Fibroadenoma

o Most common benign tumor of the female breast

o Arise from cells of the intralobular stroma.
o “Biphasic tumors”, they also include a non- neoplastic epithelial component, the
proliferation of which may be stimulated by growth factors elaborated by the stromal
cells.
o Increase occurrence in young women (20s-30s).
o Driven by somatic mutations in MED 12 gene, a component of a multiple protein
complex called mediator that links RNA polymerase II specific DNA binding transcription
factors.
o Exact cause is unknown, they may be related to changing levels of hormones
o Hormone sensitive tumors, which means that they grow in size during puberty or
pregnancy and regresses after menopause
o Taking oral contraceptives before the age of 20 has been associated with a higher risk of
developing fibroadenomas as well
o Clinically, FA presents as a solitary, freely mobile lump in the breast. Because of their
high mobility, they are also termed as mouse in the breast / breast mouse.
o Frequently multiple and bilateral.

Types of Fibroadenoma:
 Juvenile FA- seen in young or adolescent women, with history of rapid growth. Here,
there is epithelial and stromal hyperplasia
 Complex FA-FA with fibrocystic changes, with the presence of apocrine change,
sclerosing adenosis, and cyst formation
- Has a higher risk of subsequent malignancy
 Giant FA- this happens when the tumor reaches massive size, greater then 10 cm

Risk of subsequent malignany is higher in:

 Complex FA
 FA in older women
 FA in women with a family history of breast Cancer