Fibroadenoma
About the disease
Symptoms and classification
Diagnostics
Treatment
Prognosis and prevention
About the disease
Fibroadenoma of the breast is a neoplasm of a benign nature that develops from the glandular tissue of the breast.
The tumor is usually diagnosed in women in the early reproductive period, at the age of 14 to 35 years. The prevalence of fibroadenoma in adults is relatively low.
Fibroadenoma: general information
Breast fibroadenomas are more common at a young age. The peak of pathology detection occurs at the age of approximately 25 years. At the same time, the prevalence of fibroadenoma in adolescent girls is estimated at 54%, and in the general population it does not exceed 10%.It has not yet been possible to determine exactly what causes give rise to the development of breast fibroadenoma. Modern researchers ARE CONSIDERING THE THEORY of the appearance of a neoplasm with a hormonal factor. The tumor develops from cells of the stroma and epithelium. These tissues have receptors for the main female hormones estrogens and progesterone. One of the risk factors, the effect of which is well studied, is hyperestrogenism (excess of estrogens) with a decrease in progesterone levels. This condition causes excessive growth of the epithelium, which leads to the formation of a tumor.
The association of breast fibroadenoma with hormonal factor confirms that these formations show a tendency to increase during the period of hormonal changes in adolescent girls before the final establishment of menstruation, and also inwomen during pregnancy.
In addition, there is a genetic factor in the development of neoplasms. The tumor is more common in patients whose close relatives have been diagnosed with benign dysplasia. To date, fibroadenoma has been linked to a somatic mutation in the MED12 gene, which was detected in 60% of cases of pathology.
Symptoms and classification
Symptoms
The development of fibroadenoma may be associated with symptoms such as:
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Palpable formation in the mammary gland
Probing allows you to detect a dense, elastic nodule with clear, smooth outlines. The nodule does not cause pain, it is easy to dislodge it under the skin. Fibroadenoma sizes exceed 2.5cm only in rare cases.
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Mastalgia
Breast tenderness accompanying fibroadenoma is more common in adolescent girls. As a rule, this symptom is not caused by the actual development of education, but by hormonal disorders. In the last weeks of the cycle, the size of the neoplasm may increase, which is associated with swelling of the breast tissue.
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Violation of breast symmetry
With large and gigantic neoplasms, it can affect the shape of the breast and cause its pronounced asymmetry. The nodule protrudes from the tissues, even when the patient is lying on her back.
Small fibroadenomas often do not show themselves as pronounced symptoms.
Classification of breast fibroadenoma
A common fibroadenoma is a homogeneous, slow-growing formation. Doctors often do not remove such a tumor immediately, but prescribe an operation to remove it after a few months, assessing the growth dynamics and the associated risks of contour deformity. According to their structure, such neoplasms are divided into pericanalicular (grow around the ducts), intracanalicular (grow inside the duct) and mixed.
However, the treatment strategy differs for such types of fibroadenomas as:
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The complex structure of such fibroadenoma includes other neoplasms: cysts, calcifications, and hyperplasia. Formations of this type can grow rapidly and this often serves as a reason for enucleation or removal.
Gigantic
Such neoplasms include fibroadenomas that exceed 5 cm in size and weigh 500 grams. Such tumors are rare, but they significantly reduce the patient's quality of life, as they grow rapidly and provoke a sharp asymmetry of the mammary glands. Although this formation is not malignant, it disrupts the normal development of the breast, therefore, its removal is recommended. After surgery, in most cases, the normal shape and complete symmetry of the mammary glands are restored.
Diagnostics
It is impossible to accurately determine the type of neoplasm only during a physical examination, therefore instrumental examinations are prescribed:
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Breast ultrasound
This diagnostic procedure is more informative for young women and adolescents, who make up the bulk of fibroadenoma patients.
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Mammography
This study is more often conducted in women over 40 years of age, as it may be less informative in younger patients. Mammography with tomosynthesis can be performed at the EMC clinic: the method increases the informative value of conventional mammography by about 40%, but MRI is the most informative method.
During instrumental examination, breast fibroadenoma is visualized as a formation with clear contours of a rounded or oval shape, with a homogeneous structure.
In all cases, before deciding on the need for surgical treatment, it is necessary to perform a biopsy of the neoplasm.
Treatment
Treatment of breast fibroadenoma
When detecting teenage girls in some cases, doctors use the tactics of expectant observation. Medical practice shows that in about 10-40% of cases in girls, benign formations regress independently within a few years. In late-aged women, fibroadenomas may regress after menopause. Fibroadenoma removal is considered if it remains unchanged or does not completely regress by the age of 35. If the formation is found in a woman over 35 years old, a short follow-up period (6-12 months) is recommended and, if it persists, the fibroadenoma should be removed after 12 months.
EMC uses enucleation and vacuum aspiration under ultrasound control for fibroadenoma sizes up to 1 cm. During vacuum aspiration, fibroadenoma is removed using minimally invasive surgery with a special needle with an automatic material extraction system under local anesthesia. During enucleation, the tumor is completely removed along with the capsule. Sometimes removal is performed by the method of sectoral resection or lumpectomy, then there is excision of the tumor with minimal capture of healthy tissues. The choice of treatment method depends on the indications, the age of the patient and other factors determined by the doctor.It is important to understand that both in fibroadenoma and in any other place of the breast, the appearance of breast cancer occurs in the same ratio. This indicates that fibroadenoma does not degenerate into a malignant tumor.
Prognosis and prevention
If the fibroadenoma does not malignify, the prognosis with timely treatment is favorable.
For the prevention of neoplasms in adolescent girls, measures that stabilize the endocrine system are recommended:
- proper daily routine;
- healthy eating;
- normalization of weight;
- minimizing stress.
In women, the risk of fibroadenomas can be reduced by:
- the birth of a child under the age of 30;
- breastfeeding;
- regular visits to the doctor for preventive breast examination.
Make an appointment for a consultation and we will contact you to clarify the details.
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