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1.
Ann Diagn Pathol ; 62: 152069, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36527840

RESUMO

In cases of growth of FA on imaging, core needle biopsies (CNB) are often performed to rule out phyllodes tumor (PT). We aim to focus on "growing FAs" and to identify clinical and histopathologic features that are likely to predict a PT on excision. Thirty-four FAs with radiologic documentation of growth were included. Various clinical and pathological features such as age, body mass index (BMI), lesion size, and growth rate were recorded. On excision, 17 cases (50 %) were FAs, whereas 16 (47 %) were re-classified as benign PT despite only 19 % being suspicious for PT on CNB. PT patients were older (mean age 42.6) than those with FAs (mean age 28.2), p = 0.0002. All false negative cases demonstrated intracanalicular growth. Mitotic rate was the most significant histologic feature in PT on excision compared to others, such as lesion circumscription and stromal cellularity. Recognition and careful counting of mitotic rate, especially with intracanalicular patterns in growing FAs, can potentially prevent missing a PT on CNB. In patients with "growing FAs" who are ≥40 years of age, excision may be recommended due to the high likelihood of PT diagnosis on excision and high false negative rate on CNB.


Assuntos
Neoplasias da Mama , Fibroadenoma , Fibroma , Tumor Filoide , Humanos , Adulto , Feminino , Tumor Filoide/diagnóstico , Tumor Filoide/cirurgia , Tumor Filoide/patologia , Fibroadenoma/diagnóstico , Fibroadenoma/cirurgia , Fibroadenoma/patologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/cirurgia , Neoplasias da Mama/patologia , Biópsia com Agulha de Grande Calibre/métodos , Células Estromais/patologia , Diagnóstico Diferencial , Fibroma/diagnóstico
2.
Breast Dis ; 41(1): 421-426, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36565097

RESUMO

BACKGROUND: Fibroadenomas are common among young females. The size of the lesion used to be an indication for further assessment or excision. With arising of the watch and see proponents, criteria for selecting patients are important to establish. METHODS: This is a retrospective study of a prospectively maintained database where all patients having the clinical/radiological provisional diagnosis of fibroadenoma and attending our center - from January 2008 to March 2020 - were enrolled. The primary outcome was the incidence of malignancy and the secondary outcomes were the correlation of malignancy-risk with epidemiologic and radiologic criteria. RESULTS: The study enrolled 1392 patients. The mean age of the patients was 35.7 + ∕- 13.1 years. The median of the longest diameter of the detected breast lesions was 25 mm. The incidence of malignancy was 188 (13.5%). The size of the lesion measured by largest diameter was insignificant (p = 0.99), while the patients' age, marital status, and imaging criteria as measured by BIRADS score were significant (<0.001). CONCLUSION: Approaching patients with the age above 35 or with BIRADS 4 provisionally diagnosed with fibroadenomas should be cautious with biopsy and short-term follow-ups The size of the tumor alone should not be used as an indication for surgical intervention.


Assuntos
Neoplasias da Mama , Fibroadenoma , Tumor Filoide , Feminino , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/diagnóstico , Fibroadenoma/diagnóstico , Fibroadenoma/epidemiologia , Fibroadenoma/cirurgia , Incidência , Estudos Retrospectivos , Mama/diagnóstico por imagem , Mama/cirurgia , Mama/patologia , Tumor Filoide/patologia
3.
PLoS One ; 17(11): e0277823, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36399450

