Are both distinct epithelial and stromal cells molecular analysis from phyllodes tumors versus fibroadenoma components affected in breast fibroepithelial progression?

Purpose: To determine molecular events involved in the tumorigenesis of phyllodes tumors (PT) and the role of each stromal (SC) and epithelial (EC) cell. Methods: Frozen breast samples enriched with epithelial and stromal cells from three fibroadenomas and 14 PT were retrieved and laser microdissected. Sanger and polymerase chain reaction-based sequencing of exon 2 MED12 and TERT promoter hotspot mutations were performed; 44K microarray platform was used to analyze gene expression. Results: All three fibroadenomas (FAs) presented mutations in MED12, but not in TERT, whose mutation was observed in five of the 14 PTs. EC and SC of each affected tumor displayed identical alterations. Of the total differentially expressed genes (DEG) (EC = 1,543 and SC = 850), 984 were EC-eDEGs and 291 were SC-eDEGs. We found a high similarity of diseases and functions enriched by both cell types, but dissimilarity in the number of enriched canonical pathways. Three signaling canonical pathways overlapping with EC and SC were predicted to be activated in one cell type and inactivated in the other, while no overlap in eDEGs was assigned to them. We also identified 13 EC-eDEGs and five SC-eDEGs enriched networks, in which the SC-eDEGs were able to segregate FA from PT samples. Conclusions: Identical TERT mutations from both SC and ES origins might affect the PTs tumorigenesis. Gene expression differences suggest coordinated molecular processes between these components with determinant differences acquired by SC, able to fully distinguish PTs from FAs lesions.

Repeatedly Recurrent Supernumerary Bilateral Fibroadenoma Breast with Family History of Breast Cancer in a Young Girl: A Surgeon’s Dilemma

More than 4 fibroadenomas in a single breast are uncommon. Repeated recurrences of supernumerary fibroadenomas, in multiple numbers, after excision, are extremely rare. The malignant potential of breast fibroadenoma increases significantly in women with complex fibroadenomas, proliferative disease or a family history of breast cancer. Such a condition poses a management dilemma to the surgeon. Prophylactic bilateral mastectomy is controversial, and requires a rigorous assessment of risk benefit ratio and a better assessment of psychosocial impact and ethical issues. More often than not, the patient prefers repeat excision and close surveillance as the most agreeable course of action; the relatively higher risk of malignancy notwithstanding. Repeated excision as new fibroadenomas appear seems to be a feasible option.

Fibroadenoma vulvar: comunicación de un caso

El fibroadenoma es una neoplasia benigna usualmente localizada en mama. Su localización vulvar es extremadamente rara, con publicación de pocos casos. Su origen es incierto y muy debatible, en tanto se piensa que puede originarse de un tejido mamario ectópico vulvar o de glándulas anogenitales similares a las de tejido mamario que existen normalmente. Se presenta un caso inusual de fibroadenoma vulvar en una mujer de 29 años que durante dos años evidenció tumoración a nivel de la vulva que le producía dispareunia y sangrado poscoital. A nivel del labio mayor de la vulva se extirpó un tumor bien delimitado de 3 x 2 x 2 cm, blanquecino, de consistencia firme. En la microscopia se observó un fibroadenoma que por inmunohistoquímica mostró positividad para receptores de estrógeno y progesterona.

Fibroadenoma is a benign neoplasm usually located in the breast. Its vulvar location is extremely rare, with few cases published. Its origin is uncertain and highly debatable, as it is thought that it may originate from vulvar ectopic breast tissue or from anogenital glands similar to normally existing breast tissue. An unusual case of vulvar fibroadenoma is presented in a 29-year-old woman who for two years presented with a vulvar lump that caused dyspareunia and postcoital bleeding. At the level of the labium majus of the vulva, a well-demarcated tumor measuring 3 x 2 x 2 cm, whitish, with a firm consistency was excised. Microscopy showed a fibroadenoma which by immunohistochemistry showed positivity for estrogen and progesterone receptors.

