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Understanding Pathology Results
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AskedPublicly Submitted Question
10/20/2002What is the difference between a simple and complex fibroadenoma? Does a fibroadenoma have to be large in order to be classified as simple or complex? Does a pathology report describe fibroadenomas as simple or complex or is other terminology utilized? Thanks.
RepliedJHU's Breast Center Reply
10/26/2002Fibroadenoma is the most common tumor of the breast and is usually diagnosed in adolescents and young women. This benign tumor is composed of a mixture of glands and stroma (connective tissue). It is derived from the hormonally responsive stroma of the terminal duct lobular unit, which is thought to induce benign proliferation of the epithelium. Fibroadenomas are overall associated with a very slight (approximately 2X) long-term increase in the risk of breast cancer. A “complex fibroadenoma” has one of the following 4 features: sclerosing adenosis, papillary apocrine hyperplasia, cystic change, or epithelial calcification. These 4 features are basically those of benign fibrocystic change, which is also exceedingly common in the breast. The size of the lesion does not determine if it is or is not complex. A recent study found that, compared with controls, patients with complex fibroadenomas had a slightly increased risk of breast cancer compared to those with non-complex (or simple) fibroadenomas. However, the relative risk (3.1X) was lower than that previously associated with atypical duct or lobular hyperplasia (4-5X) or carcinoma in situ (10X). Moreover, two thirds of the population with fibroadenomas had noncomplex (simple) fibroadenomas and no family history of breast cancer: these patients had no appreciable increased risk of breast carcinoma. Dupont WD, Page DL, Parl FF et. al. Long-term risk of breast cancer in women with fibroadenoma. New England Journal of Medicine 1994;331: 10-15.

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