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Fibroadenomların İçindeki ve Çevresindeki Histopatolojik Değişikliklerin Karşılaştırılması

Yıl 2021, Cilt: 16 Sayı: 3, 432 - 438, 01.11.2021
https://doi.org/10.17517/ksutfd.837941

Öz

Amaç: Fibroadenom en sık görülen benign meme tümörüdür ancak literatürde fibroadenomların ve bitişik dokuların histolojik özelliklerini tanımlayan az sayıda çalışma bulunmaktadır. Bu çalışmanın amacı fibroadenomların içindeki ve çevresindeki epitelyal ve stromal dokuların histolojik özelliklerini incelemektir.
Gereç ve Yöntemler: Bu çalışmada eksizyonel meme biyopsisi histopatolojik olarak fibroadenom tanısı alan 52 hasta retrospektif olarak tarandı ve tüm hematoksilin eozin boyalı preparatlar iki patolog tarafından yeniden değerlendirildi. Tüm veriler SPSS v.21.0 yazılım paketi ile analiz edildi.
Bulgular: Kompleks fibroadenom ile normal duktal hiperplazi arasında istatistiksel olarak anlamlı bir ilişki saptandı (p <0.001), kompleks fibroadenomların % 55.9'unda duktal hiperplazi mevcuttu. Çevre parankimde duktal hiperplazi varlığı ile fibroadenom arasında anlamlı bir ilişki saptanmadı (p = 0.132). Duktal hiperplazi içeren fibroadenomların % 26.3'ünde, komşu meme parankiminde de duktal hiperplazi mevcuttu. Kompleks fibroadenom ile çevre parankimdeki duktal hiperplazi veya fibrokistik değişiklikler arasında anlamlı bir ilişki yoktu (sırasıyla p = 0.438 ve p = 0.523).
Sonuç: Fibroadenom içinde ve çevresinde meme kanseri için bir risk oluşturan proliferatif değişikliklerin oranları genç ve ileri yaşlarda benzer bulunmuştur. Fibroadenomdaki kompleks ve proliferatif değişikliklerin ve çevre meme parankimindeki proliferatif değişikliklerin titizlikle incelenmesi ve raporda tüm bu değişikliklerin belirtilmesi, meme kanseri gelişme riskinin daha doğru bir şekilde belirlenmesini sağlayacaktır.

