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How does fibroadenoma differ from cancer on ultrasound? Breast fibroadenoma: to remove it or not

Reasons

The exact reasons for the formation of fibroadenoma are not known, but it is believed that it occurs against the background of hormonal imbalance. A benign tumor most often appears in adolescence or during menopause, when significant changes in hormonal status occur in a woman’s body.

Estrogens cause increased proliferation of glandular tissue. Levels of these hormones are highest during puberty. , during pregnancy and breastfeeding chest. Hormone replacement therapy during premenopause and menopause also sometimes leads to the appearance of fibroadenoma.

Signs

In most cases, women discover fibroadenoma themselves. This benign formation has a round shape, smooth surface, clear contours and elastic consistency. When palpated, fibroadenoma is painless. Due to the fact that it does not grow together with the surrounding tissues, this tumor is mobile and is not fused to the skin.

Most often, fibroadenoma occurs in the form of a single node, but sometimes multiple formations occur that can be palpated in both mammary glands. In some cases, the tumor can increase in size very quickly (two or three times in a few months). This is due to pronounced hormonal changes in the female body. For example, fibroadenoma grows more rapidly during pregnancy. This neoplasm almost never develops into cancer.

Leaf fibroadenoma

Leaf-shaped tumor (phylloid fibroadenoma) is one of the types of benign tumors of the mammary glands. This fibroadenoma got its name because of the layered structure on the section. The leaf-shaped tumor is delimited from the surrounding tissues, but does not have a capsule. It is often fused with the skin and tends to grow rapidly. A two-phase type of growth is also possible: in the first phase, the tumor slowly increases in size, and in the second period, sudden rapid growth begins.

In one out of ten cases, leaf-shaped fibroadenoma degenerates into sarcoma - a malignant tumor of connective tissue. This type of fibroadenoma occurs in all age groups, but more often such a tumor is detected during two time periods: from eleven to twenty years and from forty to fifty years. These periods are the most hormonally active.

A puncture biopsy reveals atypical cells. They look different from normal cells, but are not yet considered cancerous.

Diagnostics

If a nodule is detected in the mammary gland, a woman should urgently consult a mammologist. He will interview and examine the patient and prescribe the necessary tests that will help identify fibroadenoma.

The following studies are usually carried out:

Treatment

If the size of the fibroadenoma does not exceed one centimeter, then dynamic monitoring of the tumor’s condition is possible. It includes periodic ultrasound and mammography. In other cases, the main treatment for this disease is surgery.

Indications for surgical treatment:

  • Suspicion of breast cancer (according to ultrasound, mammography, examination of the cellular composition of the tumor or examination by a specialist);
  • Suspicion of phyllodes tumor;
  • Rapid growth of a node in the mammary gland;
  • Large tumor size (more than five centimeters) and associated cosmetic defect;
  • Planned pregnancy.

There are two types of operations that are performed in the presence of fibroadenoma.

This organ. Today we will talk about what breast fibroadenoma is.

The term comes from three words meaning fiber, gland and tumor. Fibroadenoma can develop in any gland, including the mammary gland.

This is a fairly common benign tumor. It begins to be detected in teenage girls; the incidence increases with age and reaches a maximum at the age of 30-40 years. Some scientists consider the pathology to be a nodal form of mastopathy.

Etiology of the disease

The causes of breast fibroadenoma are unknown. Some importance is attached to hormonal disorders, in particular, increased levels of female sex hormones - estrogens, but there is no exact confirmation of this. The following factors can provoke the development of a tumor:

  • chest injuries, bruises;
  • excessive insolation (tanning or visiting a solarium);
  • premature termination of pregnancy;
  • transferred ;
  • mistakes during breastfeeding and its completion.

As a result of the action of an unknown factor, connective tissue cells and glandular structures that form the milk ducts begin to divide in the breast tissue. The cells retain their normal morphological characteristics, do not grow into surrounding organs, and do not metastasize.

Fibroadenoma can grow rapidly and have a soft consistency, in which case it is called immature. Such formations are more common in young girls. In women, mature fibroadenoma is more common - dense, surrounded by a capsule, practically not enlarging. The discovery of such a tumor at the age of over 40 years indicates its late diagnosis.

Symptoms

Most often, the pathology does not manifest itself at all. In some women, fibroadenoma hurts, this is due to concomitant mastopathy, which responds to hormonal fluctuations.

Symptoms of fibroadenoma of the mammary gland are determined by palpating it: in the upper outer quadrant, a small dense ball is felt, as if rolling into the tissue of the gland. The skin over it is not changed, there is no pain.

Although this formation does not bother the woman, if it appears, it is necessary to contact a gynecologist, surgeon or oncologist.

Macroscopic and microscopic characteristics

- This is a painless single node of dense consistency. It has clearly defined boundaries and a diameter of up to 3 cm. This tumor grows very slowly. The difference from cancer is the absence of decay and metastasis, that is, a benign course. Fibroadenoma does not have a true capsule, but during surgery it is easily removed (husked) from the breast tissue.