RESUMO

INTRODUCTION: Fibroadenomas are benign lesions found in the breast tissue. Widespread access to and use of the internet has resulted in more individuals using online resources to better understand health conditions, their prognosis and treatment. The aim of this study was to investigate the readability and visual appearance of online patient resources for fibroadenoma. METHODS: We searched GoogleTM, BingTM and YahooTM on 6 July 2022 using the search terms "fibroadenoma", "breast lumps", "non-cancerous breast lumps", "benign breast lumps" and "benign breast lesions" to identify the top ten websites that appeared on each of the search engines. We excluded advertised websites, links to individual pdf documents and links to blogs/chats. We compiled a complete list of websites identified using the three search engines and the search terms and analysed the content. We only selected pages that were relevant to fibroadenoma. We excluded pages which only contained contact details and no narrative information relating to the condition. We did not assess information where links were directed to alternative websites. We undertook a qualitative visual assessment of each of the websites using a framework of pre-determined key criteria based on the Centers for Medicare and Medicaid Services toolkit. This involved assessing characteristics such as overall design, page layout, font size and colour. Each criterion was scored as: +1- criterion achieved; -1- criterion not achieved; and 0- no evidence, unclear or not applicable (maximum total score 43). We then assessed the readability of each website to determine the UK and US reading age using five different readability tests: Flesch Kincaid, Gunning Fog, Coleman Liau, SMOG, and the Automated Readability Index. We compared the readability scores to determine if there were any significant differences across the websites identified. We also generated scores for the Flesh Reading Ease as well as information about sentence structure (number of syllables per sentence and proportion of words with a high number of syllables) and proportion of people the text was readable to. RESULTS: We identified 39 websites for readability and visual assessment. The visual assessment scores for the 39 websites identified ranged from -19 to 31 points out of a possible score of 43. The median readability score for the identified websites was 8.58 (age 14-15), with a range of 6.69-12.22 (age 12-13 to university level). There was a statistically significant difference between the readability scores obtained across websites (p<0.001). Almost half of the websites (18/39; 46.2%) were classified as very difficult by the Flesch Reading Ease score, with only 13/39 (33.33%) classified as being fairly easy or plain English. CONCLUSION: We found wide differences in the general appearance, layout and focus of the fibroadenoma websites identified. The readability of most of the websites was also much higher than the recommended level for the public to understand. Fibroadenoma website information needs to be simplified to reduce the use of jargon and specificity to the condition for individuals to better comprehend it. In addition, their visual appearance could be improved by changing the layout and including images and diagrams.


Assuntos
Neoplasias da Mama , Fibroadenoma , Fibroma , Idoso , Humanos , Estados Unidos , Adolescente , Criança , Feminino , Compreensão , Medicare , Leitura , Ferramenta de Busca
4.
Surg Clin North Am ; 102(6): 1017-1030, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36335922

RESUMO

Breast stromal lesions include fibroadenomas, phyllodes tumors, pseudoangiomatous stromal hyperplasia, periductal stromal tumors, and lipomas. Most of these lesions are benign and can be managed with observation or surgical excision. Phyllodes tumors, however, are subcategorized into benign, borderline, and malignant. Benign phyllodes tumors may be removed without a margin of breast tissue while borderline and malignant phyllodes tumors need a wide excision with a greater than 1 cm margin. Because malignant phyllodes tumors have a poor prognosis, efforts should be made to discuss their treatment in a multidisciplinary setting and enrollment in a clinical trial should be considered.


Assuntos
Neoplasias da Mama , Fibroadenoma , Tumor Filoide , Humanos , Feminino , Tumor Filoide/diagnóstico , Tumor Filoide/cirurgia , Fibroadenoma/patologia , Margens de Excisão , Neoplasias da Mama/cirurgia
5.
Br J Hosp Med (Lond) ; 83(10): 1-9, 2022 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-36322437

RESUMO

Fibroadenoma is the most common cause of benign breast lumps and is typically seen in women under the age of 40 years. Fibroadenomas are classified as simple, complex, giant, myxoid or juvenile. They present as smooth, rubbery, mobile masses on palpation. Ultrasonographic and mammographic features typical of fibroadenomas include solid, round, well-circumscribed masses, with or without lobulated features. They are predominantly treated conservatively although clinical pathways recommend referral for triple assessment. Surgical intervention is indicated by the presence of one or more of the following features: the presence of symptoms, a diameter greater than 2 cm, rapid growth rate, complex features, disease recurrence or patient anxiety.


Assuntos
Neoplasias da Mama , Fibroadenoma , Feminino , Humanos , Adulto , Fibroadenoma/diagnóstico por imagem , Fibroadenoma/cirurgia , Mamografia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Registros
6.
Rev. senol. patol. mamar. (Ed. impr.) ; 35(4): 316-319, oct.-dic. 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-211075

