Breast fibroadenoma and its clinical perspectives: a prospective observational study

Background: To study the patterns of breast fibroadenoma in females and to co-relate them with the pathological findings.Methods: Sixty six females who attended the Surgery Department in Darbhanga Medical College, Bihar, a tertiary centre in rural area, with benign breast lump during the period Bihar during period of November 2009 to November 2011, were studied. Early diagnoses by doing a triple assessment like a clinical examination, FNAC or a core needle biopsy and imaging methods like ultrasonography or mammography. The clinical diagnoses were compared with the cytological or histological findings wherever possible and their accuracies were evaluated.Results: Out of the 66 confirmed fibroadenoma female patients who were studied, most patients presented as a painless lump which is need to be differentiated from carcinoma. Most of the patient (63%) presented within 6 months of development of breast lesion showing increasing awareness in females of rural India. The maximum number of patient presented (55%) is of 2nd to 3rd decade. It was found that maximum number of patients have upto three children due to early marriage in rural background.Conclusions: Fibroadenoma is a common cause for breast lump even in rural background. Triple assessment provided a quick diagnosis and it alleviated unnecessary anxiety from the patients about breast cancer. The clinical diagnosis of a breast lump, as confirmed by cytology and histology, was accurate in most of the cases.

Prevalence and characteristics of mouse mammary tumor virus-like virus associated breast cancer in China

Background Despite extensive molecular epidemiological studies, the prevalence and characteristics of Mouse Mammary Tumor Virus-Like Virus (MMTV-LV) in Chinese women breast cancer are still unclear. Besides, the prevalence of MMTV-LV in women breast cancer tissue varies in different countries and its dependent factors remain inconclusive. Methods In the first part of the study, a case-control study was performed. 119 breast cancer samples (84 from Northern China and 35 from Southern China) and 50 breast fibroadenoma specimens were collected from Chinese women patients. MMTV-like env sequence and the homology to MMTV env gene were analysed by semi-nested polymerase chain reaction (PCR). We also explored the association of MMTV-LV prevalence with sample sources (Southern and Northern China) and patients’ clinicopathological characteristics. To investigate the dependent factors of the prevalence of MMTV-LV in breast cancer worldwide, a meta-analysis was conducted in the second part of the study. Results We found that the prevalence of MMTV-LV was much higher in breast cancer tissues (17.65%) than that in breast fibroadenoma specimens (4.00%) (P < 0.05). MMTV-LV prevalence in Chinese women breast cancer tissues was significantly different between Southern China (5.71%) and Northern China (22.62%) (P < 0.05). The prevalence of MMTV-LV also associates significantly with expression of HER2, but shows no significant correlation with other parameters. In the meta-analysis, we found that MMTV-LV prevalence in breast cancer tissue was dependent on the distribution of M. domesticus mouse (M. d), M. musculus mouse (M.m) and M.castaneus mouse (M.c) worldwide (P < 0.05). Conclusion The distribution of house mice may be a crucial environmental factor that explains the geographic differences in human breast cancer incidence. Our findings may provide a potential avenue of prevention, diagnosis and treatment for breast cancer.

Giant breast fibroadenoma in pregnancy

Overview Objective: To present unusual case of rapidly growing breast fibroadenoma during pregnancy. Case report: Breast fibroadenomas are hormone-dependent tumors which can grow rapidly during pregnancy. We present a case of giant fibroadenoma, first detected before pregnancy, which grew rapidly under the influence of pregnancy hormones and was excised in the third trimester. Conclusion: Fibroadenomas are benign breast lesions in young women. They are hormone-dependent tumors, which can grow rapidly especially during pregnancy and/ or lactation and imitate malignancy. In each case of a newly created breast lesion, it is necessary to proceed responsibly to the clinical examination, which is a base for further decision concerning the necessity of taking a bio­psy for histological verification. Keywords: breast fibroadenoma – pregnancy – lactation – phyllodes tumor