Kaynakça

  • 1. Brogi E. Fibroepithelial neoplasms. Hoda SA, Brogi E, Koerner FC, Rosen PP, editors. Rosen’s breast pathology. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2014. p. 213-270.
  • 2. Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer Jr WD, Rados MS, et al. Long-term risk of breast cancer in women with fibroadenoma. N Engl J Med 1994; 331: 10-15.
  • 3. 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: 467-477.
  • 4. McDivitt RW, Stevens JA, Lee NC, Wingo PA, Rubin GL, Gersell D. Histologic types of benign breast disease and the risk for breast cancer. Cancer 1992; 69: 1408-1414.
  • 5. Moskowitz M, Gartside P, Wirman JA, McLaughlin C. Proliferative disorders of the breast as risk factors for breast cancer in a selfselected screened population: pathologic markers. Radiology 1980; 134: 289-291.
  • 6. Nassar A, Visscher DW, Degnim AC, Frank RD, Vierkant RA, Frost M, et al. Complex fibroadenoma and breast cancer risk: a Mayo Clinic Benign Breast Disease Cohort Study. Breast Cancer Res Treat 2015; 153: 397-405.
  • 7. Hoda SA. Ductal hyperplasia: Usual and atypical. Hoda SA, Brogi E, Koerner FC, Rosen PP, editors. Rosen’s breast pathology. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2014. p. 271-308.
  • 8. Kuijper A, Mommers EC, van der Wall E, van Diest PJ. Histopathology of fibroadenoma of the breast. Am J Clin Pathol 2001; 115: 736-742.
  • 9. El-Wakeel H, Umpleby HC. Systematic review of fibroadenoma as a risk factor for breast cancer. The Breast 2003; 12: 302-307.
  • 10. Ansari JN, Buch AC, Pandey A, Rao R, Siddique A. Spectrum of histopathological changes in fibroadenoma of breast. IJPO 2018; 5: 429-434.
  • 11. Thakur B, Misra V. Clinicohistopathological features of fibroadenoma breast in patients less than 20 years of age and its comparison with elder patients. IOSR J Nurs Health Sci 2014; 3: 67-71.
  • 12. Ullah N, Israr M, Ali M. Evaluation of benign breast lump. Pak J Surg 2010; 26: 261-264.
  • 13. Laxman S, Sangolgi, P, Jabshetty S, Bhavikatti A, Uttam A. Clinical profile of patients with fibroadenoma of breast. ISJ 2018; 5: 1057-1061.
  • 14. Tan BY, Tan P H. A diagnostic approach to fibroepithelial breast lesions. Surg Pathol Clin 2018; 11: 17-42.
  • 15. Pareek P, Pareek P. Giant juvenile fibroadenoma: a case report. ISJ 2018; 5: 1589-1591.
  • 16. Wu YT, Chen ST, Chen CJ, Kuo YL, Tseng LM, Chen DR, et al. Breast cancer arising within fibroadenoma: Collective analysis of case reports in the literature and hints on treatment policy. World J Surg Oncol 2014; 12: 335-340.
  • 17. Goodman ZD, Taxy JB. Fibroadenomas of the breast with prominent smooth muscle. Am J Surg Pathol 1981; 5: 99-101.
  • 18. Krishnamurthy K, Alghamdi S, Gyapong S, Kaplan S, Poppiti RJ. A clinicopathological study of fibroadenomas with epithelial proliferation including lobular carcinoma in-situ, atypical ductal hyperplasia, DCIS and invasive carcinoma. Breast disease 2019; 38; 97-101.
  • 19. Singh S, Khajuria M, Kaul R, Chauhan A, Panwar R. Histological changes associated with fibroadenoma breast. ACHR 2018; 3 :136-139.
  • 20. Shabtai M, Saavedra-Malinger P, Shabtai EL, Rosin D, Kuriansky J, Ravid-Megido M, et al. Fibroadenoma of the breast: analysis of associated pathological entities-a different risk marker in different age groups for concurrent breast cancer. Imaj Ramat Gan 2001; 3: 813-817.

Comparative study of the histopathologic changes within and around fibroadenomas

Yıl 2021, Cilt: 16 Sayı: 3, 432 - 438, 01.11.2021
https://doi.org/10.17517/ksutfd.837941

Öz

Objective: Fibroadenoma is the most common benign breast tumor but there are a few studies in the literature that describe the histological features of inner and adjacent tissues of fibroadenomas. The aim of the present study is to examine the histological features of the epithelial and stromal tissues within and around fibroadenomas.
Materials and Metods: In this study, 52 patients with histopathologically diagnosed fibroadenoma from excisional breast biopsy were retrospectively screened and all hematoxylin eosin stained slides were reevaluated by two pathologists. All data were analyzed with SPSS v.21.0 software package.
Results: A statistically significant correlation was detected between complex fibroadenoma and usual ductal hyperplasia (p <0.001), usual ductal hyperplasia was present in 55.9 % of the complex fibroadenomas. No significant association was detected between presence of usual ductal hyperplasia in the surrounding parenchyma and fibroadenoma (p= 0.132). In 26.3 % of fibroadenomas containing usual ductal hyperplasia, usual ductal hyperplasia was present in the adjacent breast parenchyma. There was no significant correlation between complex fibroadenoma and usual ductal hyperplasia or fibrocystic changes in the surrounding parenchyma (p= 0.438 and p= 0.523, respectively).
Conclusion: The rates of the proliferative changes that create a risk for breast cancer in and around the fibroadenoma in the younger ages were found similar with the older ages. The examination of the complex and proliferative changes in the fibroadenoma and the proliferative changes in the surrounding breast parenchyma meticulously and specification of all those changes in the report will allow determination of the risk for development of breast cancer more accurately.

