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Noreli Franco, PhD; Laurent Arnould, MD; Florence Mege, MD; Samy-Felix Picard, BS; Patrick Arveux, MD; Sarab Lizard-Nacol, PhD

Arch Surg. 2003;138:291-295.

Hypothesis  The cause of breast cancer is linked to many macroscopic events, including benign breast disease. In this study we asked whether molecular changes could discriminate fibroadenoma, which is one of the most common benign breast disease lesions associated or not with breast cancer.

Design  Retrospective cohort study.

Setting  Anticancer medical center.

Subjects  Archival tissues in 32 cases of fibroadenoma, diagnosed in the same breast as a breast carcinoma, are compared with a control group of 26 cases of fibroadenomas unaffected by breast cancer.

Main Outcome Measures  Histological features are characterized in all samples. The epithelial and stromal components are analyzed for a loss of heterozygosity and a microsatellite instability using a polymerase chain reaction–based method with 11 polymorphic microsatellite markers at 7 chromosomal regions frequently altered in breast cancer. The p53 gene mutations were also determined at exons 5 to 9.

Results  The frequency of complex fibroadenomas was similar in both groups (P = .42). Only in the case group did we observe proliferative lesions confined in fibroadenomas, including atypical ductal hyperplasia (2 cases), lobular neoplasia (3 cases), or low-grade ductal carcinoma in situ (2 cases). There is no significant morphological difference between the 2 groups. Neither microsatellite alterations nor p53 gene mutations are present in the fibroadenoma components. Loss of heterozygosity is found only in the epithelial component of the 2 ductal carcinomas in situ confined in fibroadenomas.

Conclusions  Genetic alterations, which are most frequently involved in malignant breast carcinomas, are not present in fibroadenomas, regardless of their association with breast cancer or their histological complexity. These findings suggest that fibroadenomas are not associated with breast carcinogenesis.

From the Laboratory of Molecular Genetics (Drs Franco and Lizard-Nacol and Mr Picard) and the Departments of Pathology (Drs Arnould and Mege) and Medical Information (Dr Arveux), Centre Georges François Leclerc, Dijon, France.

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