Benign breast tumours

Question 1

Types of benign breast tumours

Answer 1

• Fibroadenoma
• Adenoma
• Papilloma
• Lipoma
• Phyllodes tumours

Question 2

Fibroadenoma presentation

Answer 2

• Most common - women reproductive age usually
• Highly mobile - made of stromal and epithelial tissue
• Well-defined and rubbery
• Most <5cm
• Can be multiple and bilateral
• Low malignant potential

Question 3

Management fibroadenoma

Answer 3

• Can be left in-situ with routine f/u over 2yr period
• 30% usually shrink
• Indications for potential excision: >3cm in diameter or patient preference

Question 4

Adenoma - presentation

Answer 4

• Benign glandular tumour - older female populatio usually
• Nodular lesions - mimic malignancy
• Most cases therefore undergo triple assessment

Question 5

Papilloma presentation

Answer 5

• Female 40-50yrs
• Subareolar region is most common (usually <1cm from nipple)
• Clear or bloody discharge, larger can present as mass
• Can appear similar to ductal carcinomas on imaging so usually need biopsy

Question 6

Management papilloma

Answer 6

• Some excised to ensure no atypical cells or neoplasia
• Risk of breast cancer only increased with multi-ductal papilloma - microdochectomy^ treats these

^removing a milk duct (or disc of milk ducts) from your breast

Question 7

Lipoma presentation

Answer 7

• Asymptomatic soft and mobile mass
• Only removed if causing symptomatic compression or significant enlargement due to low malignant potential

Question 8

Phyllodes tumour - presentation

Answer 8

• Rare fibroepithelial tumour
• Larger, older age group
• Epithelial and stromal tissue
• Grow rapidly

Question 9

Problem with Phyllodes and management because of this

Answer 9

• Difficult to clinically and microscopically differentiate from fibroadenomas
• 1/3 have malignant potential
• 10% benign recur after excision
• SO most undergo wide local excision or mastectomy if lesion large