STUDY OF FINE NEEDLE ASPIRATION CYTOLOGY IN PALPABLE BREAST LUMPS AT TERTIARY CARE HOSPITAL, SURYAPET, TELANGANA

Introduction: Breast carcinoma is the second most common malignancy in India preceded by cervical carcinoma. Palpable breast lumps either self detected or identi?ed by clinician are common, ef?cient evaluation and prompt diagnosis are necessary to rule out malignancy. Clinical examination, radiological evaluation and tissue sampling – Triple assessment needed for de?nitive diagnosis. FNAC has a good sensitivity, speci?city and accuracy in the diagnosis of both neoplastic and non-neoplastic breast lumps. The present study is aimed to analyse the incidence and various cytomorphological sprectrum of breast lesions done by FNAC. Materials & Methods: This is retrospective observational study conducted in Department of Pathology, Government Medical College/ Government General Hospital, Suryapet, Telangana from January 2020 to December 2021 (2years). Clinical history was taken and FNAC done. Smears are stained with H&E stain and assessed. Results: In our study, 87 female patients were analysed. Age group of patients ranged from 15years to 70years. There was slight preponderance in right breast lesions 45cases(51.7%). Most common lesion in our study was ?broadenoma which constituted 36 cases (41.3%), peak incidence in 21-30year age group. Second most common lesion was duct cell carcinoma accounting for 27cases(31%), peak incidence seen in 41-50years age group. Conclusion FNAC is a simple, safe, cost effective procedure which is a component of triple assessment. It helps to differentiate benign from malignant lesions in majority of cases when combined with clinical and radiological examination for de?nitive management.

Histomorphological spectrum of Phyllodes Tumours: A Restrospective Study

Introduction: Phyllodes tumours are rare fibroepithelial lesions of breast. Clinical examina?on, ultrasound, cytology and histopathology are the mainstay of the diagnosis. The present research was undertaken with the aim of studying the clinicopathological features of Phyllodes tumour reported in the past seven years in a Delhi government hospital. Method: A retrospec?ve study of phyllodes tumour was carried out in females from 225 diagnosed cases of breast lesion reported in the pathology department of a government hospital in Delhi during the period of January 2013 to December2019. All the relevant history, findings of clinical examina?on and inves?ga?ons performed were assessed from files of the pa?ent. Results: Out of 225 cases of breast lesions reported in the pathology department 8 tumours were reported as phyllodes in the study period. The most common affected age group was 41- 50yrs. 5 (62.5 %) of 8 tumours were benign,2 (25) %) were borderline and only 1 was malignant. The tumour size was 15mm to 200mm. All the 8 cases (100%) presented with breast lump; 3 cases (30%) complained of pain in the lump. 2 cases developed ulcera?on and Peau D’ orange and in 1 case typical nipple retrac?on was seen. FNAC was done in 5 pa?ents. No preopera?ve inves?ga?ons were done in 2cases. Conclusion: Phyllodes tumour is a rare neoplasm of the breast. Histopathology plays an important role in differen?a?ng it from fibroadenoma. Strict histologic assessment is definitely required for the diagnosis of the PT and for its treatment and management

Dermatitis neglecta in a patient with breast fibroadenoma: case report

Dermatitis neglecta, a condition that results from inadequate skin cleansing, is still little reported in the literature and underreported. Although benign, it is aesthetically uncomfortable. It is associated with conditions that lead to fear of sanitizing a given region and may be related to psychiatric and neurological disorders. This observational study consisted of the case report of a patient followed up in a University Hospital in northeastern Brazil, with the objective of demonstrating the rare association between dermatitis neglecta and breast fibroadenoma. A young patient with a history of depressive disorder had crusted and hyperpigmented skin lesions covering the left breast and massive tumor in the same breast. The patient was oriented regarding the cleaning and removal of crusts, resulting in good clinical response. She underwent excision of the tumor, and the anatomopathological study was compatible with fibroadenoma. Interdisciplinary follow-up, including treatment for psychiatric disorder, was fundamental for the patient's recovery, considering the improvement of her mood after establishing the therapy and successful final breast reconstruction. Dermatitis neglecta can resemble other types of dermatitis, in such a way that it is essential to establish a differential diagnosis to avoid unnecessary evaluation procedures, interventions, and therapies. In this exuberant case of dermatitis neglecta, the importance of comprehensive health care is emphasized."

