Skip to main content

Advertisement

SpringerLink
Log in

Cytological features of complex type fibroadenoma in comparison with non-complex type fibroadenoma

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Background

To determine the cytomorphological features of complex type fibroadenoma (CFA), we reviewed fine needle aspiration (FNA) cytology with correlation to its histopathology findings, and compared them with non-complex type fibroadenoma (NCFA).

Methods

From excisional biopsy or resected specimens of fibroadenoma (FA) cases treated at our institution from 2004 to 2013, we chose 46 patients who underwent FNA before a diagnosis of FA was established. We histologically re-classified them into two groups: CFA and NCFA. FNA diagnosis was retrospectively re-evaluated from FNA reports. We further re-assessed detailed characteristics of each FNA smears to identify cytomorphological features of CFA.

Results

We found that 15 cases fulfilled the diagnostic criteria of CFA, in which 7 (46.7 %) had an FNA diagnosis of “suspicious for malignancy” or “indeterminate” while only 2 NCFA cases had that of “indeterminate” (p = 0.004). FNA smears from CFA cases showed discohesiveness, enlarged nuclei, prominent nucleoli, and fewer myoepithelial cells more often than NCFA. Although no significant difference was noted in patients’ age and tumor size between CFA and NCFA, 5 CFA cases (33.3 %) were accompanied by the presence of carcinoma in the same breast or the contralateral breast while no NCFA cases had carcinoma in the breast.

Conclusions

FNA of CFA can lead to erroneous or indeterminate interpretation, due to proliferative and/or hyperplastic changes of ductal epithelium with or without atypia. It is important to recognize the disease entity and characteristic cytomorphological findings of CFA to reach accurate FNA diagnosis of breast lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Duflos C, Plu-Bureau G, Thibaud E, Kuttenn F. Breast diseases in adolescents. Endocr Dev. 2012;22:208–21.

    CAS  PubMed  Google Scholar 

  2. Amin AL, Purdy AC, Mattingly JD, Kong AL, Termuhlen PM. Benign breast disease. Surg Clin North Am. 2013;93:299–308.

    Article  PubMed  Google Scholar 

  3. Greenberg R, Skornick Y, Kaplan O. Management of breast fibroadenomas. J Gen Intern Med. 1998;13:640–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Weigner J, Zardawi I, Braye S. The true nature of atypical breast cytology. Acta Cytol. 2013;57:464–72.

    Article  CAS  PubMed  Google Scholar 

  5. Shabb NS, Boulos FI, Abdul-Karim FW. Indeterminate and erroneous fine-needle aspirates of breast with focus on the ‘true gray zone’: a review. Acta Cytol. 2013;57:316–31.

    Article  PubMed  Google Scholar 

  6. Levi F, Randimbison L, Te VC, La Vecchia C. Incidence of breast cancer in women with fibroadenoma. Int J Cancer. 1994;57:681–3.

    Article  CAS  PubMed  Google Scholar 

  7. Ciatto S, Bonardi R, Zappa M, Giorgi D. Risk of breast cancer subsequent to histological or clinical diagnosis of fibroadenoma—retrospective longitudinal study of 3938 cases. Ann Oncol. 1997;8:297–300.

    Article  CAS  PubMed  Google Scholar 

  8. Carter CL, Corle DK, Micozzi MS, Schatzkin A, Taylor PR. A prospective study of the development of breast cancer in 16,692 women with benign breast disease. Am J Epidemiol. 1988;128:467–77.

    CAS  PubMed  Google Scholar 

  9. Levshin V, Pikhut P, Yakovleva I, Lazarev I. Benign lesions and cancer of the breast. Eur J Cancer Prev. 1998;7(Suppl 1):S37–40.

    Article  PubMed  Google Scholar 

  10. Kuijper A, Mommers EC, van der Wall E, van Diest PJ. Histopathology of fibroadenoma of the breast. Am J Clin Pathol. 2001;115:736–42.

    Article  CAS  PubMed  Google Scholar 

  11. 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;92:30–6.

    Article  CAS  PubMed  Google Scholar 

  12. 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;331:10–5.

    Article  CAS  PubMed  Google Scholar 

  13. Kuroda H, Takeuchi I, Ohnishi K, Sakamoto G, Akiyama F, Toyozumi Y, et al. Clinical and pathologic features of fibroadenoma of the mastopathic type. Surg Today. 2006;36:590–5.

    Article  PubMed  Google Scholar 

  14. Kinoshita S, Sakamoto G, Akiyama F, Saeki K, Sugano H, Iwase T, et al. Fibroadenoma of the breast: review of histopathological subtypes and its changes in 1968 & 1988–1989. Jpn J Breast Cancer. 1991;6:377–83 (in Japanese).

    Google Scholar 

  15. Mori I, Han B, Wang X, Taniguchi E, Nakamura M, Nakamura Y, et al. Mastopathic fibroadenoma of the breast: a pitfall of aspiration cytology. Cytopathology. 2006;17:233–8.

    Article  CAS  PubMed  Google Scholar 

  16. Jing X, Normolle D, Michael CW. Fine-needle aspiration of gray zone lesions of the breast: fibroadenoma versus ductal carcinoma. Diagn Cytopathol. 2013;41:806–11.

