What is fibroadenoma? Fibroadenoma - should you worry? Drug Treatment Options

Breast fibroadenoma is one of the types of nodular mastopathy, which is formed as a result of disorders of the human endocrine system and is a local growth in the woman’s mammary gland.

Fibroadenoma - what is it?

Breast fibroadenoma is a neoplasm that forms in the upper part of a woman’s breast. This neoplasm is most often benign and is most common among women experiencing menopause. It is worth noting that the neoplasm begins to appear in teenage girls, increases over time, and after 30 years reaches its maximum size. The main reasons for such changes may be hormonal disorders in a woman’s body associated with pregnancy or age-related changes.

There are cases when diffuse fibroadenomatosis can be confused with fibroadenoma. You should know that diffuse fibroadenomatosis is a multitude of small compactions that disrupt the structure of one or both mammary glands.

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Main causes of tumor formation

The exact cause of fibroadenoma formation has not been established. Experts pay special attention to hormonal disorders, namely the level of estrogen in a woman’s body. But it cannot be said that they are the main reason.

There are a number of factors that can cause the development of a tumor:

• Improper breastfeeding;
• Injuries and injuries to the chest;
• Abortion, premature termination of pregnancy;
• Excessive visits to solariums and heavy tanning;
• Past mastitis.

The most well-known causes of fibroadenoma formation are:

• Emotional stress and severe negative stress;
• Ovarian athyroidism, neoplasms in the ovaries;
• Formation of cysts in the mammary glands;
• Increased production of hormones characteristic of tumor growth;
• Hormonal imbalance in a woman’s body.

How to identify fibroadenoma?

There are a number of characteristic signs with which a woman can independently check for the presence of a neoplasm:

• The presence of one or several nodules at once;
• The node may move during palpation;
• Clearly defined contours, smooth surface.
• Uniformity of structure;
• The size of the nodules can vary from 1 mm. up to 70 mm.

If you palpate on your own, a woman may feel a small, dense ball in the area of ​​the upper outer quadrant of the mammary gland. Usually the skin over the tumor does not change and pain is not felt.

This pathology may remain undetected for quite a long time, since it does not manifest itself in any way. If a woman feels pain in the area of ​​fibroadenoma, this indicates the presence of mastopathy, which responds to hormonal fluctuations.

Fibroadenoma can be detected: by palpation, by an external examination by a mammologist, by ultrasound and x-rays, as well as by taking a biopsy to determine the likelihood of cancerous degeneration.

If the formation does not interfere with life in any way, the woman must consult a specialist (surgeon, gynecologist or oncologist) as soon as she discovers it.

This tumor may not be entirely dense and small, and may also change in size. In such cases, it is called immature, and it mainly occurs in younger women. If the detected tumor is dense and practically does not change in size, then it is mature and is mainly diagnosed in older women.

Fibroadenoma can be found on both the left and right sides, and in both mammary glands. In the latter case, the risk of the tumor developing into a malignant one doubles. If the tumor is small in size, then it will not cause any pain syndromes. Well, if pain is present, this indicates that the tumor is large. In such cases, it compresses the blood vessels, resulting in discomfort and pain.

Fibroadenoma can grow and transform, especially during periods when women experience hormonal changes: lactation, menopause, pregnancy, termination of pregnancy. In order to avoid undesirable consequences, and in order not to create favorable conditions for the degeneration and growth of a benign tumor, it must be removed. And also submit material for research, in order to exclude oncology.

Types of nodular mastopathy and their characteristics

There are four types of nodular mastopathy:

The characteristic features of this type of mastopathy include:

• Peculiar structure (layered);
• High risk of developing into a malignant tumor (in 10% of cases);
• Feeling pain syndromes;
• Rapid increase in size;
• Manifestations of various pathologies;
• Often connections with other gynecological diseases, such as cysts, infertility, fibroids.

Also, leaf-shaped fibroadenoma has peculiar signs with which it can be easily distinguished from other types of tumors, these are:

• Heterogeneous structure;
• Blue-purple color of the skin in the area of ​​the tumor (as the nodule enlarges, the skin stretches and becomes thinner, resulting in a change in color);
• It consists of several plexuses that look like leaves.

In cases where the tumor noticeably increases in size over a short period of time, the specialist can safely say that it is phyllodes fibroadenoma. It is at the stage when fibrocystic mastopathy acquires a leaf-shaped form that it reaches the highest level of probability of developing from benign to malignant sarcoma. According to statistics, such changes are observed in 10 cases out of 100. In such cases, it requires immediate surgical intervention and removal.