RESUMO

El fibroadenoma es la lesión mamaria benigna más frecuente en la mujer joven, siendo el fibroadenoma gigante juvenil una entidad que aparece principalmente en menores de 25 años. Con una etiología actualmente no bien establecida, se caracteriza por ser una lesión tipo masa mayor de 5cm que puede ocupar más del 80% de la mama y que presenta un importante crecimiento con las consecuencias físicas y psicológicas que ello conlleva. A pesar de ser una lesión benigna, su evolución progresiva con un rápido crecimiento obliga a descartar malignidad, lo cual ocurre en menos del 0,2% de los casos. El diagnóstico se basa en una correcta anamnesis, exploración física y pruebas complementarias, siendo preferible la ecografía. El estudio anatomopatológico mediante biopsia permite confirmar el diagnóstico clínico de benignidad o descartar malignidad ante una evolución sospechosa. El tratamiento es quirúrgico y consiste en la escisión completa de la lesión variando la técnica quirúrgica realizada (desde cirugía conservadora hasta mastectomía con reconstrucción) según el tamaño de la lesión, las características de la mama y la edad de la paciente. (AU)


Fibroadenoma is the most common benign breast lesion in young women, being the giant juvenile fibroadenoma an entity that appears mainly in those under 25 years. With an etiology currently not well established, it is described as a mass type lesion greater than 5cm or that occupies more than 80% of the breast and presents significant growth, with the physical and psychological consequences that this entails. Despite being a benign lesion, its fast evolution and growth makes it necessary to rule out malignancy, which occurs in less than 0.2% of the cases. The diagnosis is based on a correct anamnesis, physical examination and complementary tests, preferable with ultrasound. The anatomopathological study by biopsy allows to confirm the clinical diagnosis of benignity or to rule out malignancy in the event of a suspicious evolution. Its management is surgical and consists of complete excision of the lesion, varying the surgical technique performed (from conservative surgery to mastectomy with reconstruction) according to the size of the lesion, the characteristics of the breast, and the age of the patient. (AU)


Assuntos
Humanos , Feminino , Adolescente , Mama/anormalidades , Mama/cirurgia , Fibroadenoma/cirurgia , Fibroadenoma/etiologia , Mamoplastia
7.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 49(4): 100767-100767, Oct-Dic. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-211844

RESUMO

Los tumores benignos más comunes de la mama son los fibroadenomas simples. Son tumores sólidos con tejido glandular y fibroso. Aquellos que presentan un tamaño mayor de 5cm se denominan fibroadenomas gigantes. Estos pueden presentar un rápido crecimiento, por lo que se debe realizar un diagnóstico diferencial con el tumor phyllodes u otras enfermedades mamarias.Presentamos el caso de una paciente de 15 años con un fibroadenoma que comenzó con asimetría mamaria y precisó tratamiento quirúrgico mediante abordaje inframamario y enucleación de la masa, con buen resultado estético posterior. Revisamos la bibliografía al respecto.(AU)


Simple fibroadenomas are the most frequent benign tumours of the breast. They are solid tumours with glandular and fibrous tissue. They can present as a mass greater than 5cm, called giant fibroadenomas. The presentation of a rapidly growing mass cannot be easily distinguished from phyllodes tumour or other pathologies.We report the case of juvenile fibroadenoma of the breast in a 15-year-old woman who presented at our hospital with breast asymmetry. She underwent fibroadenoma excision, using inframammary access with good cosmetic outcomes. A detailed literature search and management of these lesions are discussed.(AU)


Assuntos
Humanos , Feminino , Adolescente , Fibroadenoma , Doenças Mamárias , Neoplasias da Mama , Pacientes Internados , Exame Físico , Avaliação de Sintomas , Atenção Primária à Saúde , Ginecologia , Obstetrícia , Unidade Hospitalar de Ginecologia e Obstetrícia
8.
J Med Case Rep ; 16(1): 341, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36071506

RESUMO

BACKGROUND: Accessory breast(s) is defined as the presence of more than two breasts with or without a nipple and areola in human beings. It may occur anywhere along the primitive embryonic milk lines, which extend from the axilla to the groin. Accessory breast tissue can potentially undergo the same physiological and pathological processes as the normally located breast, including lactational change, fibroadenoma, and carcinoma. Although common in the normally located breast tissue, the incidence of fibroadenoma in accessory breast tissue is rare. Furthermore, if the swelling occurs in the axilla or groin, it may present a diagnostic challenge by clinically mimicking a lymphoma or other causes of lymphadenopathy. Owing to its rarity and its tendency to pose a clinical diagnostic challenge, we decided to report a case of fibroadenoma in axillary accessory breast. CASE PRESENTATION: A 28-year-old Ethiopian female patient came to University of Gondar comprehensive specialized hospital with a complaint of left axillary swelling of 3 years duration. There was no history of cough, fever, weight loss, or night sweating. On physical examination, there was an approximately 5 × 4 cm, firm, well-defined, mobile, nontender solitary mass in the left axilla that was completely separated from the left breast. Fine-needle aspiration cytology suggested a diagnosis of fibroadenoma in axillary accessory breast tissue. The mass was completely excised, and histopathologic examination confirmed the diagnosis. Her recovery was uneventful. She was informed about the diagnosis, reassured, and discharged from care. CONCLUSION: In the clinical evaluation of a patient with axillary swelling, accessory breast tissue disorders such as fibroadenoma must be considered as a differential diagnosis for early diagnostic workup and management. Moreover, this case underscores the fact that, similar to normal breast tissue, accessory breast tissue is also susceptible to the same pathologic disease processes including neoplasms such as fibroadenoma.


