Genetics and genomics of breast fibroadenomas

J Clin Pathol. 2018 May;71(5):381-387. doi: 10.1136/jclinpath-2017-204838. Epub 2017 Dec 16.

Abstract

Fibroadenomas of the breast are benign fibroepithelial tumours most frequently encountered in women of reproductive age, although they may be diagnosed at any age. The fibroadenoma comprises a proliferation of both stromal and epithelial components. The mechanisms underlying fibroadenoma pathogenesis remain incompletely understood. In the clinical setting, distinguishing cellular fibroadenomas from benign phyllodes tumours is a common diagnostic challenge due to subjective histopathological criteria and interobserver differences. Recent sequencing studies have demonstrated the presence of highly recurrent mutations in fibroadenomas, and also delineated the genomic landscapes of fibroadenomas and the closely related phyllodes tumours, revealing differences at the gene level, which may be of potential adjunctive diagnostic use. The present article provides an overview of key studies uncovering genetic and genomic abnormalities in fibroadenomas, from initial karyotype reports revealing myriad cytogenetic aberrations to next-generation sequencing-based approaches that led to the discovery of highly recurrent MED12 mutations. A thorough understanding of these abnormalities is important to further elucidate the mechanisms by which fibroadenomas arise and to refine diagnostic assessment of this very common tumour.

Keywords: breast pathology; cancer; genetics; molecular pathology.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / genetics*
  • Biomarkers, Tumor / metabolism
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • DNA Mutational Analysis
  • Female
  • Fibroadenoma / genetics*
  • Fibroadenoma / metabolism
  • Fibroadenoma / pathology
  • Genes, ras
  • Genetic Predisposition to Disease
  • Genomics / methods*
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Karyotyping
  • Loss of Heterozygosity
  • Mediator Complex / genetics
  • Microsatellite Instability
  • Mutation
  • Neoplasms, Hormone-Dependent / genetics*
  • Neoplasms, Hormone-Dependent / metabolism
  • Neoplasms, Hormone-Dependent / pathology
  • Phenotype
  • Polymorphism, Single Nucleotide
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors
  • Tumor Suppressor Protein p53 / genetics

Substances

  • Biomarkers, Tumor
  • MED12 protein, human
  • Mediator Complex
  • TP53 protein, human
  • Tumor Suppressor Protein p53