Fibroadenoma
definition
Fibroadenoma is the most common benign tumor of the female breast and occurs mainly between the ages of 20 and 40. It consists of glandular and connective tissue of the breast and is therefore one of the mixed tumors.
Epidemiology
The Fibroadenoma occurs in around 30% of all women.
causes
A hormonal dysregulation of female hormones (Estrogens and Progestins), under the influence of which the tumor develops and grows. This explains why by taking the pill (oral contraceptives) a regression of the Fibroadenoma can be evoked.
Appearance
A fibroadenoma is a round-oval, usually sharply demarcated lump that can be moved easily against the healthy tissue of the breast. Untreated it can reach a size of 5cm. In most cases there is only a single lump, but rarely several can arise.
Fibroadenomas can be divided into two different types based on their growth form. The pericanalicular Fibroadenoma grows around the round-oval mammary glands, compressing the glands concentrically. The intracanalicular Fibroadenoma, on the other hand, compresses the glands in such a way that deer antler-like, branched, crevice-shaped cavities arise. However, this distinction has no clinical significance.
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Symptoms
A Fibroadenoma does not cause symptoms and is usually not painful. Large fibroadenomas can cause a bump in the form of a bulge on the chest.
diagnosis
Fibroadenomas are mostly discovered by women themselves during self-examination. One or more nodes can be felt, which can be close together and are not painful.
At the gynecologist they are chest and the Armpits first considered carefully (inspection) and scanned (Palpation). Then one follows Ultrasonic -Examination (Sonography), possibly also one X-ray examination the chest (Mammography). If a malignant tumor cannot be excluded in this way, a tissue sample is taken from the node for further diagnosis and examined under the microscope. The required tissue is either removed by puncturing the node or the entire node is surgically removed.
Note:
Every change in the breast, especially lumps, must be examined and assessed by a doctor as quickly as possible!
Read more about here Breast lump.
Differential diagnosis / alternative causes
The phyllodes tumor resembles that Fibroadenoma in its tissue structure, but is larger (up to 10cm) and often forms tongue-like extensions that can break through to the surface of the skin. They tend to recur even after successful treatment (Tendency to relapse) and can degenerate in 10-15% of cases.
Read how you can here Recognize breast cancer can.
therapy
Growing fibroadenomas are usually removed surgically. Little ones Fibroadenomasthat show no growth can initially only be observed if a malignant degeneration has been ruled out beforehand. There can also be oral contraceptives like that pill administered to bring about regression of the fibroadenoma and even prevent the occurrence of benign breast tumors. Before or during a pregnancy The removal of a fibroadenoma is recommended because fibroadenomas usually grow quickly during pregnancy due to the changed hormone balance and can then lead to problems. As a rule, breastfeeding can be carried out without any problems after the removal.
Removing a fibroadenoma
A fibroadenoma is a benign change in the female breast. Development into breast cancer has only been described in very few individual cases. Therefore, removal of a fibroadenoma is generally not necessary. However, there are a few situations where removal may be considered. It can seldom happen that, without removing a lump in the breast and the subsequent histopathological examination, no clear distinction can be made between a benign finding (e.g. a fibroadenoma) and a malignant finding (e.g. breast cancer) can. In such cases, tissue removal and examination should be considered. In most cases, a minimally invasive biopsy of the breast is sufficient.
Very large fibroadenomas and multiple fibroadenomas in one breast can be cosmetically troublesome if they change the shape of the breast or become visible on its surface. In such cases a removal can be considered. Removal can also be useful if fibroadenomas grow rapidly or change significantly due to hormonal influences within the female cycle or during pregnancy.
For some women, knowing about a lump in the breast is psychologically stressful and can be accompanied by severe anxiety. Even then, removal of a fibroadenoma may be justified. Various techniques are available for removing fibroadenomas. Which method makes sense depends on various things. The position of the fibroadenoma in the breast (for example, the depth), the size and the reason for the distance play a role. The size of the breast and the expected cosmetic result are also taken into account when choosing the procedure.
OP
An operation for a fibroadenoma is mainly carried out if it is cosmetically disturbing and affects the appearance of the breast, if a clear diagnosis without surgery is not possible or if the fibroadenoma is psychologically very stressful. There are a few different methods that can be used to do this.
