DOI: http://dx.doi.org/10.18203/2349-2902.isj20215169

Premenarche bilateral giant juvenile fibroadenoma of breast: literature review with a case report

Mezhuneituo Raleng, Sameer Anand, Shailesh Kannur

Abstract


Fibroadenoma is a common abnormality which every surgeon has been exposed to, and there are several international guidelines regarding its management. However giant fibroadenomas, especially in the premenarche setting has been a rare occurrence, even for the experienced surgeon. Various reports have shown that we need to treat this condition more aggressively than the normal fibroadenoma, and issues of cosmesis in a developing breast along with the aim to preserve lactation functionality becomes an issue. Since these cases remain a single life time experience for most surgeons, there is a sparsity of treatment protocols even in literature. Through this paper we hope to shed some valuable insight to this rare disorder and help surgeon colleagues, when dealing with similar cases.


Keywords


Fibroadenoma, Giant, Premenarche, Bilateral, Breast

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References


Greydanus DE, Matytsina-Quinlan L. Breast concerns and disorders in adolescent females. Pediatric Medicine. 2019;2(0).

Neinstein LS. Breast disease in adolescents and young women. Pediatr Clin North Am. 1999;46(3):607-29.

Goehring C, Morabia A. Epidemiology of benign breast disease, with special attention to histologic types. Epidemiol Rev. 1997;19(2):310-27.

Santen RJ, Mansel R. Benign breast disorders. N Engl J Med. 2005;353(3):275-85.

Dent DM, Cant PJ. Fibroadenoma. World J Surg. 1989;13(6):706-10.

Laitano FF, Neto FL, Zerwes FP. Bilateral giant juvenile fibroadenomas of the breasts-a rare indication for bilateral skin reducing mastectomy. Gland Surg. 2016;5(4):435-8.

Rafeek N, Rangasami R, Dhanraj K, Joseph S. Multimodality approach in the diagnosis and management of bilateral giant juvenile breast fibroadenoma. BMJ Case Rep. 2016;2016.

Kaur N, Saini S, Somasekhar S, Gupta A. Bilateral Florid Juvenile Fibroadenomas of the Breast in an Adolescent: A Rare Indication for Subcutaneous Mastectomy. J Pediatr Adolesc Gynecol. 2015;28(5):e135-7.

Morris A, Shaffer K. Recurrent Bilateral Giant Fibroadenomas of the Breasts. Radiology Case Reports. 2007;2(3):96.

Lee CJ, Kim YJ, Seo YT, Pak SJ, Lee SI. Treatment of multiple bilateral juvenile fibroadenomas in a teenage breast by central pedicle breast reduction, with vertical and short horizontal scar: case report. Aesthetic Plast Surg. 2004;28(4):228-30.

Baxi M, Agarwal A, Mishra A, Agarwal G, Mishra SK. Multiple bilateral giant juvenile fibroadenomas of breast. Eur J Surg. 2000;166(10):828-30.

Silfen R, Skoll PJ, Hudson DA. Florid juvenile (cellular) fibroadenomatosis in the adolescent: a case for subcutaneous mastectomy? Aesthetic Plast Surg. 1999;23(6):413-5.

Makkar N, Singh S, Paul S, Sandhu MS, Kumar A. Bilateral Giant Juvenile Fibroadenoma of Breast. J Clin Diagn Res. 2017;11(6):ED10-2.

Khan S, Khan M, Rafique S. Giant Bilateral Juvenile Fibroadenoma of the Breast in Prepubescent Girl. J Coll Physicians Surg Pak. 2015;25:S95-96.

Nikumbh DB, Desai SR, Madan PS, Patil NJ, Wader JV. Bilateral giant juvenile fibroadenomas of breasts:a case report. Patholog Res Int. 2011;2011:482046.

Mukhopadhyay M, Patra R, Mondal S, Ghosh A, Ray AK. Bilateral giant juvenile fibroadenoma of breasts. J Indian Assoc Pediatr Surg. 2009;14(2):68-9.