Assuntos
Doenças Mamárias , Neoplasias da Mama , Coristoma , Fibroadenoma , Fibroma , Adulto , Axila/patologia , Mama/patologia , Doenças Mamárias/diagnóstico , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Coristoma/diagnóstico , Coristoma/patologia , Coristoma/cirurgia , Feminino , Fibroadenoma/diagnóstico , Fibroadenoma/patologia , Fibroadenoma/cirurgia , Humanos
9.
Int J Hyperthermia ; 39(1): 1238-1244, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36123038

RESUMO

OBJECTIVE: To explore the learning curve of high intensity focus ultrasound (HIFU) treatment for breast fibroadenoma. METHODS: A database of 110 patients with 255 breast fibroadenomas who underwent HIFU treatment at two different clinical centers (Center 1 and 2) were retrospectively analyzed. The learning curves of HIFU treatment for breast fibroadenoma were drawn by CUSUM analysis in two centers, respectively. According to the inflection point of the learning curves, the treatment was divided into two groups: initial phase and consolidation phase. HIFU treatment parameters were compared between two groups. The effectiveness and safety results were also evaluated. RESULTS: The inflection points of the learning curves were the 60th treatment in Center 1 and the 65th treatment in Center 2. The screening time, treatment time, sonication time and hyperechoic scale change time were significantly shorter in consolidation phase than those in initial phase of the two centers (p < 0.05). There were no differences in non-perfused volume (NPV) ratio and energy effect factor (EEF) between the two groups in Center 1, while in Center 2, these above-mentioned results in consolidation phase led to a greater improvement than those in initial phase. There was no difference of Visual Analogue Scale (VAS) scores and no adverse event observed in both centers. CONCLUSION: HIFU treatment for breast fibroadenoma was effective and safe. The learning curve of HIFU treatment for breast fibroadenoma can be completed after treating 60-65 tumors without increasing the safety risk.


Assuntos
Neoplasias da Mama , Fibroadenoma , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Feminino , Fibroadenoma/diagnóstico por imagem , Fibroadenoma/cirurgia , Humanos , Curva de Aprendizado , Estudos Retrospectivos , Ultrassonografia
10.
Asian Pac J Cancer Prev ; 23(9): 3201-3207, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36172685

RESUMO

BACKGROUND: According to several studies, there is an association between human papillomavirus (HPV) and breast cancer. Therefore, detection and genotyping of HPV seem important. The present study aimed to investigate the presence of HPV DNA in breast tissues  by analyzing the L1 gene. MATERIALS AND METHODS: This case-control study was conducted on 63 formalin-fixed paraffin-embedded (FFPE) tissues of invasive ductal carcinoma (IDC) as the case group and 32 FFPE tissues of fibroadenoma as the control group. HPV DNA was detected using the polymerase chain reaction assay. Positive samples were then subjected to genotyping. All statistical analyses were performed in SPSS version 22.0. RESULTS: The patients' age ranged from 15 to 92 years, with a mean age of 43.54±16.36 years. HPV DNA was detected in 17/95 (17.89%) samples, including 9/32 (28.12%) fibroadenoma samples and 8/63 (12.69%) IDC samples. No significant difference was observed regarding the presence of HPV DNA between the IDC and fibroadenoma tissues (P=0.08). However, a significant difference was found in the detection of high-risk HPV (HR-HPV) between the case and control groups (P=0.03). In the case group, 87.5% of the detected viruses (7/8 samples) were HR-HPV, while in the control group, 22.22% of positive samples (2/9 samples) were HR-HPV (P=0.03). Based on the results, HR-HPV and low-risk HPV genotypes were detected in 53% (9/17) and 47% (8/17) of positive samples, respectively. CONCLUSION: In this study, 12.69% of IDC samples were positive for HPV genomes, and HR-HPV was detected in 87.5% of these samples. The present results suggest the important role of HR-HPV in the development of breast cancer.


