What are the other Names for this Condition? (Also known as/Synonyms)

• AME of Breast
• Mammary Adenomyoepithelioma
• Mammary AME

What is Adenomyoepithelioma of Breast? (Definition/Background Information)

• Adenomyoepithelioma (AME) of Breast is a rare benign tumor of the breast affecting the lobes in the breast tissue, which is observed in women of all ages that include premenopausal and postmenopausal women. AME is associated with cancer, since it can undergo malignant transformations
• The cause of AME of Breast is unknown, but the risk factors may include gender (women are affected more than men), the use of birth control pills, obesity, and one’s reproductive history
• The signs and symptoms of Adenomyoepithelioma of Breast may include the presence of a mass in the breast. Small-sized tumors may be asymptomatic and show no signs and symptoms
• Adenomyoepithelioma of Breast is indicative of a higher risk for breast cancer into the future. The degree of risk is dependent upon factors such as age of the individual, type of the tumor, and size of the tumor
• Due to this, a complete surgical excision and removal of the entire tumor is recommended. Adenomyoepithelioma of Breast is a benign tumor, and hence, its prognosis is excellent
• Nevertheless, since AME of Breast is associated with an increased risk for breast carcinoma, periodic checkups and screening mammograms are strongly advised

Who gets Adenomyoepithelioma of Breast? (Age and Sex Distribution)

• The age of presentation of Adenomyoepithelioma of Breast in women is between 20-90 years; a wide age range is observed; average age at diagnosis is 60 years
• Men are not commonly affected by this rare, benign tumor
• All racial and ethnic groups are affected and no specific predilection is seen

What are the Risk Factors for Adenomyoepithelioma of Breast? (Predisposing Factors)

The definitive risk factors for Adenomyoepithelioma of Breast are not well-understood. However, the following risk factors increase one’s chances of getting benign breast tumors, and these include:

• Gender: Women have a higher risk for developing the condition than men
• Obesity: Being overweight or obese increases the risk
• Alcohol consumption
• Menstrual cycle: Women who got their period before the age of 12 years, and those who reached menopause after age 55 have a higher risk. The longer the duration between menarche and menopause, the greater is the risk. This is due to hormonal influences during the reproductive period on the breast tissue
• Postmenopausal hormone therapy: Women taking hormone replacement therapy medications containing both estrogen and progesterone for menopause, have a higher risk
• Reproductive history: Having the first child after the age of 35, or never having a child
• Birth control pills
• Physical inactivity: A lack of physical exercise (leading a sedentary life) can increase one’s risk
• Not breastfeeding the child

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Adenomyoepithelioma of Breast? (Etiology)

The exact cause of development of Adenomyoepithelioma of Breast is currently not clearly understood.

• Studies have shown that such tumors may be caused by hormonal influence
• Certain gene mutations have also been reported in the tumors. Research is being performed to determine how these mutations contribute to the formation of the tumors

What are the Signs and Symptoms of Adenomyoepithelioma of Breast?

The signs and symptoms of Adenomyoepithelioma of Breast may include:

• A solid lump in a single breast; typically, only one breast is affected
• Adenomyoepithelioma can appear as firm and well-defined or poorly-defined (irregular) tumors
• Larger tumors may be felt by touch, while small tumors may be missed during a mammogram screening
• The breast lump is generally painless
• The tumor size may range from a few mm to a few cm (1-3 cm average size); some may be large and exceed 8 cm in size
• In some cases, there may be smaller satellite nodules adjacent to the main tumor

When a pathologist examines the tumor under a microscope, the tumor usually has irregular margins. The findings may resemble a breast cancer, and hence, a careful examination is necessary.

How is Adenomyoepithelioma of Breast Diagnosed?