Multiple fibroadenomas are rare, and they are often gigantic in size. Such nodes can reach 20 cm in diameter.

If the knot is cut, it is seen that it has a gray-white color. It contains foci of calcification, hyalinosis (formation of cartilage tissue), and mucus. When examined under a microscope, it is clear that the adenoma consists of a connective tissue base and ducts of the mammary glands. Depending on the ratio of stroma and ducts, histological types of tumor are distinguished:

  • intracanalicular - the expanding stroma compresses the glandular ducts, which turn into slit-like formations;
  • pericanalicular - the gland ducts retain a rounded shape, they are surrounded by dense connective tissue, calcifications and calcification of the node are often formed.

Mixed type tumors are often found.

There is also such a thing as a leaf-shaped or phylloid tumor of the mammary gland. It usually arises from an intracanalicular tumor.

Leaf fibroadenoma differs in the structure of its base - the stroma. It has dividing cells that form layered structures that resemble leaves.

Found in women over 40 years of age. It grows quickly, often occupying most of the volume of the mammary gland; often recurs after surgical treatment. This formation tends to become malignant when dividing stromal cells undergo transformation. Degeneration of a phyllodes tumor into cancer is observed in 10% of cases.

1. The tumor stroma is represented by loose fibrous tissue
2. Glandular tubes are compressed by the stroma

Diagnostics

In most cases, the pathology is determined by the woman herself or her sexual partner by palpation (feeling) of the mammary gland. Fibroadenoma feels like a dense, smooth, painless node, quite mobile, that is, displaced relative to the skin. If such a symptom is detected, you should immediately contact a mammologist to rule out breast cancer.

The primary diagnostic methods are inspection, palpation and ultrasound examination of the mammary gland. Ultrasound usually clearly shows signs that can be used to preliminarily distinguish fibroadenoma from cancer.

It should be said that fibroadenoma with blood flow determined using ultrasound and Doppler sonography is a common condition. If the node exceeds 2 cm in size, blood flow in it can be determined in 75% of cases. Scientists have proven that the presence of blood flow in the node does not distinguish between fibroadenoma and breast cancer. In small nodules the blood supply is almost never determined.

Fibroadenoma can also be detected using. This X-ray examination is carried out annually on all women over 40 years of age as part of a medical examination of the population.

A puncture of the node is required, that is, it is punctured with a special needle and biopsy material is taken. The resulting tissue sample is examined under a microscope to rule out malignant degeneration. A more modern and accurate diagnostic method is trephine biopsy. It allows you to obtain several small “cylinders” from different parts of the tumor and make a more reliable diagnosis. Histological examination completely confirms the disease.

Treatment

Treatment of breast fibroadenoma is almost always performed surgically. Only with very small nodes (up to 5 mm in diameter) can observation be continued. The question of whether or not to remove breast fibroadenoma is decided by the doctor after examination, hormone tests, ultrasound examination and tissue biopsy.

Is it necessary to remove fibroadenoma before or during a planned pregnancy? The combination of conditions such as fibroadenoma and pregnancy can lead to malignant degeneration of the tumor. If this does not happen, difficulties may arise during breastfeeding, especially with large nodules or multiple nodes: milk will flow poorly through the milk ducts, and mastitis will also occur.

Therefore, it is advisable to remove the formation as early as possible, mainly at the planning stage. If the tumor grows rapidly during pregnancy, less traumatic interventions will be preferable. However, the question of the extent of the operation, especially during pregnancy, is not decided immediately, but only after observation and examination by several specialists. If the size of the node is small and there is no suspicion of cancer, surgical treatment is postponed and carried out after the birth of the child and completion of breastfeeding.

Contraindications for removal:

  • fever and infectious diseases;
  • cancer and other serious illnesses;
  • woman's reluctance to undergo surgical treatment;
  • blood clotting disorders, high degrees of arterial hypertension, poorly compensated diabetes mellitus and other conditions, after correction of which surgery becomes possible.

Surgery and rehabilitation

Surgery to remove breast fibroadenoma can be performed in two fundamentally different ways:

  • enucleation (husking) – removal of only the nodule itself through a small incision near the nipple;
  • sectoral resection - removal of the tumor with surrounding tissues in the form of a sector of the gland, most often performed when malignant transformation is suspected.

Depending on the volume, surgery is performed using local or intravenous anesthesia. It lasts about an hour. After removing the tumor, cosmetic sutures are applied to the skin, which allows you to achieve a good external result.

If the node is located superficially and there is confidence in its benign quality, it is possible to remove breast fibroadenoma with a laser . This is a low-traumatic operation, accompanied by rapid tissue healing and a good cosmetic effect. In addition to laser therapy, radio wave therapy can be used.

The postoperative period proceeds without complications, the woman does not experience pain. The patient usually leaves the hospital on the same day or the next day after the intervention, the sutures are removed after a week. A histological examination of the removed material under a microscope is required to exclude a cancer process.

