Breast, Fibroadenoma and sclerosing adenosis [LMP88229]

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Diagnostic Modality: 
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Disease Category: 
Neoplasia
Diagnosis: 
Fibroadenoma and sclerosing adenosis
Species: 
Human
Organ System: 
Breast
Gender: 
Female
Age: 
47 years
Diagnosis Code: 
ICD-10: D24 | ICD-O: 9010/0
Slide Contributor Information
Lou, S., Latta, E.

Keywords

Fibroadenoma, sclerosing, adenosis

Clinical History

Left breast mass at 4 o’clock.

Clinical Discussion

Fibroadenoma is one of the most common benign breast neoplasms. It is characterized by a biphasic proliferation of ducts and stroma, and is usually managed conservatively. In this case, the fibroadenoma is associated with sclerosing adenosis, making it a complex fibroadenoma. Complex fibroadenomas habour one or more complex change(s) including cysts (> 3mm in diameter), sclerosing adenosis (as in this case), epithelial calcification or papillary apocrine changes. It has a slightly increased risk of malignancy; however, the risk remains low and can be managed similar to a simple fibroadenoma.

Sclerosing adenosis is a lobulocentric proliferation of acini around a central duct. Lumina are frequently compressed by surrounding sclerosis, mimicking invasive ductal carcinoma. This can be resolved by a simple immunohistochemical stain for myoepithelial cell layers such as p63 or smooth muscle myosin heavy chain, which will be retained in sclerosing adenosis and lost in invasive ductal carcinoma.