Fibroidadenoma is a benign hormone-dependent tumor that develops primarily from the breast tissue.
Being one of the forms of nodal mastopathy, it is most often detected in young( up to thirty-five years old) women and even fifteen-year-old girls. Fibroadenoma, which occurs asymptomatically, is often found in women of much more mature age during a preventive examination.
What is breast fibroadenoma?
Being a benign tumor-like formation, fibroadenoma is usually localized in the upper quadrant of one( in rare cases both) of the mammary gland. The basis of fibroadenomas are excessively overgrown connective tissues, surrounded and thoroughly permeated with inclusions of glandular parenchyma.
Photo of a removed fibroadenoma from the breast
A characteristic feature of fibroadenoma is the presence of clear boundaries. The dimensions of this rounded and completely painless lesion can range from two millimeters to seven centimeters.
The predominance of the stroma( connective tissue) over the glandular parenchyma is the main feature that makes it possible to distinguish it from adenoma.
The growth of fibroadenoma depends on the hormonal background of a woman consisting of the pituitary gland, steroid hormones produced by the follicular apparatus of female ovaries, as well as hormones of the adrenals and thyroid gland.
Types of
There are two types of fibroadenomas:
- nodular;
- leaf-shaped.
In turn, the neoplasm of the nodular species is divided into:
- pericanalicular;
- intracanalicular;
- mixed.
Perikanalikulyarnaya
This variant of fibroadenoma is characterized by a homogeneous structure and a clear distinction from adjacent tissues. The consistency of the tumor is characterized by a sufficient density and a tendency to dystrophic changes, often resulting in micro-calcinosis( deposition of calcifications).
Intranakalikulyarnaya
Fibroadenoma of this species differs lobed structure, fuzzy boundaries and heterogeneity of its structure.
Mixed
This variant of fibroadenoma combines the features of the two types described above: lobular structure and heterogeneity of the structure. Most of the symptoms resemble those of a pericanalicular tumor.
All three types of nodular fibroadenomas are never malignant, that is, they do not overgrow into cancer.
Philloid( leaf-like)
The leafy fibroadenoma, characterized by an extreme rate of development( the cases when the tumor reached thirty centimeters in diameter and weighed ten kilograms) is the only species of this benign tumor that can grow into a cancer tumor - sarcoma.
This photo shows how the leafy fibroadenoma of the breast looks on the ultrasound diagnosis
. Occurring not too often, it got its name because of the characteristic form of multilayered tumor structures on a leaf-like incision. When palpation, you can feel their uneven polycyclic contours.
Characteristic features of phylloid fibroaden:
- a clear distinction from adjacent tissues;
- no capsule;
- skin adhesion;
- propensity for accelerated growth.
Sometimes the growth of leaf-shaped fibroadenoma is biphasic: during the first phase, the tumor grows very slowly, during the second, sudden growth begins.
Causes of the appearance of
The exact causes of fibroadenoma development have not been revealed to this day. We can list a number of factors that can activate this process:
- thyroid disease and endocrine system;
- presence of hereditary predisposition;
- the process of puberty;
- occurrence of pregnancy;
- frequent abortions;
- physical and neural overload;
- effect of regular or severe stress;
- pathological processes in the adrenal and ovaries;
- presence of obesity and diabetes;
- improper selection of oral contraceptives;
- uncontrolled reception of contraceptives;
- trauma to the breast, as well as the thermal effect on it or improperly performed massage;
- abuse of the solarium and sunbathing.
One of the main causes of the rapid growth of connective tissue cells is a hormonal failure characterized by a significant excess of estrogen levels. This picture can be observed both during puberty and during pregnancy.
Symptoms of
The insidiousness of fibroadenoma consists in its complete painlessness and absence of visual manifestations both in the beginning and in the process of further development.
It does not cause any pain and fever.
It is possible to detect fibroadenoma by chance in case of breast self-examination and with routine medical examination.
The main feature of the already sufficiently large fibroadenoma is the presence of a tubercle, which is easily moved by fingers, but when the position of the body changes, its localization does not change.