Expression of metalloproteinases 2 and 9 and plasma zinc concentrations in women with fibroadenoma

SUMMARY OBJECTIVE: This study aims to investigate the association between the immunohistochemical expression of matrix metalloproteinase-2 and matrix metalloproteinase-9 and plasma zinc in women with fibroadenoma. METHODS: This cross-sectional study included 37 premenopausal women with fibroadenoma. Waist circumference and body mass index of the participants were measured. Plasma zinc concentrations were determined using atomic flame absorption spectrophotometry. Fragments of breast tissue were fixed and incubated with primary mouse monoclonal antibodies (monoclonal antibodies matrix metalloproteinase -2 -507 and monoclonal antibodies matrix metalloproteinase -9-439). Semi-quantitative analysis of matrix metalloproteinase-2 and matrix metalloproteinase-9 immunoreactivity was performed. Spearman's test and Friedman's test were used for statistical analyses. The p<0.05 were considered statistically significant. RESULTS: The average age of the participants was 32.81±9.51 years. The body mass index and waist circumference values were within the normal range. The mean plasma zinc concentration was 42.73±13.84 µg/dL, with 94.6% inadequacy. A statistically significant difference was found between the positive expression of matrix metalloproteinase-2 and matrix metalloproteinase-9 (p=0.0184). There was no significant correlation between the matrix metalloproteinase expression and the plasma zinc levels. CONCLUSIONS: Women with fibroadenoma had hypozincemia and positive expression of metalloproteinases.

Core needle biopsy in fibroepithelial tumors: predicting factors for phyllodes tumors

OBJECTIVES: This study aimed to evaluate the clinical and imaging predictive factors for the diagnosis of phyllodes tumors in patients with inconclusive results from core needle biopsy (fibroepithelial lesions). METHODS: We retrospectively analyzed data of patients who underwent surgical excision of breast lesions previously diagnosed as fibroepithelial lesions. Numeric variables were analyzed using the Shapiro-Wilk and t-tests, and categorical variables were analyzed using the chi-square and Fisher's exact tests. Multivariate logistic regression was performed to calculate odds ratios and detect predictive factors for the diagnosis of PT. RESULTS: A total of 89 biopsy samples were obtained from 77 patients, of which 43 were confirmed as fibroadenomas, 43 as phyllodes tumors, and 3 as other benign, non-fibroepithelial breast lesions. The mean tumor size was 3.61 cm (range, 0.8-10 cm) for phyllodes tumors and 2.4 cm (range, 0.8-7.9 cm) for fibroadenomas. The predictive factor for phyllodes tumor diagnosis was lesion size >3 cm (p<0.001). CONCLUSION: Our data indicate that fibroepithelial lesions of the breast larger than 3 cm are more likely to be phyllodes tumors.

Carcinoma ductal in situ associado à fibroadenoma: relato de caso / Carcinoma ductal in situ arising in a fibroadenoma: report of a rare case

Apesar de fibroadenoma ser uma das lesões mais comuns da mama, sua correlação a alteração maligna é rara.1,2,3,5,7 Quando ocorre tem apresentação clínica similar a dos fibroadenomas típicos, diagnóstico anatomopatológico em geral pós-cirúrgico e tratamento conforme do carcinoma do mesmo tipo histológico isolado.1,2,3,4,6 Apresentamos caso de mulher de 52 anos, apresentando em propedêutica investigativa nódulo em mama direita. Core-biopsy sugeriu carcinoma ductal in situ desenvolvido dentro de fibroadenoma, confirmado em análise anatomopatológica pósoperatória. Tratamento e seguimento se deu conforme já estabelecido pela literatura para carcinoma in situ. Devido baixa incidência, há poucas evidências científicas quanto ao diagnóstico, tratamento e prognóstico desse tipo de lesão. Portanto, apresentar à comunidade científica casos de carcinoma inclusos a fibroadenoma se faz relevante.