Assuntos
Alphapapillomavirus , Neoplasias da Mama , Carcinoma Ductal , Fibroadenoma , Infecções por Papillomavirus , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alphapapillomavirus/genética , Neoplasias da Mama/genética , Estudos de Casos e Controles , DNA , DNA Viral/genética , Feminino , Fibroadenoma/genética , Formaldeído , Humanos , Pessoa de Meia-Idade , Papillomaviridae/genética , Inclusão em Parafina , Adulto Jovem
11.
Afr J Paediatr Surg ; 19(4): 271-273, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36018214

RESUMO

Giant juvenile fibroadenomas, encountered usually in adolescents, are rapidly growing benign breast masses which lead to discomfort, anxiety and significant psychological stress. The breasts are in their early formative years, and thus, it is important to rule out malignancy as well as plan treatment options to preserve as much breast tissue as is possible. This report highlights a case of giant juvenile fibroadenoma diagnosed in a 12-year-old female child and our endeavour to achieve a good aesthetic result.


Assuntos
Neoplasias da Mama , Fibroadenoma , Adolescente , Mama , Criança , Feminino , Humanos
12.
Cytopathology ; 33(6): 707-715, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35869577

RESUMO

BACKGROUND: The clinical performance of the Yokohama reporting system for breast cytology remains uncertain. METHODS: In this study, we retrospectively evaluated 318 breast fine needle aspirations (FNABs) from Los Angeles County Hospital over a five-year period, analysing data for breast cytology, histology, and radiology. RESULTS: Among 318 breast FNAB cases, 78.3% (249/318) were benign and 5.3% (17/318) malignant. Of 83 cases with follow-up histology, 14.5% (12/83) were insufficient, 66.3% (55/83) were benign, and 16.9% (17/83) were malignant. Of 55 benign cases, 61.8% (34/55) were fibroadenoma and 9 (9/55, 16.4%) were fibrocystic changes. Two cases were diagnosed as "atypical" but confirmed "benign" on core needle biopsy (CNB). No "suspicious" cases were found. Seventeen malignant cases were confirmed by CNB, including 70.6% (12/17) invasive ductal carcinoma, 11.8% (2/17) invasive lobular carcinoma, and one malignant phyllodes tumour. Receptor studies on cell blocks of three malignant cases showed concordant results with CNB results. In addition, 82.2% (148/180) of lesions with Breast Imaging-Reporting and Data System (BI-RADS) scores of 2 or 3 were benign and 92.3% (12/13) BI-RADS score 5 lesions were malignant on FNAB. Finally, 90% (67/74) of BI-RADS 4a lesions were benign, and 97% (36/37) of fibroadenomas were BI-RADS score 4a. CONCLUSION: This, by far the largest U.S. breast cytology study, showed 93.3% sensitivity, 100% specificity, 100% positive predictive value, and 98.2% negative predictive value for breast FNAB. Women with breast lesions of BI-RADS score 3 or less have a low risk of malignancy; FNAB would contribute to the reduction of excisional biopsies. FNAB can be considered as an initial diagnostic tool for BI-RADS 4 mass/lesions and satellite lesions, as well as for triaging patients.


Assuntos
Neoplasias da Mama , Fibroadenoma , Biópsia por Agulha Fina , Mama/anormalidades , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Feminino , Fibroadenoma/diagnóstico , Hospitais , Humanos , Hipertrofia , Estudos Retrospectivos , Sensibilidade e Especificidade
13.
Virchows Arch ; 481(4): 519-531, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35906487

