Foxcroft L, Evans E, Hirst C
Wesley Breast Clinic, Brisbane, Queensland, Australia.
Aust N Z J Surg. 1998 Jun;68(6):419-22. doi: 10.1111/j.1445-2197.1998.tb04790.x.
Fifty-one cases of de novo fibroadenoma in women aged 35 years and older were found during an analysis of 117,729 visits to the Wesley Breast Clinic from 1990 to 1996.
The clinical, mammographic and ultrasound diagnosis of fibroadenoma was confirmed by either fine needle aspiration cytology or histology of an open biopsy specimen. In all cases there was a well-documented previous visit available for review, at which there was no clinical or radiological evidence of the fibroadenoma.
Thirty-seven of the de novo fibroadenomas were palpable, the remainder satisfying strict mammographic and/or ultrasound criteria. Four of the new fibroadenomas were in women aged 50-52.
This study provides information about the natural history of fibroadenomas, confirming that they can appear for the first time in middle-aged women. This has important clinical implications, since new lesions appearing in women over 35 have tended to be automatically categorized as suspicious of carcinoma. However, a multidisciplinary approach involving clinical examination, mammography, ultrasound, and fine needle aspiration cytology or core biopsy can result in a confident diagnosis of fibroadenoma. This will allow some women with new lesions to be managed conservatively rather than by open biopsy.
在对1990年至1996年间韦斯利乳腺诊所的117729次就诊进行分析时，发现了51例年龄在35岁及以上的女性新发纤维腺瘤。
纤维腺瘤的临床、乳腺X线摄影及超声诊断通过细针穿刺细胞学检查或开放活检标本的组织学检查得以证实。所有病例均有详细记录的此前就诊情况可供回顾，当时并无纤维腺瘤的临床或放射学证据。
37例新发纤维腺瘤可触及，其余病例符合严格的乳腺X线摄影和/或超声标准。4例新发纤维腺瘤发生在年龄为50 - 52岁的女性中。
本研究提供了有关纤维腺瘤自然史的信息，证实它们可首次出现在中年女性中。这具有重要的临床意义，因为35岁以上女性出现的新病变往往会被自动归类为可疑癌。然而，采用包括临床检查、乳腺X线摄影、超声以及细针穿刺细胞学检查或粗针活检的多学科方法，能够对纤维腺瘤做出可靠诊断。这将使一些有新病变的女性能够接受保守治疗而非开放活检。