Kaynakça

  • 1. Brogi E. Fibroepithelial neoplasms. Hoda SA, Brogi E, Koerner FC, Rosen PP, editors. Rosen’s breast pathology. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2014. p. 213-270.
  • 2. Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer Jr WD, Rados MS, et al. Long-term risk of breast cancer in women with fibroadenoma. N Engl J Med 1994; 331: 10-15.
  • 3. 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: 467-477.
  • 4. McDivitt RW, Stevens JA, Lee NC, Wingo PA, Rubin GL, Gersell D. Histologic types of benign breast disease and the risk for breast cancer. Cancer 1992; 69: 1408-1414.
  • 5. Moskowitz M, Gartside P, Wirman JA, McLaughlin C. Proliferative disorders of the breast as risk factors for breast cancer in a selfselected screened population: pathologic markers. Radiology 1980; 134: 289-291.
  • 6. Nassar A, Visscher DW, Degnim AC, Frank RD, Vierkant RA, Frost M, et al. Complex fibroadenoma and breast cancer risk: a Mayo Clinic Benign Breast Disease Cohort Study. Breast Cancer Res Treat 2015; 153: 397-405.
  • 7. Hoda SA. Ductal hyperplasia: Usual and atypical. Hoda SA, Brogi E, Koerner FC, Rosen PP, editors. Rosen’s breast pathology. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2014. p. 271-308.
  • 8. Kuijper A, Mommers EC, van der Wall E, van Diest PJ. Histopathology of fibroadenoma of the breast. Am J Clin Pathol 2001; 115: 736-742.
  • 9. El-Wakeel H, Umpleby HC. Systematic review of fibroadenoma as a risk factor for breast cancer. The Breast 2003; 12: 302-307.
  • 10. Ansari JN, Buch AC, Pandey A, Rao R, Siddique A. Spectrum of histopathological changes in fibroadenoma of breast. IJPO 2018; 5: 429-434.
  • 11. Thakur B, Misra V. Clinicohistopathological features of fibroadenoma breast in patients less than 20 years of age and its comparison with elder patients. IOSR J Nurs Health Sci 2014; 3: 67-71.
  • 12. Ullah N, Israr M, Ali M. Evaluation of benign breast lump. Pak J Surg 2010; 26: 261-264.
  • 13. Laxman S, Sangolgi, P, Jabshetty S, Bhavikatti A, Uttam A. Clinical profile of patients with fibroadenoma of breast. ISJ 2018; 5: 1057-1061.
  • 14. Tan BY, Tan P H. A diagnostic approach to fibroepithelial breast lesions. Surg Pathol Clin 2018; 11: 17-42.
  • 15. Pareek P, Pareek P. Giant juvenile fibroadenoma: a case report. ISJ 2018; 5: 1589-1591.
  • 16. Wu YT, Chen ST, Chen CJ, Kuo YL, Tseng LM, Chen DR, et al. Breast cancer arising within fibroadenoma: Collective analysis of case reports in the literature and hints on treatment policy. World J Surg Oncol 2014; 12: 335-340.
  • 17. Goodman ZD, Taxy JB. Fibroadenomas of the breast with prominent smooth muscle. Am J Surg Pathol 1981; 5: 99-101.
  • 18. Krishnamurthy K, Alghamdi S, Gyapong S, Kaplan S, Poppiti RJ. A clinicopathological study of fibroadenomas with epithelial proliferation including lobular carcinoma in-situ, atypical ductal hyperplasia, DCIS and invasive carcinoma. Breast disease 2019; 38; 97-101.
  • 19. Singh S, Khajuria M, Kaul R, Chauhan A, Panwar R. Histological changes associated with fibroadenoma breast. ACHR 2018; 3 :136-139.
  • 20. Shabtai M, Saavedra-Malinger P, Shabtai EL, Rosin D, Kuriansky J, Ravid-Megido M, et al. Fibroadenoma of the breast: analysis of associated pathological entities-a different risk marker in different age groups for concurrent breast cancer. Imaj Ramat Gan 2001; 3: 813-817.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

İlke Evrim Seçinti 0000-0002-8614-3971

Didar Gürsoy 0000-0002-0674-7047

Yayımlanma Tarihi 1 Kasım 2021
Gönderilme Tarihi 9 Aralık 2020
Kabul Tarihi 24 Mayıs 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 16 Sayı: 3

Kaynak Göster

AMA Seçinti İE, Gürsoy D. Comparative study of the histopathologic changes within and around fibroadenomas. KSÜ Tıp Fak Der. Kasım 2021;16(3):432-438. doi:10.17517/ksutfd.837941