1. Case 2 Jane McNicholas Consultant Oncoplastic Breast Surgeon
East Lancashire Hospitals

2. Case 2 42 year old woman Noticed a lump in breast 6 weeks ago
Unchanged since first noticed
No significant personal or family history
On examination a 1.5cm lump found at 6o’clock in the left breast - P2

3. Case 2
What investigations would you do?

4. Case 2
Mammogram - dense breasts, discrete benign looking lesion at 6o’clock in left breast - M2
Ultrasound - 18mm benign mass corresponding to area on examination - U2
FNA - highly cellular aspirate, benign cells - C2
Core biospy - fibroadenoma - B2

5. Case 2 M1 - normal mammogram M2 - benign features M3 - indeterminate
M4 - probably malignant
M5 - malignant

6. Case 2
What would you advise?

7. Case 2 New discrete mass in breast in woman over 35 - offer to excise
Otherwise - reassure and discharge

8. Fibroadenoma Classified as an aberration of normal breast development
Made of a combination of connective tissue and proliferatory epithelium
Arise from the lobule of the terminal duct lobular unit and influenced by hormones (so increase in size in pregnancy)
In one study, over a 2 year period, 55% stayed the same, 37% stayed the same or got smaller and only 8% increased in size