Treatment methods

Can fibroadenoma be cured? The possibility of treating fibroadenoma depends entirely on the behavior of the tumor, the level of risk of malignancy, the type of tumor and its response to drug treatment.

Basically, types of tumors such as fibroadenoma are removed surgically. In cases where the size of the tumor is very small (up to about 5 mm), the specialist doctor may decide to continue observation without surgery. But this decision is made only after a series of studies, such as: biopsy, ultrasound, checking hormonal levels and examination by a mammologist.

Removing a fibroadenoma cannot guarantee that it will not appear again. The key to a successful cure can be an accurate identification of the causative agent of this neoplasm and its elimination. As a rule, these are various diseases in the internal organs of a person.

It is worth noting that a fibroadenoma discovered during a woman’s pregnancy will not in any way affect the development of the embryo. Pregnancy can cause tumor malignancy; therefore, removal of fibroadenoma is mandatory. If the size of the node is small and suspicion of cancer is excluded, then the operation is postponed to a later date and performed after childbirth and the end of breastfeeding.

In cases where, during the period of gestation, fibroadenoma rapidly increases in size, specialists may decide on a low-traumatic intervention. How complex the operation will be and the urgency of its implementation is decided after examination by several specialists.

In the presence of a tumor, the milky ducts of a woman’s mammary gland are completely blocked, breastfeeding becomes impossible, resulting in lactostasis and inflammation of the breast (i.e. mastitis). Thus, it is considered most appropriate to remove the tumor at the stage of pregnancy planning.

The tumor cannot be removed if:

• The presence of cancer and other serious diseases;
• Diabetes mellitus, blood clotting disorders;
• High blood pressure;
• Various infectious diseases, as well as fever.

In such cases, surgery becomes possible after correcting the patient's condition.

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1 treatment method: medication

In cases where the size of the fibronodular formation is no more than 10 mm. and it does not progress, drug treatment is carried out, which can cause tumor resorption.

Drug treatment means the use of:

With fibroadenomatosis, constant monitoring of tumor growth, ultrasound and examination by a mammologist are necessary.

When the presence of not one, but several fibroadenomas is diagnosed, then to increase the effectiveness of the medications, drugs with an antiestrogenic effect, choleretic drugs and vitamin A are added to the treatment, which have a positive effect on mammary gland tissue and reduce the production of estrogen.

Most prescriptions for breast medication exclude immunostimulants. There are cases when a woman takes adaptogens on her own, which in no case should be done, since active biological products encourage the tumor to grow.

The main goal of drug treatment for fibroadenoma is to normalize hormonal balance and body weight, which are directly related to disorders in this area.

Treatment method 2: surgical

Surgical intervention for fibroadenomatosis is inevitable if:

• Fibroadenoma is of the leaf-shaped type;
• The tumor size is more than 20mm;
• The patient is planning pregnancy
• Oncology is suspected;
• The neoplasm is growing rapidly;
• Voluntary desire of the patient.

There are 2 types of surgical intervention:

1. Removal of affected tissues with a capsule (enucleation), as a result of such an operation there are practically no scars left;
2. Sectoral resection (excision of part of the gland along with the tumor);

In the above operations, anesthesia is used; in cases where high-tech methods are used, anesthesia is not performed or local anesthesia is used.

In order to exclude or confirm malignancy of tissues, after surgery the obtained material must be sent for histological examination.

The duration of both operations is from 30 to 60 minutes. The patient is under observation for up to 24 hours. Sutures are removed 5-10 days after surgery.

Treatment method 3: non-surgical

If the disease was diagnosed at an early stage, a non-surgical method of removing fibroadenoma is allowed.
There are 4 such ways:

All 4 methods are low-traumatic, they leave virtually no scars, and the risk of blood loss is minimal.

How to distinguish a cyst from a fibroadenoma?

When palpated, the cyst is very easy to confuse with a fibroadenoma.

A cyst can be distinguished by several signs:

• In terms of density (the cyst, unlike the node, is softly elastic);
• Presence of pain (pain occurs when the cystic tumor is large);
• Ultrasound indicators (the structure of the cystic tumor is hyperechoic);
• Hormonal changes in the body. The cause may be: endocrine disorders, pregnancy, termination of pregnancy.

An accurate diagnosis can be made by a specialist doctor after all research methods have been carried out, so it is very important to identify the type of tumor in the mammary gland at the preoperative stage.