The most common method is that Withdrawal (Excision) of the fibroadenoma through a small operation. The fibroadenoma is usually used for this purpose Ultrasonic localized in the chest and then cut out. The location of the incision in the skin depends on the size of the fibroadenoma, the number of fibroadenomas to be removed, and their location in the breast. In doing so, the least possible impairment of the appearance of the breast from the scar and the removed tissue is considered. With modern techniques and cuts, very good cosmetic results can usually be achieved.
Other techniques use strong ones heat or cold to destroy the fibroadenoma. With the so-called Cryoablation a strong cold is generated on the fibroadenoma by means of a probe, which leads to the destruction of the fibroadenoma. In this case, no tissue is removed, so the technique is not suitable for cases in which a histopathological examination is to be carried out. This technique needed no General anesthesia and makes do with a very small cut in the skin, which is associated with a smaller scar. As a rule, no operating room is required, which is why cryoablation can also be carried out in practices. In studies of many patients, the strong reduction in size led to the fibroadenoma no longer being palpable after therapy.
Fibroadenomas can also be treated with high heat. As with cryoablation, a probe is brought to the fibroadenoma. Using lasers, ultrasound, microwaves or radio waves, the tissue is heated locally and thereby destroyed.
Mom
Mamma is the Latin term for feminine chest and is widely used in medical parlance. The mom is made up of Adipose tissue, Connective (supporting) tissue and the glandular tissue. Their size and shape depends on the relationship between these types of tissue and their structure.
The glandular tissue changes depending on its size and shape Menstrual cycle and especially strong during pregnancy and breastfeeding. During this time, changes in the hormonal balance and other messenger substances lead to a transformation of the glands and preparation of the Milk production. The glands become larger and more numerous and, among other things, the additional stimulus of sucking the infant on the mammary gland leads to milk production.
Fibroadenomas are made up of both connective tissue, as well as parts of the Glandular tissue. The exact mechanism of the formation of these nodular structures has not yet been precisely clarified. Like the glandular structures of the breast, fibroadenomas can also fluctuate somewhat in size and texture due to hormonal effects within the female cycle. Major changes in size (usually increase in size) can also occur during pregnancy.
With the Menopause the woman's hormonal balance changes. The concentrations of female hormones (among others estrogen) decrease and the cycle-dependent changes in the sexual organs come to a standstill. This also has an impact on the mother. The glandular tissue proportions decrease relative fat percentage increases (so-called involution). Similar to the female breast (breast) in general, the same applies to fibroadenomas. Due to the lower exposure to female sex hormones, it can lead to a Decrease in size the fibroadenomas are coming. This can also mean that these are no longer palpable. If a fibroadenoma causes symptoms, these too can disappear during and after the menopause (peri- and post-menopausal). Therefore, especially during this time, surgical therapy should be critically weighed up against wait-and-see behavior.
After menopause, fibroadenomas occur much less often. This can also be explained by the changes to the mamma. The glandular tissue becomes less and with it the original tissue of the fibroadenomas. In addition, the female hormones are also missing an important growth stimulus. Taking hormones during this time counteracts these mechanisms and thus increases the likelihood of new fibroadenomas developing, or existing fibroadenomas can grow. Due to the higher proportion of malignant changes, spatial demands after the menopause should be clarified particularly carefully.
rehabilitation
Complete removal leads to immediate recovery. Incompletely removed Fibroadenomas tend to grow back (Tendency to relapse).
prophylaxis
The best prophylaxis is woman self-examination. This should be done at least once a month, regardless of age. The best time to do this is a week after the start of the Menstrual period (Menstruation), because the breast is then particularly soft. For women taking a hormone supplement like the pill, the best time to do it is one week after starting a new monthly supply. In addition, women from the age of 30 should have their breasts examined once a year by a gynecologist. The cost of this Medical check-up is covered by health insurance companies from the age of 30.
forecast
Patients with a Fibroadenoma do not have an increased risk of developing breast cancer. The fibroadenoma itself does not usually degenerate and remains benign.
Important conclusion
Unless proven otherwise, the discovery of a lump in the breast is considered to be malignant and requires a medical evaluation. In contrast to breast cancer (breast cancer), fibroadenomas are usually benign and easy to remove surgically. It is therefore important to have the woman examine herself monthly and, if a change in the breast is discovered, to visit the gynecologist immediately!
