Podcast
Questions and Answers
What is the estimated percentage of women in the United States having breast fibroadenomas?
What is the estimated percentage of women in the United States having breast fibroadenomas?
- 5%
- 15%
- 10% (correct)
- 20%
Which gene mutation is found in up to 65% of fibroadenoma cases?
Which gene mutation is found in up to 65% of fibroadenoma cases?
- TP53
- MED12 (correct)
- BRCA2
- BRCA1
What is the main clinical presentation of fibroadenomas?
What is the main clinical presentation of fibroadenomas?
- Multiple, tender nodules
- Painful, large mass
- Soft, fluctuant swelling
- Solitary, painless small nodule (correct)
Which type of stroma gives rise to fibroadenomas?
Which type of stroma gives rise to fibroadenomas?
What are the two main histological features of fibroadenomas?
What are the two main histological features of fibroadenomas?
When may fibroadenomas grow rapidly?
When may fibroadenomas grow rapidly?
What is the estimated increased risk of breast cancer in fibroadenoma cases compared to the general population?
What is the estimated increased risk of breast cancer in fibroadenoma cases compared to the general population?
Which type of neoplasm are fibroadenomas classified as?
Which type of neoplasm are fibroadenomas classified as?
What is the source of fibroadenomas in the breast?
What is the source of fibroadenomas in the breast?
What is the primary event in the formation of fibroadenomas?
What is the primary event in the formation of fibroadenomas?
What is the main composition of fibroadenomas?
What is the main composition of fibroadenomas?
Which of the following is a specific pathologic feature of complex fibroadenoma?
Which of the following is a specific pathologic feature of complex fibroadenoma?
What is the association between size and complexity of fibroadenomas?
What is the association between size and complexity of fibroadenomas?
What is considered very rare in relation to malignant transformations in fibroadenomas?
What is considered very rare in relation to malignant transformations in fibroadenomas?
How do fibroadenomas typically appear on mammograms?
How do fibroadenomas typically appear on mammograms?
What is the growth pattern of most fibroadenomas over 12 months?
What is the growth pattern of most fibroadenomas over 12 months?
How are fibroadenomas usually diagnosed in the male breast?
How are fibroadenomas usually diagnosed in the male breast?
What is the composition of phyllodes tumor?
What is the composition of phyllodes tumor?
What percentage of all fibroepithelial tumors of the breast do phyllodes tumors account for?
What percentage of all fibroepithelial tumors of the breast do phyllodes tumors account for?
What percentage of phyllodes tumors are benign and behave similarly to benign fibroadenomas?
What percentage of phyllodes tumors are benign and behave similarly to benign fibroadenomas?
What gene mutation has been identified in about 70% of phyllodes tumors?
What gene mutation has been identified in about 70% of phyllodes tumors?
Which type of fibroadenoma harbors specific pathologic features like sclerosing adenosis, papillary apocrine hyperplasia, cystic change, or epithelial calcification?
Which type of fibroadenoma harbors specific pathologic features like sclerosing adenosis, papillary apocrine hyperplasia, cystic change, or epithelial calcification?
What does size determine in relation to the classification of fibroadenomas?
What does size determine in relation to the classification of fibroadenomas?
What is the association between simple fibroadenomas and the risk of breast cancer?
What is the association between simple fibroadenomas and the risk of breast cancer?
What is the increased risk of breast cancer associated with complex fibroadenomas compared to the general population?
What is the increased risk of breast cancer associated with complex fibroadenomas compared to the general population?
How rare are malignant transformations in the epithelial components of fibroadenomas considered to be?
How rare are malignant transformations in the epithelial components of fibroadenomas considered to be?
What is the typical ultrasound appearance of fibroadenomas?
What is the typical ultrasound appearance of fibroadenomas?
What percentage of fibroadenomas show regression or complete resolution after reaching a size of 2 to 3 cm and remaining unchanged for several years?
What percentage of fibroadenomas show regression or complete resolution after reaching a size of 2 to 3 cm and remaining unchanged for several years?
Are fibroadenomas common or uncommon in the male breast?
Are fibroadenomas common or uncommon in the male breast?
How rare are phyllodes tumors compared to fibroadenomas in the context of all breast malignancies?
How rare are phyllodes tumors compared to fibroadenomas in the context of all breast malignancies?
What is the estimated median age at presentation for phyllodes tumors?
What is the estimated median age at presentation for phyllodes tumors?
What is the gross appearance of phyllodes tumors?
What is the gross appearance of phyllodes tumors?
What is the characteristic microscopic architecture of phyllodes tumors?
What is the characteristic microscopic architecture of phyllodes tumors?