Although fibroadenoma is one of the most common lesions of the breast, its correlation with malignant changes is rare. When it occurs, the clinical presentation is similar to typical fibroadenomas, anatomopathological diagnosis is after surgery and treatment goes according to the carcinoma histological type. A case of a 52-year-old woman is presented, with an impalpable nodule in the right breast, diagnosed from screening exams. Corebiopsy suggested carcinoma ductal in situ developed within fibroadenoma, confirmed in the postoperative anatomopathological analysis. Treatment and follow-up followed as established in the literature for carcinoma in situ. Due the low incidence, there are poor scientific evidence regarding the diagnosis, treatment and prognosis of this type of injury. Therefore, presenting cases of Carcinoma ductal in situ arising in a fibroadenoma to the scientific community is so relevant.

Low-grade carcinoma in situ in fibroadenoma: a case report

Fibroadenomas are the most common benign breast neoplasms. In rare cases, a carcinoma may develop within a fibroadenoma. The aim of this study was to report a case of low-grade carcinoma in situ in a fibroadenoma. A 31-year-old female, G0P0A0 and without family history of cancer, arrives at the service with an expressive breast lump growth along the year year. Core biopsy, histopathological and immunohistochemical studies showed an in-situ carcinoma in a fibroadenoma. Surgical resection was performed with a safety margin, and anatomopathological study and immunohistochemistry of the surgical specimen confirmed the core biopsy diagnosis. Currently, the patient is under annual clinical follow-up with mammography and breast ultrasound and no evidence of neoplastic disease. Although this is a rare event and few cases are described in the literature, carcinomas in situ can occur in a fibroadenoma.

Fibroadenoma gigante juvenil de mama: presentación de un caso clínico / Juvenile giant fibroadenoma of the breast: presentation of a clinical case

RESUMEN El fibroadenoma gigante juvenil es un tumor de mama benigno y una variante rara de los fibroadenomas. La presentación clínica suele ser una masa tumoral unilateral, de crecimiento rápido e indolora. En este artículo presentamos el caso de un fibroadenoma gigante juvenil de 12 cm de diámetro en la mama de una niña de 13 años. Se realiza estudio radiológico e histológico de la lesión siendo categorizada como un fibroadenoma gigante juvenil por lo que se realiza tumorectomía completa con remodelación mamaria posterior. A los dos meses de seguimiento, la paciente se encuentra sin signos de recidiva, con buena situación general y a la espera de cirugía de remodelación mamaria.

ABSTRACT Juvenile giant fibroadenoma is a benign breast tumor and a rare variant of fibroadenomas. The clinical presentation is usually a painless, fast growing, unilateral tumor mass. In this article we present the case of a giant juvenile fibroadenoma of 12 cm in diameter in the breast of a 13-year-old girl. A radiological and histological study of the lesion was carried out and it was categorized as a juvenile giant fibroadenoma, so a complete lumpectomy with posterior breast remodeling was performed. After two months of follow-up, the patient is without signs of recurrence, in good general condition and waiting for the breast remodeling surgery.

Study of spectrum and clinical profile of benign breast disease in the rural area: is there any change

Background: Recent understanding of pathophysiology and health awareness may have impact on spectrum of benign breast disease (BBD) in rural area. We have analyzed clinical data of 88 cases of BBD for spectrum and clinical profile to compare with present studies.Methods: Clinical records of 88 cases of BBD were reviewed for demographic details, clinical presentation, management and outcome. Recent literature related to BBD in rural area was searched using various search engines. Results of our study were compared with recent studies.Results: Fibroadenoma (FA) was most common condition followed by fibrocystic disease. BBD were common in third decade 46 (52.3%). Lump was present in 87 cases. Lump was painful in 45 (52.3%), and associated with fever in 15 (17.1%) cases. Fine needle aspiration cytology and ultrasound was done in 70 and 32 patients in which diagnostic accuracy with histopathology was seen in 69.7% and 56.2% respectively. Surgical treatment included lumpectomy, lump excision, mastectomy, drainage with debridement and axillary clearance. Three patients of breast tuberculosis were treated with 9 months AKT. When compared with recent studies, over all spectrum was same expect chronic abscess presenting as lump was more in our series.Conclusions: Our study revealed benign neoplasms, inflammatory condition and tumor like lesions in 43.1%, 14.6% and 13.8% cases respectively. FA was the most common lesion. BBD were common in third decade. Except the chronic mastitis, incidence of various types of benign lesions was comparable with those found in other studies. There is not much change in overall spectrum of benign breast disease.