Any tumor in the breast is a natural cause of concern, but not all of them are associated with malignant tumors. Thus, breast fibroadenoma is a benign tumor. At its core, fibroadenoma is a nodular form of breast tissue pathology, and occurs as a result of abnormal development of cells of glandular tissue (parenchyma) and connective tissue (stroma) of the breast.

ICD-10 code

N60.2 Fibroadenosis of the mammary gland

Causes of breast fibroadenoma

To date, the true causes of breast fibroadenoma remain the subject of scientific research and have not been fully established. However, no one doubts the fact that dense, moving “balls” form in women’s breasts due to various hormonal disorders. As doctors say, the mammary gland is a “target” for hormones.

Throughout life - from puberty to menopause, including the menstrual cycle and periods of pregnancy - the mammary glands undergo cyclical changes caused by fluctuations in the level of sex hormones. The cells of the epithelial and muscle tissue of the breast are especially sensitive to the action of hormones, as a result of which the structure of these tissues is constantly changing. This leads either to an increase in the number of their structural elements (hyperplasia) or to abnormal development (dysplasia). So, the etiology of the pathological process of development of breast fibroadenoma is associated precisely with tissue tissue, which is manifested by an increase in the mass of fibrous tissue.

Hormonal imbalances, in particular excess estrogen levels and progesterone deficiency, play a major role in the pathogenesis of breast fibroadenoma. Among the factors that provoke the occurrence of this pathology, experts also include diseases of the ovaries, thyroid gland, adrenal glands and pituitary gland; diabetes mellitus, liver disease, obesity, as well as gynecological diseases and menstrual irregularities.

According to British and American doctors, the use of hormonal contraceptive pills by girls under the age of 20 is also associated with the risk of fibroadenoma.

Symptoms of breast fibroadenoma

It is believed that breast fibroadenoma is a disease without clinical manifestations. Almost the only symptom of breast fibroadenoma is a fairly dense round or oval shaped node with clear boundaries that can be felt in the thickness of the soft tissue of the breast.

This “ball” or “pea” can have a diameter from a few millimeters to three or more centimeters. If the size of the formation in diameter exceeds 6 cm, then such fibroadenoma is classified as “giant”. The formation is mobile and has nothing to do with the surrounding tissues or skin. The typical location of the tumor is in the upper part of the outer side of the mammary gland.

In most cases, a woman discovers a tumor in the mammary gland by chance - while feeling the breast. Only a large tumor can be detected visually. Moreover, it is painless upon palpation. In general, there is no pain with breast fibroadenoma. The exception is phyllodes fibroadenoma of the mammary gland.

When a woman complains that she has pain from breast fibroadenoma, this may mean that she has this particular type of tumor. Or she has another formation in the breast, for example, a cyst, in which pain in the mammary gland may be felt during menstruation.

As a rule, during the examination a single formation is revealed - fibroadenoma of the left breast or fibroadenoma of the right breast. But, as mammologists emphasize, at least 15% of cases are multiple fibroadenomas of the mammary gland, which can affect both breasts at once.

The growth of fibroadenoma occurs spontaneously and at some stage stops. In women of childbearing age, during menstruation, breast fibroadenoma may increase slightly in size and then decrease again.

Forms

According to the International Classification of Diseases, 10th revision (ISD 10), developed by WHO, which is used by physicians to code diagnoses, breast fibroadenoma ICD-10 is classified as class D 24 - Benign neoplasm of breast, that is, non-cancerous fibroepithelial tumors in the breast that arise in as a result of neoplasia (neoplasm). Breast fibroadenoma accounts for about 7% of these neoplasms, and cancerous tumors account for 10%.

Breast fibroadenoma during pregnancy

Speaking about the hormonal factors in the occurrence of this type of benign formation, it is necessary to highlight such an important issue as breast fibroadenoma and pregnancy.

During pregnancy, against the background of general hormonal changes in a woman's body, the growth of an existing benign tumor accelerates. The growth of glandular tissue of the mammary glands is stimulated by estrogen, and the development of the mammary glands and preparation for lactation by the hormone prolactin. Thus, during pregnancy, a physiologically determined intensive proliferation of parenchyma cells occurs in the breast. Therefore, during pregnancy, breast fibroadenomas increase in size in almost a quarter of cases. And although, as doctors assure, this disease does not negatively affect the course of pregnancy and the development of the fetus, they strongly recommend removing fibroadenoma when planning pregnancy.

The opinion of gynecologists is similar regarding the solution to the problem - breast fibroadenoma and IVF. Both in preparation for in vitro fertilization and directly during it, the woman’s ovaries are stimulated, so that a high level of estrogen (estradiol) in the blood can lead to increased growth of fibroadenoma.

