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Case Reports
. 2017 May 31;2017(5):rjx064.
doi: 10.1093/jscr/rjx064. eCollection 2017 May.

Fibroadenoma progress to ductal carcinoma in situ, infiltrating ductal carcinoma and lymph node metastasis? Report an unusual case

Yu-Ting Wu  1 , Hua-Koon Wu  2 , Shou-Tung Chen  3   4 , Chih-Jung Chen  5   6   7 , Dar-Ren Chen  3   4   8 , Hung-Wen Lai  3   4   8   9
Affiliations
Case Reports

Fibroadenoma progress to ductal carcinoma in situ, infiltrating ductal carcinoma and lymph node metastasis? Report an unusual case

Yu-Ting Wu et al. J Surg Case Rep. .

Abstract

Fibroadenoma of the breast is the most common benign neoplasm in young women who present with a palpable, movable mass. Malignancy inside fibroadenomas is rare, with reported rates ranging from 0.002% to 0.125%. Carcinoma in situ inside a fibroadenoma is usually found incidentally when tumours are excised. Whether fibroadenoma is a risk factor for breast cancer remains controversial. Due to the rarity of carcinomas inside fibroadenomas, medical institutes have little experience with this phenomenon. We report an unusual case in which progression occurred from benign fibroadenoma to ductal carcinoma in situ, infiltrating ductal carcinoma and lymph node metastasis. A nipple-areolar complex-preserving mastectomy with immediate breast reconstruction with a gel implant and contralateral augmentation was performed. No local recurrence or metastasis was found during 5 years of follow-up.

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Figures

Figure 1:
Figure 1:
(a) Sonogram of the left breast reveals a 3.5-cm hypoechoic lesion with increased vascularity in the 2 o'clock/1-cm region. (b) Mammogram (mediolateral-oblique view) of the left breast shows a well-defined sharply circumscribed mass. (c) A maximal intensity projection magnetic resonance imaging image of the left breast revealed a 4.0-cm well-defined tumour with an engorged drainage vein beneath the nipple areolar complex region.
Figure 2:
Figure 2:
(a) Preoperative CNB (low-power field). The upper left tissue shows a complex glandular growth pattern in the fibro-myxomatous stroma. The lower right tissue shows DCIS in solid and cribriform patterns. (b) Postoperative final pathology (high power field). Grade II infiltrating ductal carcinoma characterized by nesting to glandular structure with intermediate-sized nuclei and rare mitotic figures.
Figure 3:
Figure 3:
Postoperative view 3 months after nipple-sparing mastectomy with immediate breast reconstruction with a gel implant combined with contralateral augmentation.
See this image and copyright information in PMC

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