1. Fibroadenoma
Dr. Gehan Mohamed

2. Structure of normal breast
Each of breasts contains 15 to 20 lobes of glandular tissue.
The lobes are further divided into smaller lobules that produce milk during pregnancy and breast-feeding.
Small ducts conduct the milk to a reservoir that lies just beneath the nipple.
Supporting this network is a deeper layer of connective tissue called stroma.

3. Normal histology of the breast
Stromal tissue
Connective tissue, capillaries.
Adipose tissue
Ductal tissue lined by
Columnar or cuboidal
epithelium
10-15 lactiferous sinuses exiting nipple

4. Normal Breast Breast profile A ducts B lobules C
dilated section of duct to hold milk D
nipple E
fat F
pectoralis major muscle G
chest wall/rib cage
Enlargement A
normal duct cells B
basement membrane (duct wall) C
lumen (center of duct)
Illustration © Mary K. Bryson

5. Normal breast lobules

6. Differential diagnosis for breast lump
Malignant lump
Breast abscess
Fibrocystic changes: Lumpiness, thickening and swelling, often associated with a woman’s period
Fibroadenomas: A solid, round, rubbery lump that moves under skin when touched, occuring most in young women
Infections: The breast will likely be red, warm, tender and lumpy
Trauma: a blow to the breast or a bruise can cause a lump (traumatic fat necrosis)

7. What is a fibroadenoma?
Fibroadenomas are solid benign mixed tumors formed of both fibrous and glandular tissue.
most common in younger women (between the ages of 15 and 35).
Its origin from the terminal duct-lobular unit.

8. Cause of fibroadenoma
Fibroadenoma are partially hormone-dependent and frequently regress after menopause.
So they appear before the age of thirty years.

9. Diagnosis of fibroadenoma
It is usually diagnosed through:
1- clinical examination
2- ultrasound
3- mammography
4- needle biopsy sample of the lump

10. FIBROADENOMA by ultrasound

11. Symptoms &signs
painless, firm, solitary, mobile, slowly growing lump in the breast of a woman of childbearing years.
Fibroadenoma are sometimes called breast mouse owing to their high mobility in the breast .

12. fibroadenoma

13. Classification of fibroadenoma
1-Common fibroadenoma =Conventional FA= typical FA = simple FA
2-Multiple fibroadenoma: if there is ≥ 5 separate lesions in an individual breast
3- Giant fibroadenoma ≥ 5cm, ≥ 500g replacing ≥ 4/5 of the breast

14. Microscopic types of fibroadenoma
Depending on the proportion and the relationship between the glandular and fibrous components, there are two main histological features :
A) Pericanalicular fibroadenoma : fibrous stroma proliferates around the ductal spaces.the ducts still opened.
B) Intracanalicular fibroadenoma : stromal proliferation predominates over ductular proliferation so compresses the ducts so become irregular, reduced to slits giving false impression that the fibrous tissue is inside ducts hence the name intracanalicular FA.

15. Pericanalicular Fibroadenoma : the tumor is surrounded by pink fibrous capsule, Proliferation of both glandular and stromal elements

16. Pericanalicular fibroadenoma in it still duct opened and surrounded by fibrous tissue

17. Intracanalicular fibroadenoma :the ducts are compressed by the excess fibrous tissue

18. Intracanalicular fibroadenoma