RESUMO

Typical phyllodes tumours (PTs) of the breast are fibroepithelial neoplasms characterised histologically by stromal hypercellularity and leaf-like structures. However, morphological changes may be atypical in some cases, increasing the difficulty of diagnosis and the likelihood of misdiagnosis. To provide more morphological clues for pathological diagnosis of PTs, we retrospectively analysed 52 PT cases with typical morphological features after recurrence, and summarized the clinicopathological characteristics of the paired primary tumours. We found five special histological features in the primary tumours distinct from classic PTs, namely (1) PTs with epithelioid feature (three cases); (2) PTs with gland-rich feature (eight cases); (3) PTs with fibroadenoma-like feature (20 cases); (4) PTs with myxoid fibroadenoma-like feature (five cases); and (5) PTs with pseudohemangiomatoid stromal hyperplasia-like feature (four cases). All the features can exist independently, and a few cases displayed more than two distinctive features at the same time. In this cohort of recurrent PTs, all the primary tumours were absent of recognisable stromal hypercellularity and leaf-like structures that are the critical diagnostic criteria of PTs; however, they showed some other non-classic characteristics which may provide significant clues for the diagnosis of PTs. Particularly, tumours with epithelioid feature displayed high grade at earlier stages, tumours with fibroadenoma-like feature were most likely to be confused with classical fibroadenomas, and tumours with myxoid feature were prone to be neglected because of their hypocellularity.


Assuntos
Neoplasias da Mama , Fibroadenoma , Tumor Filoide , Mama/patologia , Neoplasias da Mama/patologia , Feminino , Fibroadenoma/diagnóstico , Fibroadenoma/patologia , Humanos , Tumor Filoide/patologia , Estudos Retrospectivos
14.
BMJ Open ; 12(6): e057080, 2022 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-35760543

RESUMO

OBJECTIVE: To provide an accurate assessment of the prevalence of breast fibroadenoma in a large population and to confirm the diagnostic accuracy of ultrasound for fibroadenoma. DESIGN: This was a cross-sectional survey. SETTING: This research was conducted at Nanfang Hospital, Guangzhou, Guangdong, China. PARTICIPANTS: A total of 11 898 women aged 18-40 years who underwent breast screening between 1 January 2019 and 31 December 2019 were included in the fibroadenoma prevalence study. From 1 June 2019 to 31 December 2019, 342 breast lesions with pathology reports and preoperative ultrasound images were collected for diagnostic fibroadenoma testing (vs histological diagnostic testing). PRIMARY OUTCOME MEASURES: Pearson's χ2 test was performed to compare the prevalence of different lesions between age groups, and descriptive statistics were used to report the clinical characteristics of fibroadenoma. For ultrasound diagnosis, fibroadenoma was defined as a well-circumscribed lesion with round or oval shape, consisting of a homogeneously hypoechoic or isoechoic solid mass, located parallel to the chest wall with a smooth margin and no posterior shadowing. Diagnostic test results for breast fibroadenoma were stratified by diagnostic type (histological vs ultrasound). RESULTS: Of the women aged 18-40 years, 27.6% (3285/11 898) had an ultrasound diagnosis offibroadenoma. Of these, the prevalence of fibroadenoma was stable across age groups (p=0.14) and did not differ between the left and right sides of the breast. Almost two-thirds of women presented with a single fibroadenoma, and most fibroadenomas did not exceed 1 cm in size. The sensitivity and specificity for fibroadenoma were 97.0% (95% CI for sensitivity: 93.7% to 98.8%) and 91.4% (95% CI for specificity: 85.4% to 95.5%) for ultrasonography, respectively. CONCLUSIONS: The prevalence of fibroadenoma in South China is as high as 27.6%, and ultrasound could be used as a tool to diagnose fibroadenoma.


Assuntos
Neoplasias da Mama , Fibroadenoma , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , China/epidemiologia , Estudos Transversais , Feminino , Fibroadenoma/diagnóstico por imagem , Fibroadenoma/epidemiologia , Humanos , Exame Físico , Prevalência , Ultrassonografia Mamária/métodos
15.
Molecules ; 27(10)2022 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-35630817

RESUMO

Fibroadenomas (FAs) and phyllodes tumors (PTs) are major benign breast tumors, pathologically classified as fibroepithelial tumors. Although the clinical management of PTs differs from FAs, distinction by core needle biopsy diagnoses is still challenging. Here, a combined technique of label-free imaging with multi-photon microscopy and artificial intelligence was applied to detect quantitative signatures that differentiate fibroepithelial lesions. Multi-photon excited autofluorescence and second harmonic generation (SHG) signals were detected in tissue sections. A pixel-wise semantic segmentation method using a deep learning framework was used to separate epithelial and stromal regions automatically. The epithelial to stromal area ratio and the collagen SHG signal strength were investigated for their ability to distinguish fibroepithelial lesions. An image segmentation analysis with a pixel-wise semantic segmentation framework using a deep convolutional neural network showed the accurate separation of epithelial and stromal regions. A further investigation, to determine if scoring the epithelial to stromal area ratio and the SHG signal strength within the stromal area could be a marker for differentiating fibroepithelial tumors, showed accurate classification. Therefore, molecular and morphological changes, detected through the assistance of computational and label-free multi-photon imaging techniques, enable us to propose quantitative signatures for epithelial and stromal alterations in breast tissues.