Rehabilitation after removal of fibroadenoma includes a mandatory consultation with a gynecologist. It is advisable to increase the content of animal protein and vegetables in the diet, avoid fatty foods and allergens (chocolate, citrus fruits, eggs). It is necessary to normalize weight and increase physical activity. Sometimes a consultation with a psychotherapist is required to help a woman understand her illness and cope with its consequences, especially with a large volume of surgery.

If a lump remains after removal, you should consult a doctor again. This may be a sign of suppuration of the mammary gland, the growth of a malignant tumor, or occur as a result of scarring of the suture. In any case, a thorough examination by a specialist is necessary, preferably the doctor who performed the operation.

Small scar after fibroadenoma removal:
1. after surgery
2. a month later

Forecast

When surgically removed, the tumor practically does not recur. Can fibroadenoma develop into cancer? This possibility exists, although the likelihood of malignant degeneration is low. Some doctors deny this possibility altogether, others talk about a 20-50% probability. The risk is especially high with the leaf-shaped form of fibroadenoma. The answer to the question whether a formation can resolve without treatment depends on many conditions. More often, immature fibroadenomas in girls resolve on their own after the final establishment of the menstrual cycle. In mature women, such a tumor will not go away without treatment, but will slowly increase in size.

Prevention

Since the true causes of the disease are unknown, there are no specific preventive measures. To prevent the development of tumor processes, it is recommended to eat well, avoid strong emotional shocks and chronic nervous strain, and protect your mammary glands from bruises. It is recommended to limit visits to the solarium and natural tanning during the daytime.

It is important to periodically perform breast self-examination. It is performed by a woman in front of a mirror 7-10 days after the start of menstruation, when the mammary gland is painless. Pay attention to the symmetry of the glands, the surface of the skin, the supraclavicular and axillary areas, the areola and the nipple. Then the entire gland is superficially probed in a spiral or radially outward from the center. After this, a deeper palpation of the entire gland tissue is carried out. It is convenient to do this by lubricating your hands with cream or lotion. You can conduct a self-examination of the glands in the shower, after soaping your skin. The main thing is to do this regularly. This measure will help to recognize both fibroadenoma and malignant processes in time.

It is necessary to treat all gynecological diseases in a timely manner, including menstrual irregularities and. It is known that with these diseases the likelihood of developing fibroadenoma increases. Thus, regular visits to the gynecologist and self-examination become the key to a woman’s health.

Breast fibroadenoma is a benign formation that is more often diagnosed in women aged 25-45 years. If left untreated, fibroadenoma can develop into cancer. Fibroadenoma is a tumor that has a capsule and clear boundaries. It is easily identified in the form of well-defined round tumors of soft elastic consistency, painless, not associated with the skin.

The size of fibroadenomas ranges from a few millimeters to five centimeters in diameter. During puberty, fibroadenomas often disappear on their own. During pregnancy it often increases in size.

Fibroadenomas in women aged 18-40 years require surgical intervention (partial removal of the mammary gland or enucleation). Consists of connective and proliferating epithelial tissue. The source of development is the lobules of the mammary gland. Because fibroadenomas are most often seen in young women, routine mammography is not indicated. In older women, it appears on photographs as a single, uniformly dense formation, somewhat denser than the surrounding tissue. Like all benign formations, it does not disrupt the structure of the breast tissue. With age, fibroadenoma can calcify and is then clearly visible on mammograms.

Diagnostic fine-needle biopsy, as a rule, does not have any special prognostic value.

Treatment is usually surgical. For small tumors (up to 20 mm), identified on ultrasound or mammograms that do not tend to further growth, with multiple fibroadenomas, monitoring of patients is possible.

What is fibroadenoma?

Fibroadenoma is a benign breast tumor, one of the forms. Fibroadenoma is localized in the upper part of the mammary gland. Upon palpation, the formation may shift. This is explained by the fact that it does not attach to the skin, unlike malignant structures.

On average, a benign formation grows to 3-8 mm in diameter. In advanced cases, the compaction grows up to 15 mm and becomes the cause of a visual defect. Due to the growth of the seal, deformation of the breast or its increase in size may occur.

Note! It is impossible to predict the outcome of the problem. A benign tumor progresses in some cases, and resolves in others. The optimal treatment regimen is selected by a mammologist, taking into account all the features of the pathology.

Symptoms

Breast fibroadenoma is not accompanied by characteristic signs in the initial stages of development. The small lump is invisible to palpation and does not cause pain.

It is possible to independently identify the problem only if the nodule is of a significant size. The main sign of pathology in this case is a visible tubercle located under the skin. The seal has an oval or round shape and clear contours.

If the formation is located next to the nipple, then in addition to the elastic seal on the chest, it may be accompanied by additional signs:

  • the appearance of ulcers on the halo;
  • transparent liquid, odorless and colorless;
  • pain when palpating the problem area.

Some forms of the disease (leaf fibroadenoma) have a high probability of degeneration into. At the same time, the woman’s general well-being worsens, and the following symptoms appear:

  • cracks appear on the surface of the nipple;
  • cloudy or bloody fluid is discharged from the chest;
  • The color of the skin located above the tumor will change.

