American Journal of Roentgenology, Vol 171, 1331-1334, Copyright © 1998 by American Roentgen Ray Society
Fibroadenomatoid hyperplasia: a cause of suspicious microcalcification on mammographic screening
M Kamal, AJ Evans, H Denley, SE Pinder and IO Ellis
Department of Radiology, Nottingham City Hospital, United Kingdom.
OBJECTIVE: Fibroadenomatoid hyperplasia is a well-described but rare benign
breast lesion with composite features of fibroadenoma and fibrocystic
change. Because fibroadenomatoid hyperplasia has not to our knowledge been
reported as a cause of suspicious microcalcifications and because several
pathology reports of biopsies of mammographically detected
microcalcification at our institution included fibroadenomatoid
hyperplasia, we undertook this study to describe the features of
mammographically detected microcalcification seen in patients with
fibroadenomatoid hyperplasia. MATERIALS AND METHODS: Two breast
pathologists reviewed the records of 54 mammographically detected lesions
that were compatible with a diagnosis of fibroadenomatoid hyperplasia and
that provoked subsequent core biopsy or surgical excision of
microcalcifications. Eleven cases (20%) fulfilled the diagnostic criteria
for fibroadenomatoid hyperplasia. The sites of all calcifications found at
histology were documented, and the mammographic features were described.
RESULTS: Eleven cases of fibroadenomatoid hyperplasia were identified in
nine core biopsy samples and two surgical specimens. Calcification was
present in all 11 pathologic specimens. Calcification was stromal in nine,
subepithelial in two, and epithelial in none. The mammographic features of
fibroadenomatoid hyperplasia in all 11 cases were granular
microcalcifications that varied in shape, size, and density and had no
associated mass; of these calcifications, 91% were in a localized,
irregularly shaped cluster. Rod-shaped calcifications were also seen in 64%
of cases. CONCLUSION: Fibroadenomatoid hyperplasia is a cause of
suspicious, granular, clustered microcalcifications on screening
mammography. Fibroadenomatoid hyperplasia can be confirmed using 14- gauge
core biopsy in most cases.
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