Fibroadenoma of breast make it a perfect mbbs university exam answer with required subheading answer for 5 marks questions
Here is a complete, exam-ready 5-mark answer on Fibroadenoma of the Breast, structured for MBBS university examinations:
FIBROADENOMA OF THE BREAST
Definition
Fibroadenoma is the most common, benign fibroepithelial neoplasm of the female breast. It shows biphasic proliferation of both epithelial and stromal components, arising from the intralobular stroma.
Epidemiology / Age Group
- Most common in females between 20-30 years of age.
- Growth is hormonally influenced - tumors may enlarge rapidly during pregnancy and regress after menopause.
Clinical Features
- Presents as a palpable, freely movable, well-circumscribed mass.
- The characteristic mobility on examination earns it the name "breast mouse."
- Usually solitary, but may be multiple or bilateral.
- Non-tender, smooth, rubbery consistency.
Morphology
Gross Appearance
| Feature | Description |
|---|---|
| Shape | Solid, round to ovoid |
| Circumscription | Well-circumscribed, not fixed |
| Cut section | Uniform, rubbery, lobulated, glistening grayish-white nodule |
| Slit-like spaces | Present on cut surface |
| Size | Usually 1-4 cm in diameter |
The tumor compresses surrounding breast tissue but does not invade it.
Microscopy
Fibroadenomas contain a mixture of:
-
Neoplastic epithelial component - Ducts lined by a double layer of epithelium ranging from normal lobules to varying degrees of hyperplasia; ducts may be simple/round or elongated/branching.
-
Neoplastic stromal component - Fibrous connective tissue stroma that is uniform, delicate, myxoid, and of low cellularity; resembles normal intralobular (peritubular) stroma; contains spindle cells without atypia.
Growth Patterns (Two Types)
- Pericanalicular pattern: Epithelium forms round or oval tubules with patent lumen; proliferating stromal cells grow around open ducts in a circumferential fashion.
- Intracanalicular pattern: Stromal growth compresses ducts into curvilinear slits (clefts); ducts appear distorted.
Both patterns may coexist and have no prognostic significance.
Hormonal Changes
- Pregnancy: Epithelial component may show lactational changes; glands increase in size.
- Post-menopause: Stroma becomes more fibrous and densely hyalinized; may calcify forming "popcorn" calcifications on mammography.
Variants
| Variant | Key Feature |
|---|---|
| Juvenile fibroadenoma | Most common in adolescent girls; grows rapidly; may reach 20 cm; stroma is more cellular; does not recur after excision |
| Tubular adenoma | Closely packed tubular structures with small lumina; very scanty stroma |
| Lactating adenoma | Occurs during pregnancy/postpartum; composed of normal-appearing breast acini with secretory activity |
Malignant Potential
- Malignant transformation is extremely rare (<0.3%).
- Fibroadenoma is considered a benign lesion with an excellent prognosis.
Treatment
- Surgical excision (lumpectomy) is the treatment of choice.
- Does not recur after complete excision.
Exam Tip: Remember the key triad - young woman + freely mobile breast lump ("breast mouse") + biphasic (epithelial + stromal) histology = Fibroadenoma.
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