An audit and clinicopathological study of fibroepithelial lesions of the breast at a tertiary care centre and comparison with WHO grading

Background: Mammary fibroepithelial lesions encompass a wide spectrum of tumors ranging from an indolent fibroadenoma to potentially fatal malignant phyllodes tumor (PT). The criteria used for their classification based on morphological assessment are often challenging to apply and there is no consensus as to what constitutes an adequate resection margin. The aims of the study were to study histopathological spectrum of fibroepithelial lesions of breast at tertiary care centre, to stratify and classify various fibroepithelial lesions into fibroadenomas and PT, reclassify all confirmed cases of PT seen in the study period according to standard histopathological WHO criteria.Methods: Records and slides of fibroepithelial lesions of the breast received at the department between January 2016 and August 2019 were retrieved and reviewed.Results: A total 891 fibroepithelial lesions of breast were diagnosed during this duration. Out of these, 826 (92.7%) were fibroadenoma and its variants, 34 (3.8%) cases were of fibroadenomatoid mastopathy and 31(3.5%) were PT. Among all PT, 8 (25.8%) were borderline and 4 (12.9%) were malignant, rest (61.3%) were benign.Conclusions: Fibroepithelial tumours of the breast are a heterogenous group of lesions ranging from fibroadenoma at the benign end of the spectrum to malignant PT. There are overlapping histologic features among various subtypes, and transformation and progression to a more malignant phenotype may also occur. Given the significant clinical differences within various subtypes, accurate pathologic classification is important for appropriate management. Although some immunohistochemical markers may be useful in this differential diagnosis, histomorphology still remains the gold standard.

A Histopathological Study of Malignant Lesions of the Female Breast in a Tertiary Care Centre.

Incidence of breast malignancy is increasing in India which can be attributed mostly to changing lifestyle and increased hormone usage, and partly to increasing awareness. We wanted to determine the prevalence of malignant breast lesions in females, evaluate the histological spectrum of malignant breast lesions and study their association with common findings like age, side, histological grade and their biological behaviour.METHODSPresent study is a two-year (August 2016 to July 2018) cross sectional study of malignant lesions of female breast, conducted in the Department of Pathology of Jawaharlal Lal Nehru Medical College, Ajmer, Rajasthan.RESULTSIn this study, 159 malignant lesions of the female breast were diagnosed during study period that comprised of 26.02% of total breast lesions and 1.22 % of the total histopathological samples received. Age of the females having malignant breast lesions ranged from 28 years to 92 years with a mean age of 52.87 ± 12.944 years. The incidence of malignant breast lesions was maximum in 5th and 4th decades of life. The most common clinical symptom for presentation was the palpable lump (79.25%) in the breast. Lesions were more common in the right breast (53.5%), than left. The commonest quadrant involved in malignant lesions of breast was upper outer (30.19%). Infiltrating ductal cell carcinoma was the most common malignant lesion (85.33%) followed by invasive lobular carcinoma (5.66%). Out of 99 specimens having lymph node with it, 65 (65.66%) cases show metastatic deposits of malignancy. Grade II (MBR score) lesions (51.35%) were found most commonly.CONCLUSIONSHistopathology of the malignant lesion is useful in understanding the morphological and biological behaviour of the malignancy as some types of malignancy have aggressive behaviour. Grading and staging have an important role in treatment plan (surgery, radiotherapy, chemotherapy and hormonal therapy) and also in assessing the prognosis