Any of the listed signs is a reason to immediately consult a doctor. The faster therapy is carried out, the greater the chance of eliminating fibroadenoma.

Reasons

Doctors have not established the exact reasons for the appearance of a benign lump. There are a number of negative factors that influence the growth and formation of fibroadenoma. These include:

  • hormonal imbalance;
  • hereditary predisposition to cancer;
  • numerous abortions;
  • stressful situations;
  • uncontrolled use of contraceptives;
  • injury to breast tissue;

Note! The main cause of fibroadenoma is considered to be hormonal imbalance. When the functions of the thyroid gland are impaired, the mammary glands are affected in 50% of cases. A lump on the chest is formed under the influence of estrogen, the level of which increases with endocrine pathologies.

Types and forms

There are 4 types of fibroadenomas:

  1. Intracanalicular. The formation is formed from connective tissues growing into the cavity of the milk ducts. On palpation, the intracanalicular tumor is felt as a loose structure with uneven boundaries.
  2. Perikanalicular. The tumor grows around the milk ducts and is a homogeneous fibroglandular structure. Diagnosed in girls during puberty and in women during pregnancy. Pericanalicular fibroadenoma is treated with medication.
  3. Mixed. The formation combines tissues of the pericanalicular and intracalicular types and is located inside the milk duct.
  4. Leaf-shaped. The most unfavorable type of education according to the forecast. The nodule rapidly grows in size and has a high risk of degenerating into a cancerous tumor. Fibromatosis reaches up to 4-5 cm in diameter. Diagnosed in women after 45 years of age during menopause.

Note! In 10 out of 100 patients, leaf-shaped fibroadenomas develop into cancer. For this reason, experts recommend surgical removal of the seal followed by medication.

Depending on the age of a woman, there are 2 forms of fibroadenomas:

  1. Immature. Formed in girls during adolescence. The seal does not have a capsule, so its removal is possible without surgery.
  2. Mature. Diagnosed in women after 25 years or during menopause. The nodule has a dense structure and does not respond well to drug therapy.

What is leaf-shaped (phylloid) fibroadenoma?

Phylloid fibroadenoma is described as a “borderline” tumor between malignant and benign tumors. As a rule, it is distinguished by its large size, polycyclic contours, and rapid growth. May degenerate into sarcoma in approximately 10% of cases (according to Donegan W. L. 1995)

Diagnostics

As a rule, to establish a diagnosis, an examination by an oncologist surgeon, an ultrasound of the mammary gland and a puncture biopsy are sufficient. In some cases, a mammogram is required.

The pathology is treated by a mammologist. To determine the type of tumor, the doctor palpates the problem area, and then prescribes the patient a series of laboratory and instrumental tests:

  1. . The study examines the structure of the tumor, its size and location.
  2. . If fibroadenoma is suspected of degenerating into a malignant structure, a cytological examination is prescribed. It allows you to identify atypical cells in the structure of the compaction. A biopsy makes it possible to diagnose breast cancer in the early stages of development. The puncture during the biopsy is carried out under the control of an ultrasound machine.
  3. I. The examination reveals how long ago the nodule appeared. Over time, fibroid tissue is saturated with calcium salts and is visualized most clearly on an x-ray.

Can fibroadenoma develop into cancer?

No, it's practically impossible. However, there is a special form of fibroadenomas - the so-called leaf-shaped fibroadenomas. These tumors can develop into sarcoma.

Does fibroadenoma need to be treated?

Yes, it is necessary. However, in some cases, only observation without any intervention is possible. This can be done in the following cases:

  • Small size fibroadenoma (up to 2 cm)
  • Absence or very slow growth
  • Multiple fibroadenomas, when the risk of disease recurrence is very high

Treatment

Treatment of breast fibroadenoma can be complex or include only one of the therapeutic areas:

  • medicinal;
  • surgical;
  • minimally invasive.

Before drawing up a treatment regimen, the doctor must identify the cause of the benign formation. Surgical removal of fibroadenoma does not guarantee that the problem will not recur in the future.

Indications for surgical removal

The treatment regimen for the pathology depends on the type of tumor. Unconventional methods of treatment or dietary supplements will not help to cope with the problem. Fibroadenoma resolves on its own in rare cases.

If a tumor up to 1 cm in diameter is diagnosed, the mammologist offers drug treatment and monitors the dynamics of the development of the lump. If the node continues to grow after taking medications, surgical intervention is recommended. There are other indications for surgery:

  • the possibility of transforming a benign tumor into cancer;
  • cosmetic defects caused by compaction;
  • pregnancy planning;
  • leaf-shaped form of the disease.

Conservative

The doctor selects medications and calculates their dosage for each woman individually. Violation of the recommended doses and independent cancellation of treatment threatens the development of complications.

