NEWLY ARISING FIBROADENOMAS IN WOMEN AGED 35 AND OVER

Background: Fifty-one cases of de novo fibroadenoma in women aged 35 y ears and older were found during an analysis of 117 729 visits to the Wesley Breast Clinic from 1990 to 1996. Methods: The clinical, mammogr aphic and ultrasound diagnosis of fibroadenoma was confirmed by either fine needle aspiration cytology or histology of an open biopsy specim en. 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. Results: Thirty-seven of the de novo fibroadenomas were palpable, the remainder satisfying strict mammographic and/or ult rasound criteria. Four of the new fibroadenomas were in women aged 50- 52. Conclusions: This study provides information about the natural his tory of fibroadenomas, confirming that they can appear for the first t ime in middle-aged women. This has important clinical implications, si nce new lesions appearing in women over 35 have tended to be automatic ally categorized as suspicious of carcinoma. However, a multidisciplin ary approach involving clinical examination, mammography, ultrasound, and fine needle aspiration cytology or core biopsy can result in a con fident diagnosis of fibroadenoma. This will allow some women with new lesions to be managed conservatively rather than by open biopsy.