In clinical practice, breast fibroadenomas are divided into the following types according to histological features: pericanalicular, intracanalicular, mixed and phylloid (or leaf-shaped).

Pericanalicular fibroadenoma of the breast

With this type of tumor, proliferation of connective tissue cells is observed in the lobules of the gland. A tumor of dense consistency, precisely limited from other tissues, is formed and localized around the milk ducts of the mammary gland. The structure of the formation is dense, and quite often - especially in elderly patients - calcium salts (calcifications) are deposited in it. Then, based on the results of mammography, the so-called calcified fibroadenoma of the mammary gland or calcified fibroadenoma of the mammary gland can be diagnosed.

Intracanalicular fibroadenoma of the breast

Intracanalicular fibroadenoma differs from pericanalicular fibroadenoma in its lobulated structure and looser consistency, as well as the absence of clear contours. The stroma (connective tissue) grows into the lumens of the mammary gland ducts, tightly adjacent to their walls.

Mixed fibroadenoma has features of both types of breast fibroadenoma.

Phyloid fibroadenoma of the breast

The least common type of this pathology, leaf-shaped fibroadenoma of the mammary gland, also known as phyllodes fibroadenoma of the mammary gland, reaches particularly large sizes (5-10 cm or even more). This tumor is a marker of increased risk of developing breast cancer.

Phylloid fibroadenoma of the mammary gland develops very slowly at first, and may not show itself for many years. And then suddenly it starts to grow rapidly.

With a significant size of the tumor, it can cover a significant volume of the mammary gland or even the entire mammary gland; the skin of the breast becomes thinner and becomes bluish-purple (due to the expansion of subcutaneous blood vessels). As mentioned above, pain with breast fibroadenoma is observed precisely with this type of pathology. In addition, discharge from the nipple of the affected breast is very likely.

By the way, when patients say that they have nodular fibroadenoma of the mammary gland, it obviously means that fibroadenoma of the mammary gland is a nodular form of mastopathy (mastopathy includes almost all benign pathological growths of breast tissue). And the definition of “diffuse fibroadenoma of the mammary gland” most likely means a diffuse form of mastopathy, one of the varieties of which is fibroadenosis. Its difference from breast fibroadenoma is that with fibroadenosis, not only epithelial and fibrous tissue, but adipose tissue are involved in the process of tumor formation.

Complications and consequences

The consequences of breast fibroadenoma in the form of malignant transformations in the epithelial components are considered rare or almost impossible. According to recent studies conducted in Israeli clinics, the incidence of breast carcinoma that developed from fibroadenoma is in the range of 0.002-0.0125%. At the same time, experts do not hide the fact that clinical test data and mammography results often show the presence of benign fibroadenomas, and during surgical removal of tumors their malignant nature was revealed.

Despite the fact that cases of diagnosis of phyllodes fibroadenoma do not exceed 2% of all fibroepithelial tumors of the breast, the level of its malignancy, that is, degeneration into a malignant form, is, according to some sources, 3-5%, according to others – 10%.

So women who are diagnosed with leaf-shaped fibroadenoma of the breast may face problems such as fibroadenoma and breast cancer. Moreover, women with a family history of breast cancer have a 3.7% higher risk of cancer compared to women with a family history of breast cancer.

Consequences of removal of breast fibroadenoma

There are two information - bad and good. Let's start with the good: the effects of breast fibroadenoma removal in the form of a scar on your chest become almost invisible a few years after the operation.

And now about the sad thing. Removal of breast fibroadenoma is not the same as recovery. The reason for the appearance of a tumor in the breast is associated with hormonal imbalance. The tumor was cut out, but the imbalance remained.

Diagnosis of breast fibroadenoma

Most often, this disease is diagnosed in women from 20 to 35 years old, but it can be first identified in teenage girls during puberty, and in mature women after 45-50 years.

Nowadays, the arsenal of methods for diagnosing breast fibroadenoma (except for examining patients with palpation and collecting anamnesis) includes a biochemical blood test for the content of sex hormones, mammography (breast x-ray), ultrasound examination (US), biopsy and cytological examination of tumor tissue.

Ultrasound signs

An ultrasound examination of breast fibroadenoma makes it possible to obtain a clear picture of even those “impenetrable” X-ray zones of the organ that are located directly near the chest wall.

Ultrasound also allows you to differentiate fibroadenoma and breast cyst. But ultrasound is not able to determine whether a fibroadenoma is benign or malignant.

