Multiple fibroadenomas of the breasts: a cause of monthly chest pain

Clinical image A 35-year-old woman reported of continuous bilateral chest pain lasting several years, aggravated by vibration or shaking and most intense during menstruation. The pain limited her daily activities. Physical examination revealed masses resembling rugged rocks in both breasts. Her medical and family histories were unremarkable, and she received no medication. Ultrasonography revealed more than 100 oval-shaped, well-circumscribed tumours, each 5–30 mm. Each breast was 200x200x60 mm. Contrast-enhanced MRI revealed multiple tumours throughout the breasts on dynamic gradual enhancement and no early washout (figure 1). Biopsies revealed fibroadenomas. Therefore, her pain was attributed to these multiple fibroadenomas. Conservative management with low-dose oestrogen and progesterone (norethisterone and ethinylestradiol initially, and dienogest subsequently) was ineffective. Tamoxifen was planned to suppress oestrogen; however, based on the risk of overlooking malignancy, the nonresponse to conservative treatment, and the patient’s desire, we performed bilateral mastectomy with skin areola grafting. Histopathological examination showed...
Source: Postgraduate Medical Journal - Category: General Medicine Authors: Tags: Images Source Type: research