To eliminate breast fibroadenoma, the following drugs are prescribed:

  1. Progestogel in gel form. The main active ingredient of the drug is micronized progesterone. The medicine is applied in a thin layer to the problem area 2 times a day. The gel is recommended for use in the 2nd half of the menstrual cycle. The main substance of the drug is absorbed through the skin, but does not penetrate the circulatory system. For this reason, Progestogel is considered a relatively safe medicine.
  2. Mastodinon in the form of drops or tablets. The product contains natural ingredients and contains no hormones. The drug is effective only if the nodule does not have a capsule and clear contours. The therapeutic effect of Mastodinon is aimed at reducing the level of the hormone prolactin, which provokes further growth of fibroadenoma.
  3. Duphaston. A hormonal drug that reduces estrogen levels in the body. Due to this, the tumor either resolves or stops growing in size. The medicine does not affect ovulation. The only side effect of the drug is weight gain.
  4. Vitamin E.

In addition to conservative treatment, the doctor may recommend traditional medicine. They do not affect the size of the tumor and have no visible effect in fighting the disease. The result of their use is strengthening the body’s defenses and preventing complications of pathology.

Surgical

Breast fibroadenoma is removed in several ways:

  1. Through enucleation. The goal of the intervention is to completely eliminate the abnormal compaction without damaging adjacent tissues. The procedure is carried out only after determining the nature of the neoplasm. Enucleation is contraindicated for cancerous structures.
  2. Using sectoral resection. During the operation, not only the fibroadenoma is removed, but also part of the tissue surrounding the node. This is done to eliminate the risk of recurrence of the problem. An operation of this type is prescribed if the tumor rapidly increases in size or is accompanied by pain upon palpation.

The duration of the operation is from 30-60 minutes. After general anesthesia, the doctor makes a small incision in the skin of the breast, through which the lump is then removed. If necessary, the surgeon installs a drainage into the surgical field and stops the bleeding. After the tumor is removed, sutures are applied.

How difficult is the operation?

Patients who have undergone this operation claim that the fears before the operation do not correspond at all to the ease of the postoperative period. The fact is that even the early postoperative period is practically painless. The time frame for suture removal is approximately 9 (+/-2) days after surgery. This operation is considered one of the most easily tolerated in breast surgery.

What are the cosmetic consequences of the surgery?

If the operation is performed correctly in compliance with the principles of plastic surgery, surgery for fibroadenoma leaves virtually no visible marks on the body. Surgery for fibroadenoma, like any operation on the mammary gland, should end with the application of intradermal cosmetic sutures, which, after their removal and complete healing, become almost invisible. Unfortunately, not all clinics still profess this principle in breast surgery, so before the operation, be sure to check with your doctor what type of suture will be used.

Non-surgical removal

The advantage of non-surgical techniques is that they are less painful than surgery and do not require general anesthesia. The tumor is eliminated on an outpatient basis without further hospitalization. Regeneration of soft tissue occurs without scars on the skin.

Minimally invasive intervention is prescribed only for the removal of benign tumors that do not exceed 3-3.5 cm in diameter. Gentle methods of dealing with the problem include:

  • cryodestruction;
  • high-frequency ablation;
  • laser burning;
  • echo therapy.

The essence of cryodestruction is that argon is introduced into the abnormal compaction. The tumor tissue is frozen and then dies. The procedure is performed after local anesthesia of the surgical field. The effect of the procedure is achieved only if the size of the fibroadenoma does not exceed 3 cm in diameter.

With high-frequency ablation, the problem area is heated by radio waves. The destroyed structure is removed through a small incision in the skin under ultrasound guidance.

Burning out the tumor is performed using a laser beam. Under the influence of heat, abnormal structures collapse and die. Laser burning completely eliminates infection of the mammary gland.

Echo therapy is carried out in a non-contact manner. After the intervention, no traces remain on the skin. The impact on pathological cells is carried out through ultrasound.

Fibroadenoma and pregnancy

Fibroadenoma does not affect the course of pregnancy. When carrying a child, the tumor increases due to hormonal changes.

Note! The growth of a benign formation is diagnosed in 10-15% of pregnant women.

The need for removal depends on the type of formation. Surgery is indicated for leaf-shaped adenoma, because an increase in compaction can cause problems during breastfeeding.

Can fibroadenoma form again?

Yes, the occurrence of fibroadenoma is possible in other areas of the same or opposite breast, even after surgery.

Relapse of the pathology occurs due to the fact that the causes of its occurrence have not been eliminated. Treatment methods do not affect the prognosis of the disease. The risk of tumor recurrence is up to 1%. The threat of fibroadenoma degenerating into cancer persists in up to 20% of cases.

If treatment is not timely, a woman risks losing her mammary gland due to irreversible processes in the glandular tissues. A benign tumor can provoke inflammation of the breast, which negatively affects a woman’s well-being.

Prevention

Prevention of the disease consists of the following points:

  • maintaining a healthy lifestyle;
  • balanced nutrition;
  • preventing emotional overload;
  • choosing the right underwear;
  • regular breast ultrasound examination (once every six months);
  • breastfeeding a child;
  • maintaining a full sex life.