Biopsy

To determine the nature of the tumor, a biopsy of breast fibroadenoma must be performed. This diagnostic procedure is carried out using the non-operative method of aspiration biopsy, that is, a puncture of the breast fibroadenoma is taken.

A needle on a syringe is used to penetrate the tumor and “pump out” a certain amount of tissue from it. Despite the minimally invasive nature of this method, the reliability of the puncture results is considered not high enough. And the doctor can and should resort to an incisional biopsy, in which a small fragment of tumor tissue is excised under local anesthesia. The resulting sample is sent for histological examination.

Histology

To determine the correct diagnosis, histology of breast fibroadenoma is the cornerstone method. Only histological examination makes it possible to determine the nature and extent of damage to breast tissue by the pathological process.

During a cytological (cellular) study of tumor samples, the nature and intensity of proliferation of parenchyma and stroma cells included in the “body” of mammary fibroadenoma is determined.

Cytology of breast fibroadenoma is also important for the differential diagnosis of other benign tumors of this organ. A cytological examination allows you to verify with a high degree of certainty the most important thing - the absence or presence of cancer cells, as well as determine the histogenesis of the tumor - the tissue structure from which it developed.

Nutrition for breast fibroadenoma

A special diet for breast fibroadenoma has not been developed, but you need to eat correctly for this disease. It is recommended to eat more fruits and vegetables, especially cabbage and kelp; use coriander and nutmeg as seasonings; drink green tea and freshly squeezed juices.

It is better to avoid: eating fatty foods (fatty foods cause increased secretion of bile, and bile is a source of steroid hormones); consumption of legumes (beans, peas, beans) and natural coffee.

Treatment of breast fibroadenoma

Currently, oncologists believe that breast fibroadenomas, except phyllodes, are not capable of degenerating into cancer. The highly recommended treatment for phylloides is exclusively surgical.

In addition, surgery is performed if the length of the tumor exceeds 30 mm or increases rapidly (doubling within 4-5 months). And also in the case when it is necessary to remove a cosmetic defect of the mammary gland that reduces a woman’s quality of life.

It is recommended to remove breast fibroadenoma for those over forty, as well as for pregnant women, in order to deprive the tumor of the chance to degenerate into breast cancer. In addition, a growing fibroadenoma can interfere with normal breastfeeding of a child.

What treatment for breast fibroadenoma is used in all other cases? Doctors say that all medications are powerless against this disease. And all other patients need to live in peace, register with a dispensary, and regularly visit their doctor.

Surgical treatment

Surgery for breast fibroadenoma has available options such as lumpectomy and nucleation.

By lumpectomy or partial resection, breast fibroadenoma is removed (under general anesthesia) with the capture of part of the healthy breast tissue. As a rule, this operation is performed if there is reason to suspect the malignant nature of the pathology, in particular, with leaf-shaped fibroadenoma of the mammary gland.

Enucleation of breast fibroadenoma (nucleation) is the removal of the tumor itself (without surrounding tissue). This operation lasts no more than 60 minutes and is performed under local (or general) anesthesia. During surgery, an emergency histological examination of the removed lesion is mandatory.

Postoperative period for breast fibroadenoma: in the hospital - a maximum of 24 hours and another 10 days at home (with mandatory antiseptic treatment of the wound), removal of sutures - 8-9 days after the operation. Doctors warn that the scar area may ache for several months.

Where to remove breast fibroadenoma? Such operations are performed by oncology surgeons only in specialized oncology clinics. Information about the cost of surgery for breast fibroadenoma is communicated directly to patients of a particular medical institution and depends on the degree of complexity of the operation.

Removal of breast fibroadenoma with laser

Breast fibroadenomas can be removed with a laser - a method of laser-induced thermotherapy. A laser device, precisely aimed at the tumor using ultrasound guidance, destroys the pathological formation in the mammary gland (under local anesthesia). After two months, new connective tissue forms at the site of the destroyed tumor. After this outpatient treatment, which lasts no more than an hour, a miniature scar remains on the breast, and the shape of the breast does not change. According to experts, after removal of breast fibroadenoma with a laser, patients recover very quickly.