Patient Satisfaction in the Complete Removal of Giant Breast Fibroadenoma under Vacuum-Associated Breast Biopsy Procedure

INTRODUCTION: Fibroadenomas are one of the most common benign tumors of the breast in the adolescent population. They account for 68% of all breast masses and 44–94% of all biopsied breast lesions. Fibroadenomas can range from asymptomatic masses to painful and rapidly growing tumors that can cause significant esthetic distortions of the breast. With breast examinations becoming common in women as young as their 20s, excision of benign breast tumors using vacuum-assisted breast biopsy (VABB) became more common. The VABB procedure with ultrasound guiding is still used for removal benign breast tumors. CASE REPORT: A 24-year ago woman presents with complaints of a lump in the right breast for 3 years, the lump is slow growing. The mass diameter is about 6 cm and no ulcers. Ultrasound examination found a solid mass, firm boundaries, regular contours, mobile in the outer quadrant of the right breast, no specific microcalcification size 6.13 cm × 3.11 cm × 5.33 cm (BIRADS 4a). Core biopsy examination showed fibroadenoma mammae intracanalicular and pericanalicular. We used an 8G needle and got 458 slices about 100 g. After the procedure, a total removal is obtained by ultrasound examination from a previously existing mass of 6 cm. CONCLUSIONS: The VABB procedure is very effective and efficient in removing breast fibroadenoma (benign lesion) and the results are satisfactory. The advantage of this procedure apart from the cosmetic aspect which does not leave any marks is also a high level of safety. From our case, we can take complete removal with a diameter of 6 cm, whereas in the previous literature, it can only remove a mass of 3–4 cm in size.

Homoeopathic Management of Breast Fibroadenoma—An Open Label, Single Arm, Observational Trial

Achtergrond Fibroadenoom van de borst is de meest voorkomende kwaal bij vrouwen met een aanzienlijk risico op overlijden. Uit de beschikbare literatuur blijkt dat borsttumoren verdwijnen door homeopathische behandeling. De huidige studie evalueerde de rol van homeopathische behandeling op borstfibroadenoma met behulp van ‘Triple assessment criteria’ (dubbel blind) en onderzoekt of homeopathische geneesmiddelen therapeutisch effect teweeg brengen door het veranderen van de oestrogeen en progesteron receptor (ER/PR) status op tumorweefsel. Materialen en Methoden Een open-label, prospectieve, single-arm, observationele studie werd uitgevoerd bij 64 vrouwelijke patiënten met fibroadenoom van de borst. Er werden drievoudige beoordelingscriteria gebruikt om de doeltreffendheid van de homeopathische behandeling van borstfibroadenomen te onderzoeken. Geïndividualiseerde homeopathische geneesmiddelen werden voorgeschreven. De meetresultaten vertoonden veranderingen in het klinisch beeld en het aantal en de omvang van de knobbels door middel van ultrasoonmammografie. ER/PR studie werd uitgevoerd door immunohistochemie met gebruik van quick score analyse. Resultaten Bij 23 gevallen (35,93%) van fibroadenomen was er na de behandeling geen knobbel meer meetbaar. Gedeeltelijke verbetering werd waargenomen in 22 gevallen (34,37%) met significante vermindering van de gemiddelde grootte (p < 0,001). Ook werd een significante vermindering van het aantal laesies gezien bij fibroadenomen (p < 0,05). Conium maculatum en Phytolacca decandra bleken de meest bruikbare remedies te zijn. De quick score waarde van ER na behandeling toonde significante vermindering (Z ¼ 4.910). Conclusie De studie toont aan dat de therapeutische effecten van toediening van geïndividualiseerde homeopathische geneesmiddelen een belangrijke rol spelen bij de behandeling van fibroadenomen van de borst. De resultaten van ER/PR laten een significante vermindering van ER zien, wat suggereert dat homeopathische geneesmiddelen een remmend effect hebben op ER.