Breast fibroadenoma, despite its benign nature, is considered an insidious disease. At the beginning of its development, a tumor does not manifest itself with characteristic symptoms, but has a risk of degenerating into cancer. As a result, a woman may lose her mammary gland. Treatment depends on the type of lump, its size and how long ago it appeared.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Today, the bulk of breast diseases are benign pathologies, many of which are quite common. Their list includes various forms of mastopathy ( changes in breast tissue), and cysts ( cavities having a wall and contents), and also fibroadenomas. In this article we will talk specifically about fibroadenomas, the causes of their occurrence, symptoms, as well as methods of their treatment.

Definition of the concept

Fibroadenoma is a benign tumor of the mammary gland of glandular origin, which is one of the forms of nodular mastopathy. The appearance of this tumor resembles a dense round or oval node. Its dimensions vary from 0.2 - 0.5 mm to 5 - 7 cm in diameter. There are also cases when its dimensions reach 15 cm in diameter. When palpated, it is also possible to reveal that this tumor is mobile, that is, it is not connected to the skin. Women do not feel pain during palpation. A distinctive feature of this neoplasm is considered to be the predominance of connective tissue stroma ( basics) above the glandular parenchyma ( main fabric). Most often, this tumor can be diagnosed in women aged 15 to 35 years.

Compound

It consists of 2 types of tissues, namely connective and epithelial tissue. Both of these tissues are among the normal components of the breast.

Reasons for development

The exact reasons for the development of the tumor are still unknown. Experts are of the opinion that its appearance is due to the increased effect of estrogens ( female sex hormones), which provoke the development of focal proliferation ( focal growth) glandular tissue. They came to this conclusion because the tumor especially often forms during periods of increased estrogen synthesis, namely during pregnancy, lactation and puberty, as well as during menopause ( complete cessation of menstruation) and in the premenopausal period.

Clinical picture

In most cases, tumor development is asymptomatic. Only some patients experience slight pain at the site of the lesion. A large tumor can be seen visually. It is a subcutaneous tumor-like formation of the mammary gland, which has a dense but elastic consistency. The neoplasm is usually located outside the areolar zone ( outside the round area surrounding the nipple of the breast). Most often it can be found in the upper outer quadrant ( quarters) mammary gland.

Existing classifications

Fibroadenomas can be either mature or immature. In the first case, they are endowed with a densely elastic consistency and a shaped capsule. In addition, their growth is very slow, so that their size remains unchanged. As for the immature forms of this tumor, their consistency is soft. In addition, they are prone to progressive growth. Mature forms can most often be identified between the ages of 20 and 40 years, but immature forms are observed in most cases in girls during puberty.
There is another classification of this pathological condition, according to which fibroadenomas can be single or multiple. Multiple tumors can be located simultaneously in both mammary glands.

According to histological examination, the following variants of this neoplasm are distinguished:
1. Perikanalicular option: The tumor has a homogeneous structure. There is a clear limitation from surrounding tissues. The consistency is denser and often undergoes various dystrophic changes, during which calcifications are deposited ( microcalcifications);
2. Intracanalicular option: the tumor has a lobular structure, unclear contours and heterogeneous structure;
3. Mixed option: the structure is lobular, the structure is heterogeneous. In addition, symptoms of pericanalicular tumors are observed.

All of these tumor variants are unable to develop into cancer.

Leaf-shaped fibroadenoma - what is it?

Leaf-shaped or, as it is also called, phylloid fibroadenoma, is the only type of this tumor-like formation, which sooner or later can develop into a malignant neoplasm. This type of tumor received its name for its structure. This formation differs from other varieties in its polycyclic contours, large size and rapid growth rate.

How dangerous is this education?

There are cases when the size of fibroadenoma increases greatly, and in a fairly short period of time. As a result, the formation not only occupies the entire breast area, but also turns it into a large ball, due to which the mammary glands become asymmetrical. In the medical literature this phenomenon is called giant tumors which easily develop into cancer.


Fibroadenoma in men

This tumor can also appear in a man, but not in the mammary glands, but in the prostate gland. Unlike women, in representatives of the stronger sex it occurs at an older age due to a decrease in the amount of male sex hormones. There are also numerous predisposing factors that play an important role in the formation of this neoplasm.

Their list includes:

  • Injuries of the genitourinary organs;
  • Inflammatory diseases of the genitourinary system;
  • Pathologies of other organs and systems of the body;
  • Promiscuous or irregular sex life;
  • Various disorders of the circulatory process;
  • Hereditary predisposition;
  • Sedentary lifestyle;
  • Failure to comply with the rules of a healthy lifestyle.
As this tumor develops, men begin to experience pain in the lumbar region and prostate gland, constipation, and sexual dysfunction. In addition, they may experience various urinary disorders such as a sluggish stream of urine or false urges. Dry mouth and loss of appetite are often noted. Prolonged absence of treatment can lead to acute urinary retention. Due to the accumulation of urine in the bladder, stones often form. In addition, the veins of the bladder expand. This formation can be identified using digital examination of the rectum. The course of therapy involves surgery, during which the tumor is removed.