1Moore RL, Mungara A, Shayan K, Wallace AM. Bilaterally symmetric juvenile fibroadenomas and tubular breast deformity in a prepubescent girl. Journal of Pediatric Surgery. 2007;42(6):1133-6.

Arca MJ, Caniano DA. Breast disorders in the adolescent patient. Adolesc Med Clin. 2004;15(3):473-85.

Jayasinghe Y, Simmons PS. Fibroadenomas in adolescence. Current Opinion in Obstetrics and Gynecology. 2009;21(5):402.

Oluwole SF, Freeman HP. Analysis of benign breast lesions in blacks. Am J Surg. 1979;137(6):786-9.

Funderburk WW, Rosero E, Leffall LD. Breast lesions in blacks. Surg Gynecol Obstet. 1972;135(1):58-60.

Arowolo OA, Akinkuolie AA, Adisa AO, Obonna GC, Olasode BJ. Giant fibroadenoma presenting like fungating breast cancer in a Nigerian teenager. African Health Sciences. 2013;13(1):162-165-5.

Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44(235):291-303.

Cabrera SM, Bright GM, Frane JW, Blethen SL, Lee PA. Age of thelarche and menarche in contemporary US females: a cross-sectional analysis. J Pediatr Endocrinol Metab. 2014;27(0):47-51.

Sapino A, Bosco M, Cassoni P, Castellano I, Arisio R, Cserni G, et al. Estrogen receptor- β is expressed in stromal cells of fibroadenoma and phyllodes tumors of the breast. Mod Pathol. 2006;19(4):599-606.

Branchini G, Schneider L, Cericatto R, Capp E, Brum IS. Progesterone receptors A and B and estrogen receptor alpha expression in normal breast tissue and fibroadenomas. Endocrine. 2009;35(3):459-66.

Welsch CW, Dombroske SE, McManus MJ, Calaf G. Effect of human, bovine and ovine prolactin on DNA synthesis by organ cultures of benign human breast tumours. Br J Cancer. 1979;40(6):866-71.

Nicol M, Willis C, Yiangou C, Sinnett D, Shousha S. Relationship Between Serum Prolactin Levels and Histology of Benign and Malignant Breast Lesions: A Detailed Study of 153 Consecutive Cases. The Breast Journal. 2002;8(5):281-5.

Gill S, Peston D, Vonderhaar BK, Shousha S. Expression of prolactin receptors in normal, benign, and malignant breast tissue: an immunohistological study. J Clin Pathol. 2001;54(12):956-60.

Touraine P, Martini JF, Zafrani B, Durand JC, Labaille F, Malet C, et al. Increased expression of prolactin receptor gene assessed by quantitative polymerase chain reaction in human breast tumors versus normal breast tissues. J Clin Endocrinol Metab. 1998;83(2):667-74.

Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer WD, Rados MS, et al. Long-term risk of breast cancer in women with fibroadenoma. N Engl J Med. 1994;331(1):10-5.

Ozzello L, Gump FE. The management of patients with carcinomas in fibroadenomatous tumors of the breast. Surg Gynecol Obstet. 1985;160(2):99-104.

Carter BA, Page DL, Schuyler P, Parl FF, Simpson JF, Jensen RA, et al. No elevation in long-term breast carcinoma risk for women with fibroadenomas that contain atypical hyperplasia. Cancer. 2001;92(1):30-6.

Shaik AN, Ruterbusch JJ, Abdulfatah E, Shrestha R, Daaboul MHDF, Pardeshi V, et al. Breast fibroadenomas are not associated with increased breast cancer risk in an African American contemporary cohort of women with benign breast disease. Breast Cancer Res. 2018;20(1):91.

Diaz NM, Palmer JO, McDivitt RW. Carcinoma arising within fibroadenomas of the breast. A clinicopathologic study of 105 patients. Am J Clin Pathol. 1991;95(5):614-22.

Barrio AV, Clark BD, Goldberg JI, Hoque LW, Bernik SF, Flynn LW, et al. Clinicopathologic features and long-term outcomes of 293 phyllodes tumors of the breast. Ann Surg Oncol. 2007;14(10):2961-70.