Adenomyoepithelioma of Breast may be diagnosed in the following manner:

• Complete physical examination with comprehensive medical and family history evaluation
• Breast exam to check for any lumps or unusual signs in the breasts
• Mammogram: A mammogram uses x-rays to provide images of the breast. These benign tumors are identified as a mammogram mass, which may or may not be associated with microcalcification. The mammography findings may raise enough suspicion to warrant a tissue biopsy
• Breast ultrasound scan: Using high-frequency sound waves to produce images of the breast, the type of tumor, whether fluid-filled cyst or solid mass type, may be identified
• Computerized tomography (CT) or magnetic resonance imaging (MRI) scan of the breast
• Breast biopsy:
  • A biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
  • Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
  • Sometimes, the pathologist may perform additional studies, which may include immunohistochemical stains and molecular studies to assist in the diagnosis

Biopsies are the only methods used to determine whether an abnormality is benign or cancerous. These are performed by inserting a needle into a breast mass and removing cells or tissues, for further examination. There are different types of biopsies:

• Fine needle aspiration biopsy (FNAB) of breast mass: In this method, a very thin needle is used to remove a small amount of tissue. FNAB cannot help diagnose definitively Adenomyoepithelioma of Breast. It only helps determine if the tumor is malignant or benign. This can help the healthcare provider discuss and plan the next steps (with respect to diagnosis and treatment)
• Core needle biopsy of breast mass: A wider needle is used to withdraw a small cylinder of tissue from an abnormal area of the breast
• Open tissue biopsy of breast mass: A surgical procedure used less often than needle biopsies, it is used to remove a part or all of a breast lump for analysis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Adenomyoepithelioma of Breast?

There may not be any significant complications of Adenomyoepithelioma of Breast.

• Abnormal findings on the mammogram may cause emotional distress for breast cancer, until a definitive diagnosis is made
• In rare cases, a benign Adenomyoepithelioma of Breast can transform into a malignant Adenomyoepithelioma of Breast. Such malignant tumors can metastasize to various parts of the body (such as to the lymph nodes, lungs, brain, and mouth)
• Recurrence of the tumor is noted on an incomplete surgical removal

How is Adenomyoepithelioma of Breast Treated?

The following treatment methods for Adenomyoepithelioma of Breast may be considered:

• A simple surgical excision and removal of the entire Adenomyoepithelioma of Breast (with wide margins) is normally sufficient treatment. It is the recommended treatment due to association of the tumor with malignancy and recurrence potential
  • The surgical procedure performed is known as a breast lumpectomy. It is a surgical procedure to remove the breast lump, which may be done under a general anesthetic
  • During the surgery, a small incision is made in the skin of the breast and a hollow probe that is connected to a vacuum, inserted
  • The breast tissue is sucked through the probe, using vacuum, until the lump has been removed 
• In case of transformation of the benign tumor to a malignant Mammary Adenomyoepithelioma, a combination of surgery, radiation therapy, and/or chemotherapy treatment procedures may be performed
• Follow-up care with regular screening and check-ups are important

How can Adenomyoepithelioma of Breast be Prevented?

Adenomyoepithelioma of Breast is difficult to prevent, because it is most likely caused by abnormal or fluctuating reproductive hormone levels. Since prevention is generally not possible, it is important to be aware of the risk factors of breast lumps.

• The individual must regularly conduct breast self-exams, to ensure that no lumps are present
• Maintain a healthy body weight and exercise regularly
• Implement and follow a well-balanced diet; a high intake of fiber via fresh fruits and vegetables helps in a healthy lifestyle
• Drink alcohol in moderation; limit to one or (maximum) two drinks a day
• Limit combination hormone therapy used to treat symptoms of menopause. It is advised that individuals be aware of the potential benefits and risks of hormone therapy

What is the Prognosis of Adenomyoepithelioma of Breast? (Outcomes/Resolutions)

• The prognosis of Adenomyoepithelioma of Breast is generally excellent on a surgical excision and removal of the tumor. In some cases, there is a risk of recurrence though
• Even though a majority of the tumors are benign, Adenomyoepithelioma of Breast is associated with a very high risk for breast cancer into the future. A healthcare provider will assess the risk depending on the combination of each individual’s risk factors
• Periodic follow-up check-ups with screening is required

Additional and Relevant Useful Information for Adenomyoepithelioma of Breast:

The following DoveMed website links are useful resources for additional information:

http://www.dovemed.com/healthy-living/womens-health/

http://www.dovemed.com/diseases-conditions/cancer/