In large Western clinics, breast fibroadenoma is removed using cryoablation (cryodestruction), that is, using extremely low temperatures of liquid nitrogen to destroy tumor tissue. Cryoablation has long established itself as a safe and highly effective method of treating prostate, kidney and liver cancer. As leading experts note

According to the American Society of Breast Surgeons, this technique (officially approved by the FDA for the treatment of fibroadenoma) is an alternative to open surgery. Freezing breast fibroadenoma tissue kills its cells, which are metabolized over time. The cryoablation procedure is performed on an outpatient basis - under ultrasound guidance and local anesthesia. The scar from a skin puncture on the chest is only 3 mm and heals quickly.

Conservative treatment

Fibroadenoma does not respond to conservative treatment, some doctors say. Others assure: some of them are still treatable... The second statement looks more optimistic. So, according to this statement, conservative treatment of breast fibroadenoma is as follows:

• taking vitamin E,
• getting rid of excess weight;
• correction of hormonal levels;
• microdoses of iodine;

You should definitely consult your doctor about the use of hormonal drugs. Remember: the mammary gland is a “target” for hormones.

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Treatment with duphaston

The drug duphaston belongs to the pharmacological group of gestagens; its active substance is an analogue of the natural hormone progesterone - dydrogesterone. When taken orally, the synthetic hormone acts on the lining of the uterus (endometrium) and prevents its growth and thickening, which are provoked by excess production of estrogen in the body.

This drug is used in cases of endogenous progesterone deficiency in: endometriosis, PMS, menstrual irregularities, amenorrhea and dysmenorrhea. Moreover, taking duphaston does not suppress ovulation, that is, it does not have a contraceptive effect.

In hormone replacement therapy for hysterectomy and menopause syndrome, duphaston is used when it is necessary to neutralize the proliferative effect of estrogens on the mucous membrane of the uterine cavity. This medicine may cause breakthrough bleeding. Duphaston is contraindicated in case of liver diseases and individual intolerance to the drug.

Treatment with folk remedies

The list of remedies for the treatment of breast fibroadenoma with folk remedies begins with walnut septa. Or rather, an alcohol tincture of them, which is used for many diseases, for example, pathology of the thyroid gland, gastrointestinal tract, and joint diseases.

Walnut septum is a source of iodine, a deficiency of which causes mastopathy, fibroids and adenoma. You need to take a dark glass bottle with a capacity of 0.5 liters, fill it 1/3 with partitions, fill it with vodka to the top, close it tightly and let it steep for 20-25 days. The prepared tincture should be taken one tablespoon before meals - once a day.

Herbal treatment

Medicinal herbs such as licorice, clover and sweet clover are natural sources of estrogens, so they cannot be used for fibroadeomas. Take note of the following recipes.

Three teaspoons of wormwood herb should be poured into 200 ml of boiling water, close the container with a lid and leave for 2 hours. Take twice a day (after meals) – one teaspoon. The duration of the health course is a week. After a week of break, repeat the same thing.

For a glass of hot water you will need equal amounts of corn silk, yarrow herb, and juniper fruits. Pour the raw material with water, boil for 10 minutes and leave for 35-40 minutes (closed with a lid). Drink the infusion three times a day after meals - a quarter glass for 10 days.

It is important to know!

Echography, when combined with the Doppler method, can detect newly formed tumor vessels. Color Doppler and power Doppler are considered promising adjuncts to sonography for breast tissue differentiation. With color Doppler mapping around and inside many malignant tumors, it is possible to identify a much larger number of vessels compared to benign processes.

A manually detected knot in the chest is a good reason to conduct a full examination. Breast fibroadenoma is one of the types of benign neoplasms in which it is necessary to perform the entire scope of diagnostic studies in order to exclude oncology. The basis of successful treatment is organ-preserving surgery, which is guaranteed to rid a woman of a pathological formation in the breast.

Breast fibroadenoma - what is it?

A lump with clear contours in the mammary gland of a young woman, identified during examination, in most cases is a benign dishormonal neoplasm.

Fibroadenoma is a local proliferation of glandular tissue and connective tissue structures in the chest, occurring against the background of endocrine disorders. Typical age is 20-25 years and during perimenopause: in both cases, problems are caused by hormonal disorders associated with age-related changes in the body or pregnancy.

After examination and confirmation of the benign nature of the process, the tumor must be removed so as not to create conditions for complications and to prevent dangerous consequences. A mandatory element of diagnosis is a postoperative microscopic examination to exclude oncology.

Hello. I have a knot in my chest and am undergoing examination. Why does fibroadenoma in the mammary gland hurt? Irina, 25 years old.

Hello Irina. The small node does not cause pain. A large tumor puts pressure on tissues (vessels, nerves), causing nagging pain or discomfort. The presence of pain indicates a large size of the tumor and the need for surgical intervention.