Does the neoplasm affect the course of pregnancy?

This neoplasm does not have any effect on the course of pregnancy and the general well-being of the unborn baby.

Does pregnancy affect tumors?

Since numerous hormonal changes occur in a woman's body during pregnancy, this can cause intensive tumor growth. In such cases, specialists perform urgent surgical intervention.

Diagnosis and differential diagnosis

To make an accurate diagnosis, the following research methods are used:
1. Palpation and clinical examination of the breast;
2. Fine needle aspiration biopsy of the tumor ( excision of a small area of ​​affected tissue) with further cytological examination ( examination of the structure of cellular elements);

3. Core needle biopsy ( is carried out extremely rarely);
4. Histological examination ( examination of tissues to determine their composition, the presence or absence of pathological cells or the general condition of the removed organ);
5. X-ray mammography ( X-ray method for examining the mammary glands);
6. Ultrasound ( ultrasound examination) mammary gland.

Differential diagnosis is carried out with the following pathological conditions:

  • Breast cyst;
  • Breast cancer;
  • Cystadenopapilloma ( benign tumor arising from the ducts of the mammary gland).

Treatment

Unfortunately, today there is not a single medicine that could be used to get rid of this tumor. The course of therapy in all cases involves surgical intervention, but not in all cases the tumor is removed immediately after its detection.

There are 2 types of surgical interventions to remove fibroadenoma:
1. Sectoral resection: During the operation, both the tumor itself and the surrounding tissue are removed. The tissue around the formation is taken at a distance of 1 to 2 - 3 cm. Most often, such surgical intervention is performed when cancer is suspected;

2. Enucleation or enucleation: The operation is performed under local anesthesia through an incision several centimeters in size. During this surgical intervention, the tumor is enucleated, the surrounding tissues are not affected. Surgery is performed if there is no suspicion of cancer.

Indications for tumor removal

  • Intensive increase in its size;
  • Large formations that cause a cosmetic defect;
  • Suspicion of cancer;
  • The tumor has a leaf-shaped shape;
  • A woman is planning a pregnancy.
Surgery can be performed under either local or general anesthesia. Its duration ranges from 20 to 60 minutes. After surgery, patients are recommended to stay in the hospital from 2 hours to 1 day. Most often, no postoperative problems arise, but some women complain of minor pain at the site of the postoperative scar.

Can cosmetic defects remain after surgery?

If the operation was performed correctly and intradermal cosmetic sutures were applied during the operation, then there should be no special marks left on the body, since the suture material in such cases dissolves on its own. If the patient received sutures that need to be removed 7-10 days after surgery, then most likely she will have a small scar.

What medications are prescribed to patients after surgery?

  • Immunomodulatory agents;
  • Drugs that improve liver function;
  • Anti-inflammatory medications;
  • Homeopathic remedies;
  • Progesterone preparations;
  • Antiviral medications.

Can the tumor reoccur?

In fact, it can, but it happens extremely rarely. When it recurs, a completely different area of ​​the same or another mammary gland is affected. Do not forget that surgical intervention is carried out by specialists to eliminate the consequences, and not the causes of the development of fibroadenoma.

Prevention measures

  • Regular self-examination of the mammary glands;
  • Timely consultation with a mammologist.
These preventive measures will not be able to prevent the development of benign tumors, but with their help you can protect yourself from cancer.

Having discovered a lump in the form of a pea or a small ball in their breasts, women go to the doctor with the hope that it is not a cancerous tumor. Having learned that the tumor is benign, they begin to doubt whether it is necessary to have an operation to cut out the tumor. This issue is especially concerning for pregnant women who have been diagnosed with breast fibroadenoma. There are situations in which postponing or refusing surgery is dangerous. In each case, the doctor individually decides which treatment method to choose.

There are several types of fibroadenoma:

  • pericanalicular (tissue grows around the milk duct);
  • intracanalicular (tumor forms inside the milk duct);
  • mixed (tissues grow inside and outside the duct);
  • leaf-shaped (leaf-shaped slits filled with mucus form in the tumor). It is this type of breast fibroadenoma that is most likely to degenerate into sarcoma.

A tumor is detected in the form of a soft spherical formation with a diameter of 5 mm to several centimeters. Unlike a cancerous tumor, fibroadenoma is not connected to the skin of the breast and moves freely during palpation. It is localized, as a rule, in the upper outer part of the gland. Moreover, it occurs in one of them or simultaneously in both. It is possible for several tumors to form, located in different areas of the mammary gland.

The tumor is painless. With a significant size of the tumor, an enlargement of the mammary gland is observed. Her skin looks normal.

