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Case Reports: Learning from unexpected outcome (positive or negative)
Incidental DCIS within a fibroadenoma
  1. Arnold Chen1,
  2. Shaveen Kanakaratne1,2,
  3. Philip Britten-Jones1,2 and
  4. Janne Bingham1,2
  1. 1Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
  2. 2Breast and Endocrine Surgical Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  1. Correspondence to Arnold Chen; a1744906{at}student.adelaide.edu.au

Abstract

A female in her early 20s was referred to the breast-endocrine surgeons with a self-detected tender left breast lump on the background of a family history of breast cancer. A physical examination revealed a rubbery and mobile mass in the left upper breast. Ultrasound demonstrated a solid hypoechoic mass with a likely differential diagnosis of fibroadenoma, with a subsequent core needle biopsy (CNB) confirming a fibroadenoma. Given the size and tenderness of the lump, an excisional biopsy was performed. Histology revealed a fibroadenoma with components of low-grade ductal carcinoma in situ, contained within the fibroadenoma and excised with clear margins.

Following surgical excision, a multidisciplinary review determined that no further local therapy was required and recommended a genetics referral. This case was interesting as it raised important questions, including what the best surveillance strategies are for female patients with breast cancer within fibroadenoma and determining the risk and probability of missing epithelial atypia via CNB.

  • Breast cancer
  • Breast surgery

https://doi.org/10.1136/bcr-2023-254609

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    Footnotes

    • Contributors AC, SK, PBJ, and JB were responsible for the drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, critical revision of important intellectual content and final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.