Assuntos
Neoplasias da Mama , Fibroadenoma , Neoplasias Fibroepiteliais , Inteligência Artificial , Neoplasias da Mama/patologia , Computadores , Diagnóstico Diferencial , Feminino , Fibroadenoma/diagnóstico por imagem , Fibroadenoma/patologia , Humanos , Neoplasias Fibroepiteliais/diagnóstico
16.
Breast Cancer Res Treat ; 194(2): 307-314, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35639263

RESUMO

PURPOSE: Fibroepithelial lesions (FEL) range from benign fibroadenoma (FA) to malignant phyllodes tumor (PT), but can be difficult to diagnose on core needle biopsy (CNB). This study assesses risk factors for phyllodes tumor (PT) and recurrence and whether a policy to excise FELs over 3 cm in size is justified. METHODS: Patients having surgery for FELs from 2009 to 2018 were identified. The association of clinical, radiology and pathological features with PT and recurrence were evaluated. Trend analysis was used to assess risk of PT based on imaging size. RESULTS: Of the 616 patients with FELs, 400 were identified as having FA on CNB and 216 were identified as having FEL with a comment of concern for phyllodes tumor (query PT, QPT). PT was identified in 107 cases; 28 had CNB of FA (7.0%), while 79 had QPT (36.6%). Follow-up was available for 86 with a mean of 56 months; six patients had recurrence of PT, all of whom had QPT on CNB. The finding of PT was associated with CNB of QPT, increasing age and size on multivariate logistic regression. All patients diagnosed with PT following CNB of FA had enlarging lesions with a mean size of 38.3 mm. CONCLUSIONS: Our data does not support routine excision of FELs based on size alone. All patients with QPT on CNB, regardless of size should consider excision due to high risk of PT and recurrence, and the decision to excise FAs to rule out PT should also consider whether the lesion is enlarging.


Assuntos
Neoplasias da Mama , Fibroadenoma , Tumor Filoide , Biópsia com Agulha de Grande Calibre/métodos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/cirurgia , Feminino , Fibroadenoma/diagnóstico , Fibroadenoma/epidemiologia , Fibroadenoma/cirurgia , Humanos , Hipertrofia , Tumor Filoide/diagnóstico , Tumor Filoide/epidemiologia , Tumor Filoide/cirurgia , Estudos Retrospectivos
17.
Int J Hyperthermia ; 39(1): 743-750, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35634911

RESUMO

OBJECTIVE: To investigate the factors influencing the sonication dosage and efficiency of ultrasound-guided high intensity focused ultrasound (USgHIFU) for breast fibroadenomas. MATERIALS AND METHODS: Forty-nine patients with 78 breast fibroadenomas who underwent USgHIFU were retrospectively analyzed. The energy efficiency factor (EEF) was set as dependent variable, and the factors possibly influencing the sonication dosage, including age, body mass index (BMI), fibroadenoma size, distance from the shallow margin of the fibroadenoma to skin, distance from the deep margin of the fibroadenoma to pectoralis major, types of near field acoustic pathway, and Adler blood flow classification of ultrasound, were set as independent variables. The correlation between EEF and these independent variables were analyzed, and an optimal scaling regression model was established. RESULTS: Fibroadenoma size, distance from the shallow margin of the fibroadenoma to skin and type of near field acoustic pathway had significant correlation with EEF (p < 0.05). An EEF (y) dosimetry model of y= -0.496X1 + 0.287X2 + 0.203X3 was established, in which X1 stands for size of fibroadenoma, X2 stands for the distance from shallow margin of the fibroadenoma to skin, and X3 stands for type of near field acoustic pathway. The predicted EEF value was significantly related to actual EEF (R = 0.698, p = 0.000). CONCLUSIONS: Fibroadenoma size, distance from the shallow margin of the fibroadenoma to skin and type of near field acoustic pathway could be used as predictors to evaluate the dosage delivery of USgHIFU treatment for breast fibroadenomas.


