Carcinoma developing in a fibroadenoma in a woman with a family history of breast cancer: a case report and review of literature

Abstract

IntroductionMalignant transformation of a fibroadenoma is rare with only about 100 cases reported in the world literature. Fibroadenoma occurring in middle aged woman with a strong family history of breast or ovarian cancer should be investigated with a high suspicion for malignancy.Case presentationA 35-year- old Indian lady operated previously for fibroadenoma of the right breast presented with a recurrent lump at the same site. She had a strong family history of breast carcinoma. Mammography and trucut biopsy was suggestive of infiltrating duct carcinoma. She was managed by lumpectomy and axillary lymph node dissection with a satisfactory outcome. There was no evidence of BRCA-1, BRCA-2 mutation on immunohistochemistry.ConclusionMalignant change in a pre-existing fibroadenoma is rare, however in a middle aged woman with a family history of breast cancer it should be suspected. In the absence of any definite clinical and radiological criteria of diagnosing malignant change in a fibroadenoma, high suspicion index is mandatory. The management and outcome depends on the stage and grade of presentation.

Ductal carcinoma in a multiple fibroadenoma: Diagnostic inaccuracies

“…[8] There are several theories suggested for a carcinoma arising in a fibroadenoma. Fibroadenoma can get involved by an adjacent carcinoma.…”

Invasive Breast Carcinoma Occuring Within Fibroadenoma: Case Report

“…2,10 Although malignant transformation of a fibroadenoma is very rare, fibroadenoma in a woman with a positive family history may have greater clinical importance than fibroadenoma occuring in a woman with no additional risk factors. 1,3,6,10 Fibroadenomas observed cysts, sclerosing adenosis, epithelial calcifications or papillary apocrine changes. These are classified as complex and a longterm risk factor for breast cancer.…”

“…Breast conservative surgery like as lumpectomy or wide local excision with or without axillary lymph node dissection can be selected if the tumor is small or modified radical mastectomy with axillar dissection can be selected for greater tumors or patient's willingness. 6,13 Follow up of both the breasts is recommended because of the high incidence of contralateral breast cancer. 14 In conclusion; although carcinomas occuring within fibroadenoma are rare conditions, histopatho-logical examination should be performed routinely to rule out malignancy because of no definitive clinical or radiological criteria for diagnosing carcinoma occuring within fibroadenoma in women older than 35 years for changing diameter or echogenity of fibroadeomas.…”

“…8 Histopathological examination should be performed routinely to rule out malignancy because of no definitive clinical or radiological criteria for diagnosing carcinoma occuring within fibroadenoma. 6 We presented a case of invasive carcinoma of the breast that occuring within fibroadenoma.…”

“…1,3 Malignant transformation of fibroadenoma to carcinoma is very rare (equal or less than 0.5%), and the mean age is fifth decade. 2,[4][5][6][7] The most common malignant histologic type coexistence with fibroadenoma is lobular carcinoma in situ (66.9%), followed by ductal carcinoma in situ (12.4%), invasive ductal carcinoma (11%), and invasive lobular carcinoma (3.4%). 4 Positive family history, complex fibroadenomas, proliferative disease adjacent fibroadenomas and BRCA mutation are associated with Turkiye Klinikleri J Case Rep 2015;23 (2) fibroadenomas mild increase risk of subsequent breast cancer.…”