Fibroadenoma, located near the nipple, is characterized by the following features:
- the appearance of small cracks and sores both on the nipple itself and near it;
- by isolation of a clear, odorless liquid;
- soreness of touch.
The specific symptomatology of fibroadenoma, manifested in self-examination of the chest, is characterized by:
- having a round or oval seal having an elastic dense structure with clear boundaries;
- by the absence of pain when the detected tubercle is displaced or when it is pressed against it;
- no changes in skin condition( their structure, color and temperature do not differ from other skin areas).
Quite differently manifests itself as a cyst of the breast. Being painless at the very beginning of its development, with an increase in size, it begins to deliver a woman a fairly strong pain in the chest.
A large cyst, filled with a lot of secretion, causes constant pain, severe burning, pulling sensation and uneven compaction of the mammary glands.
Can fibroadenoma develop into cancer and how can it be distinguished from oncology?
Nodular fibroadenomas are purely benign neoplasms that do not malignate ever.
There are two time intervals in the life of each woman, during which she has a high probability of developing fibroadenoma of this species. The first period covers a period of twelve to twenty years. The second one is from forty to fifty. These are the periods marked by the highest hormonal activity.
The basis for suspicion of a benign neoplasm in sarcoma is the rapid growth of the tumor. If its size exceeded 1.5 cm, the patient is operated on, and the removed tissue is sent for histology. Only a laboratory test can confirm or disprove a preliminary diagnosis.
Fibroadenoma, not exceeding one centimeter, is observed by the attending physician. To determine whether it is benign, the patient is referred for biopsy or performs a puncture.
Compatibility with IVF and Pregnancy
- Fibroid adenoma of the breast does not pose any threat to the pregnant woman and the proper development of her fetus. Some discomfort can only cause a tumor that has reached a significant size. Cases of spontaneous disappearance of small fibroadenomas in mothers who have finished feeding a baby are described.
- As for the IVF procedure, the opinions of physicians are divided here. Some of them believe that it can be dangerous for a woman with such a diagnosis. In order to develop several ovaries in the ovaries of the future mother, she undergoes a course of stimulating hormonal therapy. The impact of hormones can stimulate the development of not only eggs. Just as rapidly can develop and tumor cells. However, as practice has shown, in a number of cases no growth of fibroadenoma was observed. Since there is still no unity in the opinions of physicians, the decision on the possibility of an IVF procedure in each specific case is taken on an individual basis. Sometimes IVF procedure is preceded by a preventive operation to remove fibroadenoma.
Than a tumor is dangerous?
- Nodular forms fibroadenom - benign neoplasms, not dangerous to the health of the patient. They should be removed only if there is a positive dynamics to prevent the tumor from reaching a large size, since removing a large node can lead to a noticeable cosmetic defect.
- The danger is only the malignancy of the phylloidal fibroadenoma , leading to the development of an extremely aggressive disease - breast sarcoma.
Diagnosis
You can diagnose a tumor with:
- Palpation and clinical examination. Palpation allows you to determine the approximate parameters of the neoplasm( features of location, shape, consistency, contours, displacement).
- X-ray mammography. It confirms the presence of a tumor that differs from neighboring tissues and has clear boundaries.
- ultrasound. This study allows you to clarify what the neoplasm is: fibrous or cystic.
- Fine needle aspiration biopsy. The subsequent cytological analysis of the taken tissue will show the degree of benign neoplasm.
Methods of treatment
Having received a morphological confirmation of the diagnosis, fibroadenoma can be subjected to:
- Dynamic observation. This tactic is suitable for tumors not exceeding two centimeters, which do not disturb the patient and do not increase in size.
- Hormone therapy.
- Surgical removal. The removal of the nodular fibroadenoma is performed by enucleation( neoplasm excision without removing adjacent tissues) through the incision made along the margin of the areola. The removal of the leafy tumor is carried out by sectoral resection( together with the tumor, the surrounding affected tissues are also removed).
Prevention
- Specific methods of primary prevention of fibroadenomas have not been developed so far.
- Secondary prophylaxis is a regular examination using the methods of ultrasound examination of mammary glands.
Video on the treatment of fibroadenoma: