Clinico-Pathological Features of Fibroadenoma Occurring in a Cohort of Young African-American Patients: Single Institution Experience
Sudeshna Bandyopadhyay, Baraa Alosh, Monique Bowles, Michele Cote, Dongping Shi, Nagla Salem, Min Hui Kim, Daniel Visscher, Rouba Ali-Fehmi. Wayne State University, Detroit, MI; Karmanos Cancer Institute, Detroit, MI; Mayo Clinic, Rochester, MN
Background: Fibroadenoma (FA) commonly seen in women in the 2nd and 3rd decades of life, may be multiple and bilateral in approximately 15-20% of cases and are reportedly twice as common in young African American women compared to their Caucasian counterparts. Although surgical excision is the definitive treatment, it may be undesirable due to cosmetic/technical reasons. On the other hand, conservative management is not acceptable to all patients. In our study, we analyzed clinical and histopathological features of FA occurring in an African American cohort of women less than 25 years of age at our institution.
Design: We identified African American patients ≤25 years of age who were diagnosed with FA from years 2003 to 2007. The clinical parameters recorded were age, number, laterality, size and number (single/multiple) of tumors. Recurrence, if any, was also documented from the medical charts over a 5 year follow up period. H and E slides were reviewed and the following pathological parameters were recorded: stromal cellularity (low, intermediate, high), epithelial hyperplasia (mild, moderate and florid), stromal mitoses (per 10 HPF) and stromal overgrowth (lack of epithelial units in 1 low power field).
Results: A total of 95 women ≤ 25 years were diagnosed with FA ranged in size from 0.5 cm to 12 cm with a median of 2.3 cm. Of these, 80 (84.2%) patients did not recur; in this group, multiple FA were identified in 4 (5%) of the patients and bilaterality was present in 2 (2.5%) patients. The tumors ranged in size from 0.5 to 2.8 cm with a median of 2 cm. In the second group of 15 (15.8%) patients with multiple recurrences over the follow up period, 6 patients (40%) had multiple tumors and bilaterality was seen in 4 (26.7) patients. In this group, the tumors ranged in size from 2.8 cm to 12.1 cm with a median size of 3.8 cm. All recurrent FA were also diagnosed as FA. No differences in histopathology were noted between these 2 groups.
Conclusions: In our cohort of patients, we identified a subset of patients who were prone to recurrence of FA. This group had a greater proportion of bilateral and multiple tumors. Also, these FA tended to be larger than those which did not recur. However, none of these patients developed malignancy over a five year follow up period. Therefore, it appears that conservative management of FA occurring in young women with appropriate clinical and radiological follow up might be a viable treatment option.
Monday, March 4, 2013 1:00 PM
Poster Session II # 47, Monday Afternoon