Assuntos
Neoplasias da Mama , Fibroadenoma , Ablação por Ultrassom Focalizado de Alta Intensidade , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Feminino , Fibroadenoma/diagnóstico por imagem , Fibroadenoma/cirurgia , Humanos , Estudos Retrospectivos , Ultrassonografia , Ultrassonografia de Intervenção
18.
Semin Diagn Pathol ; 39(5): 333-343, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35523613

RESUMO

Breast fibroepithelial lesions, which are composed of biphasic epithelial and stromal proliferations, comprise the fascinating spectrum of fibroadenomas and phyllodes tumours. Common difficulties surrounding their diagnosis include distinguishing between cellular fibroadenomas and benign phyllodes tumours, grading phyllodes tumours, classifying fibroepithelial lesions in paediatric patients, and handling surgical margins. Recent molecular advances have provided insights into the pathogenesis of fibroepithelial lesions and may offer diagnostic, prognostic, and therapeutic information. In this review, we briefly revisit the pathological features of fibroadenomas and phyllodes tumours, discuss common diagnostic dilemmas and management implications, and examine their key molecular characteristics.


Assuntos
Neoplasias da Mama , Fibroadenoma , Tumor Filoide , Mama/patologia , Neoplasias da Mama/patologia , Criança , Feminino , Fibroadenoma/diagnóstico , Fibroadenoma/patologia , Humanos , Tumor Filoide/diagnóstico , Tumor Filoide/patologia
19.
Radiologia (Engl Ed) ; 64 Suppl 1: 49-53, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35428468

RESUMO

Cryoablation is a therapeutic technique that uses very low temperatures to destroy cells; transcutaneous cryoablation can be performed under imaging guidance. This simple procedure is done on an outpatient basis with local anesthesia. Cryoablation has proven effective in the treatment of benign breast lesions, such as fibroadenomas. Nowadays, its main use in malignant breast lesions is to reduce the size of the mass in cases where surgery is contraindicated. Nevertheless, other uses in malignant breast disease are being investigated. Cryoablation can strengthen the tumor response to immunotherapy. Likewise, in the near future, it may become an alternative to surgery for the local control of early-stage neoplasms. This article aims to describe our experience using cryoablation with liquid nitrogen to treat benign and malignant breast lesions and to review the fundamentals of the technique and its indications. Since 2019 we have used cryoablation to treat 7 benign and 9 malignant lesions without significant complications, achieving excellent esthetic outcomes. Cryoablation has been incorporated into our institution's breast unit's protocol.


Assuntos
Criocirurgia , Fibroadenoma , Mama , Criocirurgia/métodos , Fibroadenoma/diagnóstico por imagem , Fibroadenoma/cirurgia , Humanos
20.
Diagn Cytopathol ; 50(8): 375-385, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35429232

RESUMO

OBJECTIVE: This study has been designed in an effort to identify the clinico-radiological and cytological features that could effectively help in differentiating cellular fibroadenoma (CFA) and phyllodes tumors (PT), which have several overlapping characteristics. METHOD: Histologically proven cases of CFA and PT were reviewed. Cytological features were assessed and categorized. Clinical and radiological details were also evaluated and he the two groups were compared statistically. RESULTS: A total of 43 FA and 52 PT were specimens were reviewed. Mean age and tumor size for CFA and PT were 26.05 and 36.94 years, and 3.7 and 6.4 cm, respectively. Univariate analysis and regression models revealed that age >30 years, BIRADS grade of 4 or more, marked cellularity of stromal fragments, more than 30% spindle cells in background cell population and presence of traversing blood vessels in stromal fragments increased the odds of a tumor being phyllodes. The binary logistic regression model was able to predict PT accurately in 87.2% cases (p <  .001). CONCLUSION: PT and CFA could be differentiated if cytological findings are cautiously correlated clinically and radiologically. Age, BIRADS category along with assessment of stromal fragments and background population can effectively distinguish between CFA and PT.


Assuntos
Neoplasias da Mama , Fibroadenoma , Fibroma , Tumor Filoide , Adulto , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Feminino , Fibroadenoma/diagnóstico por imagem , Fibroadenoma/patologia , Fibroma/patologia , Humanos , Tumor Filoide/patologia , Células Estromais/patologia
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