Fibroadenoma other diagnostic studies
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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.