Sclerosing Adenosis: Should We Still Regard It as a Simple Benign Disease? Report of Two Patients with Subsequent Development of Invasive or In-situ Breast Cancer

Abstract

Sclerosing adenosis belongs to the group of benign proliferative breast diseases. The imaging and histological findings of sclerosing adenosis can mimic invasive ductal carcinoma. The diagnosis of sclerosing adenosis is challenging, and requires the combination of clinical, radiological, and pathological findings. Sclerosing adenosis is associated with a small risk of subsequent breast carcinoma. This report is of two patients with incidentally detected and biopsy-proven sclerosing adenosis. The clinical history, serial mammogram, breast ultrasonography, and preoperative breast magnetic resonance imaging findings are reviewed and the histological slides of the biopsy and surgical specimens are presented. In both patients, serial follow-up ultrasonography 7 years after the initial diagnosis showed mild increase in vascularity in the lesions. Repeat biopsies were performed, which showed invasive ductal carcinoma and ductal carcinoma in situ in patient 1 and patient 2, respectively. The authors recommend long-term follow-up for a sclerosing adenosis because of the risk of breast carcinoma with a long latency period. If any suspicious feature or change in morphology is detected in follow-up imaging, a biopsy should be performed to exclude carcinoma.

Beyond BI-RADS: Nonmass Abnormalities on Breast Ultrasound

“…Moreover, sclerosing adenosis is known to be a risk factor for breast cancer. Thus, careful follow-up may be required [ 46 ].…”