Benign Breast Tumors

Snap Shot

• A 28-year-old female presents with a 2 cm lump in the upper outer quadrant of her left breast. The mass changes in size in keeping with her menstrual cycle.

Introduction

• Several types
  • fibroadenoma 
    • most common tumor in women < 35
    • benign lesion that does not progress to breast cancer
    • size and tenderness varies with estrogen changes 
    • histology shows hypercellular stroma that encircles or compresses ducts 
  • intraductal papilloma
    • small tumor 
    • typically beneath areola in lactiferous sinuses
    • common cause of bloody nipple discharge
    • histology shows proliferative glands with intact fibrovascular cores 
  • phyllodes tumor
    • most common in post-menopausal women
    • consists of connective tissue and cysts with “leaf-like” projections
      • derived from stromal cells
• may progress to malignancy

Presentation

• Fibroadenoma
  • palpable as a small, mobile, well circumscribed and firm mass
• Intraductal papilloma
  • serous or bloody nipple discharge
• Phyllodes tumor
• large, bulky mass

Evaluation

• Fine needle aspiration of the mass