What is a specific histological feature of malignant phyllodes tumors?
What is a specific histological feature of malignant phyllodes tumors?
What is the typical mammography appearance of a phyllodes tumor?
What is the typical mammography appearance of a phyllodes tumor?
What is the mutational spectrum of MED12 gene mutations in phyllodes tumors similar to?
What is the mutational spectrum of MED12 gene mutations in phyllodes tumors similar to?
What is the behavior of benign phyllodes tumors similar to?
What is the behavior of benign phyllodes tumors similar to?
What is the typical ultrasound appearance of phyllodes tumors?
What is the typical ultrasound appearance of phyllodes tumors?
What is the distinguishing feature of borderline phyllodes tumors?
What is the distinguishing feature of borderline phyllodes tumors?
What is the typical radiological appearance of Pseudoangiomatous stromal hyperplasia (PASH)?
What is the typical radiological appearance of Pseudoangiomatous stromal hyperplasia (PASH)?
Which of the following is a characteristic histological feature of Pseudoangiomatous stromal hyperplasia (PASH)?
Which of the following is a characteristic histological feature of Pseudoangiomatous stromal hyperplasia (PASH)?
Which markers are expressed by the spindle cells in Pseudoangiomatous stromal hyperplasia (PASH)?
Which markers are expressed by the spindle cells in Pseudoangiomatous stromal hyperplasia (PASH)?
Which type of breast tumor presents predominantly as a painless, palpable, firm or hard mass, which may be accompanied by skin dimpling and nipple retraction?
Which type of breast tumor presents predominantly as a painless, palpable, firm or hard mass, which may be accompanied by skin dimpling and nipple retraction?
What is the characteristic gross appearance of myofibroblastoma of the breast?
What is the characteristic gross appearance of myofibroblastoma of the breast?
What is the typical ultrasound appearance of fibromatosis?
What is the typical ultrasound appearance of fibromatosis?
Which breast tumor is thought to arise from cells of the mammary stroma with myofibroblastic and myoid differentiation?
Which breast tumor is thought to arise from cells of the mammary stroma with myofibroblastic and myoid differentiation?
What is the imaging study that may reveal a stellate lesion that mimics carcinoma in fibromatosis?
What is the imaging study that may reveal a stellate lesion that mimics carcinoma in fibromatosis?
What is a specific histological feature of fibromatosis?
What is a specific histological feature of fibromatosis?
Which breast tumor is encountered mainly in older men and postmenopausal women aged between 40 and 87 years?
Which breast tumor is encountered mainly in older men and postmenopausal women aged between 40 and 87 years?
What is the behavior of fibromatosis on mammography?
What is the behavior of fibromatosis on mammography?
What is the typical presentation of non-epithelial primary breast malignancies?
What is the typical presentation of non-epithelial primary breast malignancies?
Which of the following is a characteristic microscopic architecture of phyllodes tumors?
Which of the following is a characteristic microscopic architecture of phyllodes tumors?
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Study Notes
Complex Fibroadenoma and Phyllodes Tumor: Key Points
- Complex fibroadenoma harbors specific pathologic features like sclerosing adenosis, papillary apocrine hyperplasia, cystic change, or epithelial calcification.
- Size does not determine if a fibroadenoma is complex or not.
- Simple fibroadenomas do not correlate with an increased risk of breast cancer.
- Complex fibroadenomas are associated with a modest 1.3 to 2.1 increased risk of breast cancer compared to the general population.
- Malignant transformations in the epithelial components of fibroadenomas are considered very rare.
- Fibroadenomas typically appear as smooth-margined oval or round masses on mammograms and as solid, well-circumscribed, and hypoechoic on ultrasound.
- Most fibroadenomas grow over 12 months to reach a size of 2 to 3 cm and then remain unchanged for several years. After this period, regression or complete resolution is noted in 50% of cases.
- Fibroadenomas are very uncommon in the male breast and are usually diagnosed clinically as gynecomastia.
- Phyllodes tumor is an uncommon biphasic tumor composed of benign epithelial elements and a cellular spindle-cell stroma.
- Phyllodes tumors are rarer than fibroadenomas, accounting for 2.5% of all fibroepithelial tumors of the breast and less than 0.5% of all breast malignancies.
- Phyllodes tumors are capable of a diverse range of biologic behavior; about 70% are benign and behave similarly to benign fibroadenomas, while 5% are malignant and undergo mainly hematogenous spread.
- Somatic mutations of the MED12 gene have been identified in about 70% of phyllodes tumors, similar to fibroadenomas, supporting an underlying commonality in pathogenesis.
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