Characterisctics, Clinical Features, And Management Of Fibroadenoma Mammae Patients At Dustira Hospital Cimahi

Ris Kristiana; Salsha Regina Syakyra; Endah Hamidah; Endry Septiadi; Fitriardi Sejati; Tatang Bisri

Authors

Ris Kristiana Department of Anatomical Pathology, Faculty of Medicine, University of General Ahmad Yani, Cimahi, West Java, Indonesia
Salsha Regina Syakyra Medical Study Program, Faculty of Medicine, University of General Ahmad Yani, Cimahi, West Java, Indonesia
Endah Hamidah Department of Anatomical Pathology, Faculty of Medicine, University of General Ahmad Yani, Cimahi, West Java, Indonesia
Endry Septiadi Department of Nutritional Sciences, Faculty of Medicine, University of General Ahmad Yani, Cimahi, West Java, Indonesia
Fitriardi Sejati Department of Surgery, Faculty of Medicine, University of General Ahmad Yani, Cimahi, West Java, Indonesia
Tatang Bisri Department of Anesthesia and Intensive Care, Faculty of Medicine, University of General Ahmad Yani, Cimahi, West Java, Indonesia

Keywords:

Age, body mass index, FAM, management, topography

Abstract

Fibroadenoma mammae (FAM) is the most common benign breast tumor that occurs at the age of 14-35 years. About 10% of the female population has FAM. FAM manifests as solitary masses that are easily movable, well-defined, with a smooth surface. The aim of this study was to determine the characteristics, clinical features, and management of FAM patients at Dustira Hospital using secondary data from medical records. A total of 68 FAM patients were selected as samples during the period 2018-2023. The research variables consisted of the number of cases, age, body mass index(BMI), location, topography, size, quantity, and management of FAM. Univariate analysis was used in this study and the results were presented in narrative and tabular forms. The results of the study showed that the highest number of FAM cases occurred in 2018, reaching 28 (41.1%). Characteristics of FAM patients included 49 individuals (72%) in the 16-30 age group, 32 individuals (47%) with normal body mass index. Clinical features of FAM were found in 31 individuals (45.6%) on the right breast, 24 individuals (35.3%) in the upper medial quadrant, with a size of 3-5 cm in 24 individuals (35.3%), and 49 individuals ( 72.1%) limited solitary masses. Management included surgery in all 68 individuals (100%), with 67 individuals (98.5%) underwent excision, while 1 individual (1.5%) underwent incision. Age and BMI are suspected to play a role in FAM formation related to estrogen hypersensitivity and mutations in the mediator complex subunit 12 (MED12). Lesion size is influenced by estrogen exposure. Management of fibroadenoma depends on the patient's preferences and clinical conditions. Women at risk or suspecting breast masses are advised to perform self-breast examination (BSE) and efficiently consult with healthcare professionals.

References

Adaming SFS, Lufiyati A. Gambaran tingkat pengetahuan tentang fibroadenoma mammae dan perilaku SADARI pada wanita usia subur. JPKM 2022; 3(2): 101-10.

Westmead Breast Cancer Institute. Fibroadenoma. BCI. Australia. 2014

Salati SA. Breast fibroadenomas: a review in the light of current literature. POL PRZEGL CHIR 2021: 93(1): 1-9.

Kementerian Kesehatan Republik Indonesia. Profil kesehatan Indonesia tahun 2019. Kemenkes RI. Jakarta. 2020.

Kumar V, Abbas AK, Aster JC. Robbins basic pathology. 9th ed. Canada: Elsevier Saunders; 2013.

Bhardwaj P, Au CC, Martin AB, Ladumor H, Oshchepkova S, Moges R, et al. Estrogens and breast cancer: mechanisms involved in obesity- related development, growth and progression. J Steroid Biochem Mol Biol 2019; 189: 161-70.

Piscuoglio S, Murray M, Fusco N, Marchiò C, Loo FL, Martelotto LG, dkk. MED12 somatic mutations in fibroadenomas and phyllodes tumours of the breast. Histopathology 2015; 67(5): 719–29.

Loke BN, Md Nasir ND, Thike AA, Lee JYH, Lee CS, Teh BT, et al. Genetics and genomics of breast fibroadenomas. J Clin Pathol 2018;71(5):381–7.

Tan WJ, Chan JY, Thike AA, Lim JCT, Md Nasir ND, Tan JSY, et al. MED12 protein expression in breast fibroepithelial lesions: Correlation with mutation status and oestrogen receptor expression. J Clin Pathol 2016; 69(10): 858–65.