Options for benign nodulation

An important factor in therapy is an accurate determination of the type of nodular mastopathy. Breast fibroadenoma can be:

1. Leaf-shaped;
2. Intracanalicular;
3. Perikanalicular;
4. Involutive.

Expert opinion

Svirid Nadezhda

Obstetrician-gynecologist

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The type of tumor determines treatment tactics and prognosis for recovery: in most cases, the tumor must be removed, but in some situations conservative treatment methods can be used. For each patient, the mammologist will select an individual treatment regimen.

Leaf-shaped fibroadenoma in the chest

The phylloid (leaf-shaped) variant is the most unfavorable from a prognostic point of view. Typical features of the common benign form of mastopathy include:

• rapid growth of the node;
• the presence of pain with a large tumor size;
• layered structure;
• high risk of malignancy (about 10%);
• detection of pathology in women of any age;
• frequent combination with gynecological diseases (leiomyoma, ovarian cysts, infertility).

A small node does not hurt, so detection of a tumor in the chest occurs by accident - during a doctor’s examination or during a preventive ultrasound scan. The size of a fibroadenomatous node with a leaf-shaped structure can rapidly increase, which is manifested by typical symptoms (the node begins to hurt, the tumor is difficult to miss). It is important to consult a doctor in a timely manner: in this case, surgery cannot be avoided.

Intracanalicular tumor

Benign growths of fibrous tissue inside the milk ducts are the basis for a shapeless tumor. The intracanalicular type of neoplasm is characterized by:

• the presence of a node without clear contours;
• slow growth;
• diffuse changes in the chest.

The risk of malignant degeneration is low, but it is impossible to exclude the possibility of breast cancer, so the mammologist will perform all the necessary diagnostic tests at the stage of preparation for surgery.

Pericanalicular neoplasm

The formation of a node around the milk ducts creates conditions for a neoplasm with the following signs:

• tumor dense in structure;
• clearly defined boundaries;
• the appearance of the disease in older women;
• formation of calcifications.

Expert opinion

Svirid Nadezhda

Obstetrician-gynecologist

Ask a question to an expert

The threat of cancer is minimal, but until all necessary therapeutic and diagnostic procedures are carried out, it is impossible to exclude oncopathology.

Involutive processes

In women at menopausal age, as ovarian function fades and hormonal influence significantly decreases, typical changes occur in the mammary glands.

Involuting fibroadenoma is a node consisting of fibrous and adipose tissue, and is formed in a mixed type (pericanalicular, intracanalicular). Against the background of natural processes of replacement of glandular structures, a neoplasm is formed, which extremely rarely poses a danger to a woman.

Hello. I am seeing a mammologist; there is a small benign nodule in my breast. Is it possible to sunbathe with breast fibroadenoma? Maria, 41 years old.

Hello Maria. You can sunbathe, but even if there are no problems with your breasts, it is better to protect your mammary glands from ultraviolet radiation. If you have fibroadenoma, you should avoid topless sunbathing.

Differences between cysts and fibroadenomas

With a routine palpation examination of the breast, it is impossible to distinguish between a cyst and a node. When conducting diagnostic studies, a mammologist will definitely evaluate the structure of the tumor. A cyst differs from a fibroadenoma in the following features:

• consistency (the node is dense, the cyst is soft-elastic);
• the presence of pain (large cystic tumors provoke pain);
• Ultrasound signs (hypoechoic structure in case of adenoma, hyperechoic structure in case of cyst);
• the influence of hormonal changes (pregnancy, abortion, age-related endocrine disorders can trigger the occurrence of nodular pathology in the breast).

The result of using all diagnostic methods will be an accurate diagnosis: tumor removal is carried out according to indications, so it is necessary to identify the structure of the tumor in the breast at the preoperative stage.

Hello. Can a small fibroadenoma resolve on its own? Ekaterina, 35 years old.

Hello, Ekaterina. If the size of the node is up to 1 cm, against the background of correction of hormonal levels, fibroadenoma in the mammary gland may disappear. If the node is large (2 cm or more), the tumor must be removed through surgery.

Combination of fibroadenoma and pregnancy

Conception and gestation have a pronounced impact on a woman’s hormonal system. Pregnancy creates conditions for the growth of existing fibroadenoma, but does not cause the appearance of a benign tumor in the breast.

At the stage of preconception preparation, it is necessary to do all the necessary examinations (ultrasound of the mammary glands, mammography) in order to promptly detect a small tumor. This is especially true for women with infertility - the preparation program for in vitro conception (IVF) includes mandatory examinations of all the woman’s reproductive organs.

