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Type:
Educational Exhibit
Keywords:
Neoplasia, Cancer, Biopsy, Ultrasound, MR, Mammography, Breast
Authors:
F. Can1, �. S. Okcu2, A. Oktay2, I. G. Bilgen3; 1Kutahya/TR, 2Izmir/TR, 3Bornova/TR
DOI:
10.1594/ecr2015/C-0194
Conclusion
The development of carcinoma in a benign breast lesion is a rare occurance.
Pre-operative diagnosis is challenging and usually is an incidental pathologic finding in case the lesion is excised (1,2). Radiologic findings rarely indicate malignancy and the patients are often followed-up.
Fibroadenomas are most frequently reported benign lesions,
with an incidence of 0.01-0.03 %.
There are 100-200 cases in the literature (1,4). The most frequent tumor encountered in fibroadenoma is reported as DCIS and LCIS,
invasive tumors are rare (5,6,7).
Hamartomas harboring malignancy are reported even rarer.
There are 13 cases in the literature.
Kai et.al had reported such a case with IDC occuring in an hamartoma as in our case (8).
Intraductal papilloma is another benign lesion,
we encountered to have malignancy inside as DCIS and intracystic papillary carcinoma.
There is only one such a case,
in the literature,
reported to have DCIS arising in an intraductal papilloma in an axillary lymph node (9).
As far as we know,
tubulolobuler carcinoma and glycogen-rich carcinoma have not been reported in the literature,
to arise in a fibroadenoma.
So as,
squamous-cell carcinoma arising in benign phyllodes tumor.
In women with a strong family history for breast cancer or a BRCA mutation and in women over 40,
this risk is higher.
Besides,
it is needed to be cautious against probably benign lesions having indistinct margins or clustered micro calcifications during follow-up (1,3,7).
Radiologists should be aware of this entity and should be alert to warn the surgeon against any morphologic change during follow-up. This study highlights the importance of a careful diagnostic approach towards benign appearing solid breast lesions.