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Fibroadenoma and microcalcifications
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Fibroadenoma and microcalcifications

Hi there, I have had a FNB and core biopsy of a lump in R breast (3.7 x 2.8 x 1.7 cm) and looks to be a benign fibroadenoma. It is very tender (that is how I noticed it) and appears to be vascularized. Would it be prudent to remove it? Would removing a lump of this size cause my breast to appear very different? The doctors have also found indeterminate microcalcifications (one large, two other groups)in my L breast (nonpalpable). Having stereotactic biopsy soon. What are my chances that this is benign? If not benign, what would treatment be? Age 43, breast feed two girls for about 1 year each.
Many many thanks,
Worried California girl living in New Zealand
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Avatar_n_tn
Dear girlie-NZ, The reason to remove a fibroadenoma would be if it is causing problems, or it there is a question as to whether it is cancerous or not.  In regards to the cosmetic result of a lumpectomy it would depend on the location of the lump, the size of the lump in relation to the remaining breast tissue.

In terms of the other breast, the findings of these microcalcifications could be more or less suspicious but until a biopsy is done and looking at the cells under the microscope it is impossible to say something is cancerous or not(benign).  If this is not benign - then it would be a pre-cancerous or a cancerous finding.  Treatment would depend on the findings.
10 Comments
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Avatar_n_tn
There's not a specific reason to remove a fibroadenoma if it's certain that's what it is. If it bothers you, it's simple to remove. A pretty large area of breast tissue can be removed with no change in breast shape, if the surgeon is experienced. The statistics on indeterminate calcifications are that at least 90% are benign; it depends on how they actually look to make an accurate guess, and even then it's only a guess til the biopsy is done. Most by far turn out ok. Specific decisions on treatment can only be made after knowing exactly what the nature of the cancer is, if that's what it is: invasive, not invasive, etc.
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Avatar_n_tn
Many thanks for the replies!  Could someone please translate these findings and interpret results (i.e., is this normal?) for me? These are for a fibroadenoma 3.7 x 2.9 x 1.7cm that is constantly painful. Likely to have grown very fast as it was noticed only about 4 weeks ago, previous mammogram in 1990 was normal.

"heterogeneous solid mass, some cystic components, increased vascularity in this region (is this a bad thing?)"

"Sections show small fragments of normal appearing fibrofatty female breast tissue and fragments of fibroadenoma comrising hypocellular myxoid stromal tissue supporting gland and branching canalicular spaces. Several of the canalicular spaces are cystically dilated."

"the smears show abundant amorphous debris and foamy macrphages together with soe sheets and groups of benign epithelial cells (C2).

Can you refer me to a journal article or web page tht shows images of "bad" microcalcifications?

Many thanks again!!!
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Avatar_n_tn
I assume the "heterogenous solid mass...." words are from an ultrasound report. They are descriptive but not diagnositic. The next phrases are, I assume, from the pathology report, and those are more meaningful because they tell what it actually is. And they describe completely typical findings for a fibroadenoma. The final phrase sounds like it's regarding a smear of fluid taken from somewhere (I'm assuming all this because you didn't state it) and it's perfectly innocent.

As to calcifications, the few I've seen online are very hard to see because of the degradation in quality between the film, the posting, and the downloading.
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Avatar_n_tn
You might want to look at this site:

http://radiology.creighton.edu/Mammography.html#anchor38616

Go to Section 4 for some views of calcifications.
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Avatar_f_tn
Here is an interesting site that shows many calcifications on mammo's. I found it helpful when I was researching my own cluster microcalc's. Good luck to you.
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Avatar_f_tn
sorry...forgot to add the url
http://sprojects.mmi.mcgill.ca/mammography/mammoanalysis.htm

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Avatar_n_tn
Many thanks! Great sites! Can't wait til the 29th for my consult and stereotactic biopsy...and the results :-)
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Avatar_n_tn
Sorry about that, you are right, the first was the ultrasound, followed by the core biopsy and then the FNA.

The left breast has two distinct "constellations" of numerous, very small dots towards the upper portion of the breast and then a bright irregularly shaped microcalcification that doesn't seem to be associated with anyother calcifications.

Many thanks to all for your support and information. It is making the wait a bit more tollerable!
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Avatar_n_tn
It's more a question, than a comment.  Anyone out there.  I had a mammography, ultrasound, needle biopsy, core biopsy, and finally, a 'lumpectomy'on my right breast.  I was told I had an 'atypical cell' with rapid growth.  My surgeon told me a 'name' that he 'believed' it was from my initial pathology report, and I was 'so upset' at the time, that I couldn't remember it.  I believe it started with an 'L', but I am positive it was NOT 'lavage'.  
He told me, they are 'still' not sure if it 'is' cancerous, after a pathology report, and he will be sending it out to a specialist at Cornell University for a more definate answer.  As I got home, I am NOW going 'crazy' because, while I was in his office hearing, 'They're still not sure it is definately NOT cancerous', I kept hearing, 'blah, blah, blah' after that, and it was not being retained in my brain.  I NEED HELP.  Would anyone out there possibly know what the 'L' word could have been?
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