The tumor is hormone dependent. It is formed and grows as a result of exceeding the norm of estrogen content in the body, which can be caused by endocrine disorders, the use of hormonal drugs, including for the purpose of contraception. Hyperestrogenism can also occur as a result of ovarian disease, obesity, insufficient physical activity of a woman and the influence of other factors. Most often, such a tumor is found in women aged 20-35 years, when the content of estrogen in the body reaches its maximum.

What treatment methods are used for fibroadenoma?

The choice of treatment method depends on the woman’s age, size and type of fibroadenoma. There are 2 treatment methods: conservative and surgical.

The doctor decides whether to remove the fibroadenoma or not after conducting an examination, including ultrasound, mammography, blood tests for hormones and antibodies to cancer cells, a biopsy of the mammary glands, followed by histological examination of tumor tissue.

Conservative treatment is carried out when the tumor has a diameter of no more than 8 mm. The woman is prescribed medications that suppress the production of estrogen and reduce their content in the blood, as well as medications containing vitamin E and iodine. A special diet is recommended to help you lose weight. The condition of the patient's mammary gland is constantly monitored using ultrasound. If it is noticed that the tumor not only does not decrease, but begins to grow, it is eliminated surgically.

When is the operation performed?

Surgical removal is the main treatment method. The operation is required in the following cases:

  1. When the test results cannot accurately determine the nature of the tumor. Suspicions of cancer are refuted or confirmed by subsequent histological examination of the removed material.
  2. When even a small leaf-shaped tumor is detected.
  3. If rapid growth of fibroadenoma is noticed (it doubles in size within 5 months).
  4. The neoplasm has a diameter of 3-5 cm or more.
  5. If a woman wishes to remove a cosmetic defect of the mammary gland or if the patient has cancer phobia.
  6. When planning a pregnancy.
  7. In women over 40 years of age (there is an increased likelihood of the formation of malignant cells due to a sharp change in hormonal levels).

Warning: Unfortunately, even surgery does not guarantee that the tumor will not appear again if the cause of its formation is not eliminated - a hormonal imbalance. Therefore, it is important to treat diseases that result in hormonal shifts and regulate body weight.

Video: Indications for fibroadenoma removal and surgical methods

Fibroadenoma during pregnancy

During pregnancy, the level of estrogen in the blood increases significantly, as they are produced by the placenta. As a result, rapid tumor growth may begin. This affects milk production and makes it difficult for the baby to feed. If during pregnancy a tumor larger than 1 cm in diameter with a dense capsule is discovered, it must be removed, although the presence of the tumor does not affect the course of the pregnancy itself and the condition of the fetus.

However, in some cases, when the size of the tumor is small, the membrane has not yet fully formed, removal is not performed, since the operation is stressful for the pregnant woman’s body. In this case, the condition of the tumor is constantly monitored. With prolonged breastfeeding (for 1.5-2 years), it can resolve on its own.

Fibroadenoma during menopause

If the diagnosis has confirmed that the tumor is benign, and it arose before the onset of menopause symptoms, then it is not removed. The reason is that when the amount of estrogen decreases, which occurs in a woman due to the aging of the body, tumor growth sometimes stops completely, and the disease regresses.

How is fibroadenoma surgically removed?

As a rule, the operation is performed under local anesthesia. After the tumor is removed, a cosmetic suture is applied.

Breast fibroadenoma can be removed in the following ways:

  1. Enucleation (husking). This method is used to eliminate small tumors, if its nature is established absolutely precisely, suspicion of cancer is completely removed.
  2. Sectoral resection. The operation is performed under local or general anesthesia. This method eliminates bulky tumors when cancer is suspected. In this case, not only the fibroadenoma itself is removed, but also the tissues surrounding it. Applying a cosmetic suture allows you to make the incision site invisible. Sometimes a special gel is used to quickly dissolve the suture to prevent scar formation. It is applied on the first day after surgery. The disadvantage of this method is that after the operation, pain is felt in the chest until complete healing.
  3. Laser burning. The operation is performed within 15 minutes and is used to eliminate fibroadenoma of any type. After the tumor is removed, a small, quickly healing suture remains. After such an operation, pain may be observed in the suture area for several days. Removal is performed under local anesthesia.

Addition: In very rare cases, when the tumor grows to a size greater than 8 cm or many scattered lumps are found, it is necessary to completely remove the breast, but usually it is possible to detect and remove fibroadenoma at an earlier stage.

Video: What is fibroadenoma. How is the operation to remove it performed?

Complications after surgery

After surgery to remove a tumor, wound suppuration may occur due to infection. Possible increase in temperature. Eliminate the inflammatory process with antibiotics.

Comment: When deciding whether or not to have surgery, women should take into account that after removal of fibroadenoma by any surgical method, the lactation function of the mammary gland is not impaired.

In order for healing to proceed quickly and safely, a woman must follow the recommendations of doctors: for 2 weeks after removal of fibroadenoma, do not visit the sauna, do not exercise, avoid exposure to sunlight, do not take a hot bath, use only a shower. It is prohibited to apply any compresses to the chest or self-medicate in other ways.

In 15-20% of cases, a relapse of the disease occurs, and the operation has to be repeated.