Presentation of a Case Report and Literature Review on Granular Cell Tumour of the Breast

A 21 years old woman presented with a breast swelling of 4 years duration and with an associated pain of a more recent onset. On clinical examination, the mass was found to be firm, mobile and without attachment to the skin or surrounding structures. An excisional biopsy was performed based on a provisional clinical diagnosis of fibroadenoma. However, histological evaluation showed the tumour to be a granular cell tumour. The clinical features of this rare tumour may mimic a variety of conditions and cause a diagnostic dilemma

Fibroadenoma como causa de tumor en la vulva. Presentación de caso / Fibroadenoma as the cause of tumor in the vulva. A case report

Introducción: El fibroadenoma es una lesión bastante común en mama, pero su localización en la región vulvar es extremadamente rara, con alrededor de sesenta casos, descritos en la literatura. Se presenta como una masa unilateral, subcutánea y asintomática, de crecimiento insidioso. El tamaño de este tipo de lesión varía entre 1 y 12 cm en los casos reportados hasta la fecha. A pesar de ser infrecuentes, las tumoraciones a nivel vulvar continúan siendo importante motivo de consulta. La histogénesis de este tipo de lesiones ha sido tema de discusión en los últimos años, sobresalen dos teorías: la presencia de tejido mamario ectópico, y la degeneración tumoral de un grupo de glándulas similares a tejido mamario, descritas como componente habitual de la región. Objetivo: Aportar un diagnóstico diferencial polémico de tumores vulvares. Presentación del caso: Se presenta una paciente de 22 años con diagnóstico histopatológico de fibroadenoma de vulva. Se realiza exéresis de la lesión, la cual al examen macroscópico midió aproximadamente 15 cm en su eje longitudinal (la más grande reportada en la literatura). Conclusiones: A pesar de su baja frecuencia de presentación, el fibroadenoma de vulva es una entidad a tener en cuenta como diagnóstico diferencial de los tumores subcutáneos de localización vulvar(AU)

Introduction: Fibroadenoma is a fairly common lesion in the breast tissue, but its location in the vulvar region is extremely rare, with about 60 specific cases in the literature. It is presented as a unilateral, subcutaneous and asymptomatic mass, with insidious growth. The size of this type of lesion is between 1 and 12 cm in the cases reported to date. Despite being infrequent, vulvar tumors continue to be important reasons for medical consultation. The histogenesis of this type of lesions has been the subject of discussion in recent years; two theories stand out: the presence of ectopic breast tissue, and tumor degeneration of a group of glands similar to breast tissue described as a common component of the region. Objective: To providea polemic differencial diagnosis of vulvar tumors. Case presentation: We present a 22-year-old patient with histopathological diagnosis of vulvar fibroadenoma. Excision of the lesion was performed, which at the macroscopic examination measured approximately 15 cm in its longitudinal axis (the largest reported in the literature). Conclusions: Despite its low frequency of presentation, vulvar fibroadenoma needs to be considered as differencial diagnosis of vulvar tumors(AU)

Clinical and pathological correlation in benign breast diseases in women

Background: Benign breast diseases are a common problem presenting in a day to day surgical practice. A combination of three tests i.e. clinical examination, radiological imaging and pathological examination is commonly used to accurately diagnose breast diseases. This study was aimed to know the clinico-pathological correlation in diagnosing benign breast diseases in women.Methods: A study of 30 female patients of benign breast disease was conducted by clinical examination and comparing its accuracy with the pathological findings.Results: The highest incidence of benign breast diseases was in the age group of 30-39 years (33.3%). The most common presenting symptom was lump (53.3%) in the breast. The most common quadrant involved was the upper outer quadrant (60%). Fibroadenoma (53.3%) was the most common lesion in this study. The clinical examination in cases of fibroadenoma had sensitivity and specificity of 87.5 % and 92.8% respectively. In cases of fibrocystic disease, clinical examination had sensitivity and specificity of 85.7 % and 91.3% respectively.Conclusions: Overall clinical breast examination had a sensitivity of 90% and specificity of 98% in this study. Hence, combination of all three diagnostic modalities i.e. clinical, radiological and pathological examination should be used. But in rural areas where radiological and pathological facilities are not available, clinical examination can also give us a fair amount of idea in diagnosing benign breast diseases.