Breast fibroadenoma may increase in size during lactation, which is explained by the pronounced influence of hormones on glandular tissue. When feeding a baby, you need to carefully monitor the mammary glands and contact a specialist in time: in some cases, it is difficult to independently distinguish lactostasis from a growing fibroadenoma.

Hello. What does fibroadenoma look like on ultrasound? Sophia, 44 years old.

Hello, Sophia. On the monitor of the ultrasound machine, the doctor will see a space-occupying formation in the mammary gland with a hypoechoic structure and clear contours. When performing an ultrasound, one can only assume the presence of fibroadenoma - an accurate diagnosis is made on the basis of a puncture or biopsy of the tumor.

Diagnosis of the disease

When a woman complains of a lump in the breast, the mammologist will evaluate the following symptoms:

• presence of pain syndrome;
• size of the tumor;
• tumor consistency;
• changes around the node;
• reaction of axillary lymph nodes.

Detection of a node of any size is an indication for a full examination, including the following research methods:

• ultrasound scanning of the mammary glands;
• Dopplerometry (assessment of vascular blood flow);
• mammography (breast x-ray);
• MRI (if there is any doubt about the diagnosis).

In young women, ultrasound is preferred; in older women, mammography is more often used. According to American doctors, breast fibroadenoma is classified as type 2 according to ACR (a benign neoplasm with a large amount of fibrous component - up to 50%).

None of the diagnostic methods can guarantee the absence of cancer in the mammary gland, so the mammologist will prescribe an invasive examination - puncture of the node. The diagnostic operation is carried out under ultrasound guidance: the doctor punctures the nodule in order to aspirate cells from the tumor. A cytological examination after puncture can identify dangerous cells or exclude cancer.

The optimal diagnostic method is a fibroadenoma biopsy: during the operation, partial or complete removal of the tumor is performed under local anesthesia, after which the microspecimen is examined in a histological laboratory. Only the result of histology can guarantee the benignity of a nodule in the breast. The ICD-10 code for breast fibroadenoma is D24.

Therapeutic tactics for breast fibroadenoma

The most important question that arises at the examination stage is whether the fibroadenoma should be removed? Conservative treatment methods are ineffective for any form of nodulation in the breast, so the doctor will suggest surgery.

Hello. What complications can occur after removal of fibroadenoma from the breast? Anastasia, 35 years old.

Hello, Anastasia. In the early postoperative period, inflammation may occur in the wound area (seroma, suppuration of sutures). Some women are predisposed to keloid scars, which will cause the formation of an unsightly seam. In the long term, a relapse is possible - re-formation of fibroadenoma in the breast.

Surgical methods - to remove or not

The main conditions for choosing the optimal method of tumor removal are:

• tumor size;
• localization (close under the skin or deep in the tissues);
• pregnancy planning;
• cancer risk.

Hello. Can a benign fibroadenoma develop into cancer? Alla, 29 years old.

Hello, Alla. If a leaf-shaped fibroadenoma is detected and surgery is refused, the probability of malignant degeneration is about 10%. That is why the doctor will suggest surgery to remove the node from the chest.

The approach to each patient is individual: the surgeon, if the process is proven to be benign, will always perform organ-preserving intervention.

Hello. What size fibroadenoma is an indication for surgery to remove the tumor? Angelina, 41 years old.

Hello, Angelina. If the size of the tumor is 3 cm or more, it is necessary to perform surgery to remove the tumor.

Indications for surgical intervention are:

One type of nodular mastopathy is breast fibroadenoma. Should I delete or not? This question is asked by women who have been given this diagnosis. In each specific case, the doctor chooses an individual method of treating fibroadenoma.

The essence of the disease, classification, causes

Breast fibroadenoma is a non-cancerous tumor that is formed due to the proliferation of fibrous tissue. Despite its benign nature, the neoplasm can develop into a cancerous tumor (sarcoma).

Most often, fibroadenoma appears in women aged 18 to 38 years. It can be localized in one gland or in both. The tumor has a round shape ranging in size from 2 mm to several centimeters. Fibroadenoma is painless, there are 2 types:

• nodular;
• leaf-shaped.

The tumor is hormone-dependent, so the cause of the formation of breast fibroadenoma is an increase in the amount of estrogen.

This happens in the following cases:

• Pregnancy.
• Taking hormonal contraceptives.
• Endocrine diseases.
• Obesity.
• Ovarian pathologies.
• Stress.
• