breast, presents
like a large, bulky mass of connective tissue and cysts, leaf like projection, commonly in the 6th decade of life
(Lee, 2011), although it represents only about 1% of tumors in the breast. It
has a smooth, sharply demarcated texture and typically is freely movable. It is
a relatively large tumor, with an average size of 5cm. The etiology of
phyllodes tumors is unknown. (Lannin, 2012) .
The difficulty in distinguishing between fibroadenoma, benign
phyllodes tumors, and malignant cystosarcoma phyllodes may be vexing for even
the most experienced pathologist (Yohe & Yeh, 2008) .
Bibliography
Azzopardi, J. (1979). Problems in breast pathology.
In: Bennington J, ed. Major progress in Pathology. London, UK:
Bailliere-Tindall.
Haagensen, C. (1986).
Diseases of the Breast. 3ra ed. . Philadelphia, Pa: WB Saunders Co.
Lannin, D. R. (2012,
Jan 6). medscape.com. Retrieved Jan 23, 2012, from Cystosarcoma
Phyllodes: http://emedicine.medscape.com/article/188728-overviewLee, T., Bushan, V., Tolles, J., & Hofmann, J. (2011). First AID for the USMLE step 1. usa: McGraw Hill.
Roubidoux, M. A. (2011, apr 12). Medscape.com. Retrieved jan 23, 2012, from breast fibroadenoma imaging: http://emedicine.medscape.com/article/345779-overview
Warrick, J. I. (2011, Sep 29). medscape.com. Retrieved Jan 23, 2012, from Pathology of small, Peripheral Intraductal Papillomas: http://emedicine.medscape.com/article/1873858-overview
Yohe, S., & Yeh, I. (2008). Missed diagnoses of phyllodes tumor on breast biopsy: pathologic clues to its recognition. Int J Surg Pathol. , Apr; 16 (2):137-42.