Leraas HJ, Rosenberger LH, Ren Y, Ezekian B, Nag UP, Reed CR, et al. Pediatric phyllodes tumors: A review of the National Cancer Data Base and adherence to NCCN guidelines for phyllodes tumor treatment. J Pediatr Surg. 2018;53(6):1123-8.

Guillot E, Couturaud B, Reyal F, Curnier A, Ravinet J, Laé M, et al. Management of phyllodes breast tumors. Breast J. 2011;17(2):129-37.

Adesoye T, Neuman HB, Wilke LG, Schumacher JR, Steiman J, Greenberg CC. Current Trends in the Management of Phyllodes Tumors of the Breast. Ann Surg Oncol. 2016;23(10):3199-205.

Omar L, Gleason MK, Pfeifer CM, Sharma P, Kwon JK. Management of Palpable Pediatric Breast Masses With Ultrasound Characteristics of Fibroadenoma: A More Conservative Approach. American Journal of Roentgenology. 2018;212(2):450-5.

Duman L, Gezer NS, Balcı P, Altay C, Başara I, Durak MG, et al. Differentiation between Phyllodes Tumors and Fibroadenomas Based on Mammographic Sonographic and MRI Features. Breast Care (Basel). 2016;11(2):123-7.

Yilmaz E, Sal S, Lebe B. Differentiation of phyllodes tumors versus fibroadenomas. Acta Radiologica. 2002;43(1):34-9.

Wang M, He X, Chang Y, Sun G, Thabane L. A sensitivity and specificity comparison of fine needle aspiration cytology and core needle biopsy in evaluation of suspicious breast lesions: A systematic review and meta-analysis. Breast. 2017;31:157-66.

Willems SM, Deurzen CHM van, Diest PJ van. Diagnosis of breast lesions: fine-needle aspiration cytology or core needle biopsy? A review. Journal of Clinical Pathology. 2012;65(4):287-92.

Lawton TJ, Acs G, Argani P, Farshid G, Gilcrease M, Goldstein N, et al. Interobserver variability by pathologists in the distinction between cellular fibroadenomas and phyllodes tumors. Int J Surg Pathol. 2014;22(8):695-8.

Smith GEC, Burrows P. Ultrasound diagnosis of fibroadenoma - is biopsy always necessary? Clin Radiol. 2008;63(5):511-5.

Bode MK, Rissanen T, Apaja-Sarkkinen M. Ultrasonography and core needle biopsy in the differential diagnosis of fibroadenoma and tumor phyllodes. Acta Radiol. 2007;48(7):708-13.

Gatta G, Iaselli F, Parlato V, Di Grezia G, Grassi R, Rotondo A. Differential diagnosis between fibroadenoma, giant fibroadenoma and phyllodes tumour: sonographic features and core needle biopsy. Radiol Med. 2011;116(6):905-18.

Chang J, Denham L, Dong EK, Malek K, Lum SS. Trends in the Diagnosis of Phyllodes Tumors and Fibroadenomas Before and After Release of WHO Classification Standards. Ann Surg Oncol. 2018;25(10):3088-95.

Adamietz BR, Kahmann L, Fasching PA, Schulz-Wendtland R, Uder M, Beckmann MW, et al. Differentiation between phyllodes tumor and fibroadenoma using real-time elastography. Ultraschall Med. 2011;32:E75-9.

Li L-J, Zeng H, Ou B, Luo BM, Xiao XY, Zhong WJ, et al. Ultrasonic Elastography Features of Phyllodes Tumors of the Breast: A Clinical Research. PLoS One. 2014;9(1).

Koutselini H, Malliri A, Field JK, Spandidos DA. p53 expression in cytologic specimens from benign and malignant breast lesions. Anticancer Res. 1991;11(4):1415-9.

Franco N, Picard SF, Mege F, Arnould L, Lizard-Nacol S. Absence of genetic abnormalities in fibroadenomas of the breast determined at p53 gene mutations and microsatellite alterations. Cancer Res. 2001;61(21):7955-8.