Study of Histomorphological Spectrum of Benign Breast Diseases in a Tertiary Care Centre of Mumbai

Breast, a modified sweat gland exhibits a wide spectrum of pathological lesions, usually presenting as palpable masses ranging from inflammatory to neoplastic lesions. Neoplastic lesions can be either benign or malignant. These lumps are always a cause of anxiety to the patients and their family members.1 Breast diseases are showing a rising trend worldwide. A number of studies have been done in order to know the magnitude of the problem. The present study was undertaken with an aim to determine the incidence and the histopathological spectrum of various benign breast lesions at our institute.METHODSThe present study of the breast lesions was performed in the department of pathology in a general teaching hospital and tertiary referral health care centre in Mumbai. The information and data from clinical records was collected and analysed.RESULTSA total of 953 cases of breast lesions was studied and analyzed over a period of 10 years and 10 months. Of the total 953 cases, 653 (68%) cases were benign lesions. Fibroadenoma (63%) was the commonest lesion followed by inflammatory lesions (12%) and benign phyllodes tumour (5.7%).CONCLUSIONSThe term “benign breast diseases” encompasses a heterogeneous group of lesions that may present with a wide range of symptoms or may be detected as incidental microscopic findings, and these are more frequent lesions of breast than malignant ones. Histopathological study plays important role to reach the correct diagnosis in certain benign breast diseases which mimic cancers clinically. Present study is in concordance with other studies showing fibroadenoma as commonest benign breast lesion.

Role of ormeloxifene in regression of benign breast diseases

Background: Benign breast diseases are common pathological entities with which women in her early reproductive age present to OPD with fear of malignancy and significant morbidity. Except for surgery and use of non-selective estrogen receptor blockers, there are no other treatment options, and these have lot side effects. Ormeloxifene a newer drug has shown promising results with minimal side effects and used as the first line of treatment reducing the morbidity of surgery and subjecting the patient to less hormonal side effects.Methods: Diagnosis of benign breast diseases was made by baseline investigation which included measurement of size of fibroadenoma using Vernier caliper and USG, fibroadenosis,ie nodularity measured using  Lucknow-Cardiff scale and VAS score was used for pain assessment of mastalgia after which patients will be given the drug and  placebo and the response for the drug and its side effects are noted.Results: 61.9% (44) were diagnosed with fibroadenoma, 16.9% (12) with fibroadenosis and 21.1% (15) with mastalgia. Lucknow Cardiff score for fibroadenosis exhibited 50% had smooth breasts with no nodularity at the end of six months, in fibroadenoma group 52% showed decrease in size and 31% showed complete disappearance of the lump and in the mastalgia group 40% had no pain (VAS score of 0). 16(22.5%) of had menstrual abnormality as the major side effect.Conclusions: Ormeloxifene can be used as the first line of treatment in patients with fibroadenosis and mastalgia and used as an alternative to surgery for fibroadenoma.

Phyllodes tumor presented as fungating mass on right breast and fibroadenoma on contralateral breast: a case report

This is an article reporting a large phyllodes tumor with fibroadenoma. A 25 years female presented with a fungating mass of size 20×15 cms in right breast since last 1 year and amass of size 3×3 cms in left breast since 6 month. Biopsy from right side and left side breast mass proven to be Cystosarcomaphyllodes and fibroadenoma respectively. Wide local excision with 1cm normal tumor margin on right side and   excision of mass on left side done. Proliferative markers like Ki-67 and P53 were in range of 1-2% and 3-4% respectively. Histopathological diagnosis of tumor was borderline phyllodes tumor (right side) and fibroadenoma (left side). Patient had an uneventful post-operative course and is presently on three monthly follow up since 1 year.