Fibroadenoma of the female breast. Some epidemiologic surprises

Abstract

In a study of 70 cases of fibroadenoma of the female breast, two ages of peak incidence were recorded, one of them in the late 20s to early 30s and a second in the late 40s to early 50s. At the time of diagnosis, the lesions usually were less than 3.0 cm in diameter. Almost two thirds of the tumors were situated in the lateral quadrants of the breast. Incidence of fibroadenoma was significantly higher among parous females tham among nulliparas. Review of family histories showed a remarkably high incidence of breast disease of all types in the mothers and sisters of the patients studied. An inordinately high proportion of patients under 40 years of age were nonwhite. Recurrences and multiple lesions were much more frequent in patients over 40. "Recurrences" are undoubtedly serial presentations of multicentric lesions.

PIP: A retrospective study of 70 cases of mammary fibroadenomata in women 18-73 years of age is presented. They were observed for 1-3 years after excision of the tumors. Of these, 42 were less than 40-years-old. In 1 0% of cases, multiple fibroadenomas were present in 1 or both breasts. In 63%, the tumors were situated in the lateral quadrants of the breast. 74% of the younger patients and 93% of the older ones had had 1 or more children. Only 18 of the total were nulliparous. Nipple discharge had been noted in 11% of the younger patients. A history of previous breast trauma was obtained from only a few. Breast disease among mothers and sisters of patients had occurred in 57%. Of these, 24% had been cancer. History of an unremoved lump had been frequent among these relatives. Fibroadenoma had been diagnosed in 27% of relatives. Among the 70 patients recurrence rate of fibroadenomata was 34%. Recurrences occurred at intervals of several months to 15 years, with an average of 3.3 years in younger patients and 4 years in the older ones. The number of nonwhite patients was more than in the general population, especially in the group under age 40. Oral contraceptives had been taken by 42 patients (60%). In only 5 instances (7%) had the oral contraceptive main component been progesterone. Malignant or benign pelvic disease was also present in 3% of patients. Recurrences of adenomata are thought to be serial presentations of multicentric lesions.