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Incidence and Management of Complex Fibroadenomas

Miri Sklair-Levy1, Tamar Sella1, Tanir Alweiss2, Ilia Craciun1, Eugene Libson1 and Bella Mally3

1 Department of Radiology, Hadassah-Hebrew University Medical Center, Kiryat Hadassah, POB 12000, Jerusalem 91120, Israel.
2 Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
3 Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.


Figure 1
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  		Fig. 1A —64-year-old woman with complex fibroadenoma. Craniocaudal mammogram of left breast shows dense fibroglandular tissue with scattered calcifications. At upper outer quadrant, note cluster of macro- and microcalcifications (arrow).

 

Figure 2
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  		Fig. 1B —64-year-old woman with complex fibroadenoma. Spot compression mammogram with enlarged view of area of microcalcifications. Note microcalcifications (arrows) are clearly visible. Core stereotactic biopsy was performed at this site.

 

Figure 3
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  		Fig. 1C —64-year-old woman with complex fibroadenoma. Histopathology of core needle biopsy reveals complex fibroadenoma with epithelial calcifications (dotted arrow) and adjacent atypical lobular hyperplasia (solid arrows). At subsequent excisional biopsy, atypical lobular hyperplasia was upgraded to invasive lobular carcinoma.

 

Figure 4
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  		Fig. 2 —Sonography of left breast in 42-year-old woman reveals round, circumscribed hypoechoic lesion (arrow). This lesion was first seen 2 years earlier, with histopathology showing complex fibroadenoma at core needle biopsy. Because of increase in size during this follow-up interval, excisional biopsy was performed, revealing benign phyllodes tumor.

 

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