Recurrent Multiple Fibroadenomas: History of a Case Presented in MDT Meeting With Clinical Discussion and Decision Making

Main Article Content

Negar Mashoori
Abdolali Assarian
Sanaz Zand
Erica Patocskai

Keywords

Multiple fibroadenomas, Recurrent fibroadenomas, Benign breast masses, Management, Multidisciplinary team (MDT)

Abstract

Background: Fibroadenoma is a common benign breast disorder in young women which has a low risk of malignant transformation. Most fibroadenomas present as a single mass, but the presence of multiple fibroadenomas can be seen in 15–20% of patients, with average number of 3–4 masses in one breast. In different studies and reports, various treatment modalities-including observation and follow up, surgery, radiofrequency ablation, etc- have been proposed, though the best management for these patients are not determined yet.


Case presentation: We present the case of 33-year-old female with history of multiple bilateral benign breast lesions with a presumptive diagnosis of fibroadenomas. She had three previous surgical excisions in the past 14 years. Her case was presented to a breast MDT meeting to obtain a recommendation on appropriate management.


Question: The proposed a question in MDT concerned the best and most appropriate management plan for the patient; Does she require further surgical excisions? And if not, how should she be followed?


Conclusion: After reviewing past medical history, physical examination, and all documents regarding the patient, MDT members recommended that the patient should be managed with close follow up with physical examination and ultrasound every 6 months. The necessity of further surgical intervention would be determined according to any new findings.

References

1. Li P, Xiao-Yin T, Cui D, Chi JC, Wang Z, et al. Evaluation of the safety and efficacy of percutaneous radiofrequency ablation for treating multiple breast fibroadenoma. J Cancer Res Ther. 2016;12(Supplement):C138-C42.
2. Panda SK, Patro B, Mishra J, Dora RK, Subudhi BS. Multiple fibroadenomas in bilateral breasts of a 46-year-old Indian woman - A case report. Int J Surg Case Rep. 2014;5(5):262-4.
3. Rao S, Latha PS, Ravi A, Thanka J. Ductal carcinoma in a multiple fibroadenoma: diagnostic inaccuracies. J Cancer Res Ther. 2010;6(3):385-7.
4. Camara O, Egbe A, Koch I, Herrmann J, Gajda M, et al. Surgical management of multiple bilateral fibroadenoma of the breast: the Ribeiro technique modified by Rezai. Anticancer Res. 2009;29(7):2823-6.
5. Zhang Y, Kleer CG. Phyllodes Tumor of the Breast: Histopathologic Features, Differential Diagnosis, and Molecular/Genetic Updates. Arch Pathol Lab Med. 2016;140(7):665-71.
6. Duman L, Gezer NS, Balcı P, Altay C, Başara I, et al. Differentiation between Phyllodes tumors and fibroadenomas based on Mammographic Sonographic and MRI features. Breast Care. 2016;11(2):123-7.
7. Dhar A, Srivastava A. Role of centchroman in regression of mastalgia and fibroadenoma. World J Surg. 2007;31(6):1178-84.
8. Gordon PB, Gagnon FA, Lanzkowsky L. Solid breast masses diagnosed as fibroadenoma at fine-needle aspiration biopsy: acceptable rates of growth at long-term follow-up. Radiology. 2003;229(1):233-8.
9. Cant P, Madden M, Coleman M, Dent D. Non‐operative management of breast masses diagnosed as fibroadenoma. British journal of surgery. 1995;82(6):792-4.
10. Carty NJ, Carter C, Rubin C, Ravichandran D, Royle GT, et al. Management of fibroadenoma of the breast. Ann R Coll Surg Engl. 1995;77(2):127-30.
11. Pasta V, Tintisona O, Vergine M, Martino G, Torcasio A, et al. [Multiple repetitive mammary fibroadenomas. Case report]. G Chir. 2007;28(5):209-12.
12. Williamson ME, Lyons K, Hughes LE. Multiple fibroadenomas of the breast: a problem of uncertain incidence and management. Ann R Coll Surg Engl. 1993;75(3):161-3.
13. Lai H-W, Kuo Y-L, Su C-C, Chen C-J, Kuo S-J, et al. Round block technique is a useful oncoplastic procedure for multicentric fibroadenomas. the surgeon. 2016;14(1):33-7.
14. Povoski SP. The utilization of an ultrasound-guided 8-gauge vacuum-assisted breast biopsy system as an innovative approach to accomplishing complete eradication of multiple bilateral breast fibroadenomas. World journal of surgical oncology. 2007;5(1):124.