    Article  PubMed  Google Scholar 

  17. Foster ME, Garrahan N, Williams S. Fibroadenoma of the breast: a clinical and pathological study. J R Coll Surg Edinb. 1988;33:16–9.

    CAS  PubMed  Google Scholar 

  18. Sklair-Levy M, Sella T, Alweiss T, Craciun I, Libson E, Mally B. Incidence and management of complex fibroadenomas. AJR Am J Roentgenol. 2008;190:214–8.

    Article  PubMed  Google Scholar 

  19. Walters TK, Zuckerman J, Nisbet-Smith A, Hudson E, Chia Y, Burke M. Fine needle aspiration biopsy in the diagnosis and management of fibroadenoma of the breast. Br J Surg. 1990;77:1215–7.

    Article  CAS  PubMed  Google Scholar 

  20. Kollur SM, El Hag IA. FNA of breast fibroadenoma: observer variability and review of cytomorphology with cytohistological correlation. Cytopathology. 2006;17:239–44.

    Article  CAS  PubMed  Google Scholar 

  21. López-Ferrer P, Jiménez-Heffernan JA, Vicandi B, Ortega L, Viguer JM. Fine needle aspiration cytology of breast fibroadenoma. A cytohistologic correlation study of 405 cases. Acta Cytol. 1999;43:579–86.

    Article  PubMed  Google Scholar 

  22. Benoit JL, Kara R, McGregor SE, Duggan MA. Fibroadenoma of the breast: diagnostic pitfalls of fine-needle aspiration. Diagn Cytopathol. 1992;8:643–7.

    Article  CAS  PubMed  Google Scholar 

  23. Carty NJ, Carter C, Rubin C, Ravichandran D, Royle GT, Taylor I. Management of fibroadenoma of the breast. Ann R Coll Surg Engl. 1995;77:127–30.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Myers T, Wang HH. Fibroadenoma mimicking papillary carcinoma on ThinPrep of fine-needle aspiration of the breast. Arch Pathol Lab Med. 2000;124:1667–9.

    CAS  PubMed  Google Scholar 

  25. Jamal AA, Mansoor I. Analysis of false positive and false negative cytological diagnosis of breast lesions. Saudi Med J. 2001;22:67–71.

    CAS  PubMed  Google Scholar 

  26. Al-Kaisi N. The spectrum of the “gray zone” in breast cytology. A review of 186 cases of atypical and suspicious cytology. Acta Cytol. 1994;38:898–908.

    CAS  PubMed  Google Scholar 

  27. Tsuchiya S, Maruyama Y, Koike Y, Yamada K, Kobayashi Y, Kagaya A. Cytologic characteristics and origin of naked nuclei in breast aspirate smears. Acta Cytol. 1987;31:285–90.

    CAS  PubMed  Google Scholar 

  28. Stanley MW, Tani EM, Skoog L. Fine-needle aspiration of fibroadenomas of the breast with atypia: a spectrum including cases that cytologically mimic carcinoma. Diagn Cytopathol. 1990;6:375–82.

    Article  CAS  PubMed  Google Scholar 

  29. Rogers LA, Lee KR. Breast carcinoma simulating fibroadenoma or fibrocystic change by fine-needle aspiration. A study of 16 cases. Am J Clin Pathol. 1992;98:155–60.

    Article  CAS  PubMed  Google Scholar 

  30. Slanetz PJ, Edmister WB, Yeh ED, Talele AC, Kopans DB. Occult contralateral breast carcinoma incidentally detected by breast magnetic resonance imaging. Breast J. 2002;8:145–8.

    Article  PubMed  Google Scholar 

  31. Roubidoux MA, Helvie MA, Wilson TE, Lai NE, Paramagul C. Women with breast cancer: histologic findings in the contralateral breast. Radiology. 1997;203:691–4.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Ms Ayako Hayama (Division of Diagnostic Pathology, Nippon Medical School Hospital) for preparing tissue blocks and slides.

Author information

Authors and Affiliations

  1. Department of Diagnostic Pathology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Ryuji Ohashi, Miyuki Matsubara, Yasuhiko Watarai, Shin-ichi Tsuchiya & Zenya Naito

  2. Division of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan

    Keiko Yanagihara, Koji Yamashita & Hiroyuki Takei

  3. Department of Diagnostic Pathology, Iida Hospital, Nagano, Japan

    Shin-ichi Tsuchiya

  4. Departments of Pathology and Integrative Oncological Pathology, Nippon Medical School, Tokyo, Japan

    Zenya Naito

Authors
  1. Ryuji Ohashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Miyuki Matsubara
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yasuhiko Watarai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Keiko Yanagihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Koji Yamashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shin-ichi Tsuchiya
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hiroyuki Takei
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zenya Naito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ryuji Ohashi.

Ethics declarations

Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

This study was conducted in accordance with the principles embodied in the Declaration of Helsinki (2008). Patients’ consent was obtained for the use of clinical samples for research purposes according to the regulations defined by the Ethics Committee of Nippon Medical School Hospital.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ohashi, R., Matsubara, M., Watarai, Y. et al. Cytological features of complex type fibroadenoma in comparison with non-complex type fibroadenoma. Breast Cancer 23, 724–731 (2016). https://doi.org/10.1007/s12282-015-0632-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12282-015-0632-9

Keywords

Search

Navigation