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Morphologic study of the breast fibroadenomas: a comparative analysis between age groups

BACKGROUND: The increased interest in histological variations of fibroadenomas is due to the diagnostic difficulties found in small biopsies, as well as the slightly increased risk for carcinoma in cases of complex fibroadenoma. GOAL: Determine and compare the distribution of intratumoral epithelial and stromal alterations in young and older women. METHOD: Revision of gross and microscopy of 316 cases of fibroadenomas diagnosed in Department of Pathology at Hospital de Cancer de Pernambuco, from 1997 to 2000 (163 women with 15 to 39 years and 153 with 40 to 79 years). RESULTS: Pericanalicular pattern, normotrophic epithelium, adenosis, apocrine hyperplasia, typical hyperplasia, normo and hypercelular stroma prevailed in the younger group. Intracanalicular pattern, epithelial atrophy, intraductal calcification, stromal hyalinization and calcification were predominant in the older group. There was an association between intracanalicular pattern and myxoid stroma. The larger lesions were more commonly found in younger group as well as in cases showing pericanalicular pattern. These findings were statistically significant. There was no difference in incidence of complex fibroadenomas. DISCUSSION: Morphological elements that indicate lesion activity were more common in younger women, whereas involutive findings were more frequent in older group. CONCLUSION: The occurrence of a continuum of regressive alterations in fibroadenomas is confirmed by decrease in diameter, epithelial atrophy, stromal hyalinization and calcification. The study also suggests there is a progression from pericanalicular to intracanalicular pattern along the years, as well as a larger growth potential for those showing myxoid stroma, which is associated with intracanalicular pattern even in younger women.

Fibroadenoma; Breast; Morphology


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