Li R, Cui J, Shen Y. Brain sex matters: Estrogen in cognition and Alzheimer’s disease. Mol Cell Endocrinol 2014; 25(389): 13-21.

Ahsani RF, Machmud PB. Hubungan riwayat reproduksi dengan tumor payudara pada perempuan usia muda di Indonesia (Analisis Riset PTM 2016). Media Kesehatan Masyarakat Indonesia 2019; 15(3): 237.

O’brien S, Kowdley GC. Benign breast diseases and body mass index: is there a correlation?. Am Surg 2014; 80(5): 461-5.

Abhishek V, Ajitha MB, Shivaswamy BS, Srinivasan N. A systematic study on fibroadenoma of the breast. Eur J Surg Sci 2012; 3(3): 80-5.

Guray M, Sahin AA. Benign breast diseases: classification, diagnosis, and management. Breast Cancer The Oncologist 2006: 11(5): 435-49.

Mulia IGBLP, Dewi IGASM, Sumadi IWJ. Karakteristik klinikopatologi pasien fibroadenoma mammae di RSUP Sanglah Denpasar tahun 2017- 2018. Jurnal Medika Udayana (JMU) 2021; 10(4): 75-9.

Fadjari H. Pendekatan diagnosis benjolan di payudara. CDK 2012; 39(4): 308-10.

Gupta AK, Agarwal DK. Fibroadenoma of breast: our experience. IJRR 2018; 5(7): 87.

Wu YT, Wu HK, Chen ST, Chen CJ, Chen DR, Lai HW. Fibroadenoma progress to ductal carcinoma in situ, infiltrating ductal carcinoma and lymph node metastasis? Report an unusual case. J Surg Case Rep 2017; 5: 1-4.

Chang HY, Koh VCY, Nasir ND, Ng CCY, Guan P, Thike AA, et al. MED12, TERT and RARA in fibroepithelial tumours of the breast. J Clin Pathol 2020; 73(1): 51–6.

Maharani NU. Gambaran penderita tumor payudara berdasarkan usia biologis. Jurnal Medika Hutama 2022; 3(2): 1851-3.

Iyengar NM, Brown KA, Zhou XK, Gucalp A, Subbaramaiah K, Giri DD, et al. Metabolic obesity, adipose inflammation and elevated breast aromatase in women with normal body mass index. Cancer Prevention Research 2017; 10(4): 235–43.

Putri KD, Hardini N, Dewi SY, Supartono B. The relationship of age and obesity with the histopathological profile of mammae fibroadenoma patients in pasar minggu hospital 20182019. SENSORIK 2022; 3(1): 1-9.

Dafriani P, Nur SA, Delfitri R. The risk factors of fibroadenoma: cross sectional study in Solok Selatan Hospital, Indonesia. Atlantis Press 2021; 39: 246-8.

UCSF Medical Center. Cholesterol Content of Foods. 2024.

Nurprilinda M, Gultom FL, Sanjaya SJ. Profile of fibroadenoma mammae patients at MRCCC Siloam Semanggi Hospital 2019-2020. Asian Journal of Medicine and Health 2023; 21(7): 90–100.

Abdou Y, Gupta M, Asaoka M, Attwood K, Mateusz O, Gandhi S, et al. Left sided breast cancer is associated with aggressive biology and worse outcomes than right sided breast cancer. Sci Rep 2022;12(1).

Laxman S, Sangolgi P, Jabshetty S, Bhavikatti A, Uttam A. Clinical profile of patients with fibroadenoma of breast. International Surgery Journal 2018; 5(3): 1057.

Soltanian HT, Lee M. Breast fibroadenomas in adolescents: current perspectives. Adolesc Health Med Ther 2015;6: 159-63.

Eleftheriades A, Tsarna E, Toutoudaki K, Paschalidou E, Christopoulos N, Georgopoulos I, et al. Giant juvenile fibroadenoma: Case report and review of the literature. Journal of Clinical Medicine 2023; 12(5): 2-13.

Sidauruk HA, Rasmaliah, Hiswani. Karakteristik penderita fibroadenoma mammae (FAM) rawat inap di RS Santa Elisabeth Medan tahun 2007-2011. Garuda 2013.

Suyatno. Peran pembedahan pada tumor jinak payudara. Majalah Kedokteran Andalas 2015; 38(1): 1- 16.

Brennan M, Houssami N, French J. Management of benign breast conditions. Australian Family Physician 2005; 34(4): 253-5.

Ramala SR, Chandak S, Chandak MS, Annareddy S. A comprehensive review of breast fibroadenoma: correlating clinical and athological findings. Cureus 2023; 15(12): 2-13.