Hodges KB, Abdul-Karim FW, Wang M, Lopez-Beltran A, Montironi R, Easley S, et al. Evidence for transformation of fibroadenoma of the breast to malignant phyllodes tumor. Appl Immunohistochem Mol Morphol. 2009;17(4):345-50.

Schneider L, Branchini G, Cericatto R, Capp E, Brum IS. Gene and protein expression of p53 and p21 in fibroadenomas and adjacent normal mammary tissue. Endocrine. 2009;35(1):118-22.

Sosin M, Pulcrano M, Feldman ED, Patel KM, Nahabedian MY, Weissler JM, et al. Giant juvenile fibroadenoma: a systematic review with diagnostic and treatment recommendations. Gland Surg. 2015;4(4):312-21.

Tejwani PL, Nerkar H, Dhar A, Kataria K, Hari S, Thulkar S, et al. Regression of Fibroadenomas with Centchroman: a Randomized Controlled Trial. Indian J Surg. 2015;77(2):484-9.

Fisher B, Costantino JP, Wickerham DL, Redmond CK, Kavanah M, Cronin WM, et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst. 1998;90(18):1371-88.

Tan-Chiu E, Wang J, Costantino JP, Paik S, Butch C, Wickerham DL, et al. Effects of Tamoxifen on Benign Breast Disease in Women at High Risk for Breast Cancer. J Natl Cancer Inst. 2003;95(4):302-7.

Viviani RSDO, Gebrim LH, Baracat EC, De Lima GR. Evaluation of the ultrasonographic volume of breast fibroadenomas in women treated with tamoxifen. Minerva Ginecol. 2002;54(6):531-5.

Bernardes JRM, Seixas MT, Lima GR, Marinho LC, Gebrim LH. The effect of tamoxifen on PCNA expression in fibroadenomas. Breast J. 2003;9(4):302-6.

Querzoli P, Albonico G, Ferretti S, Rinaldi R, Magri E, Indelli M, et al. MIB-1 proliferative activity in invasive breast cancer measured by image analysis. J Clin Pathol. 1996;49(11):926-30.

Marrelli D, Pinto E, Neri A, Megha T, Gioffrè W, Cioppa T, et al. Mib-1 proliferation index is an independent predictor of lymph node metastasis in invasive breast cancer: a prospective study on 675 patients. Oncol Rep. 2006;15(2):425-9.

Neri A, Marrelli D, Pedrazzani C, Caruso S, De Stefano A, Mariani F, et al. Prognostic relevance of proliferative activity evaluated by Mib-1 immunostaining in node negative breast cancer. Eur J Surg Oncol. 2008;34(12):1299-303.

Sousa JAD, Seixas MTD, Lima GRD, Baracat EC, Gebrim LH. Evaluation of Monoclonal Antibody MIB-1 in the Mammary Epithelium Adjacent to Fibroadenomas in Premenopausal Women Treated with Tamoxifen. The Breast Journal. 2001;7(6):392-7.

Dhar A, Srivastava A. Role of centchroman in regression of mastalgia and fibroadenoma. World J Surg. 2007;31(6):1178-84.

Kitamura K, Hashizume M, Sugimachi K, Kataoka A, Ohno S, Kuwano H, et al. Early experience of endoscopic extirpation of benign breast tumors via an extra-mammary incision. Am J Surg. 1998;176(3):235-8.

Lai H-W, Chen S-T, Chen D-R, Chen S-L, Chang T-W, Kuo S-J, et al. Current Trends in and Indications for Endoscopy-Assisted Breast Surgery for Breast Cancer: Results from a Six-Year Study Conducted by the Taiwan Endoscopic Breast Surgery Cooperative Group. PLoS One. 2016;11(3).

Lai HW, Lin HY, Chen SL, Chen ST, Chen DR, Kuo SJ. Endoscopy-assisted surgery for the management of benign breast tumors: technique, learning curve, and patient-reported outcome from preliminary 323 procedures. World J Surg Oncol. 2017;15.

Cheng PJ, Vu LT, Cass DL, Hicks MJ, Brandt ML, Kim ES. Endoscopic specimen pouch technique for removal of giant fibroadenomas of the breast. J Pediatr Surg. 2012;47(4):803-7.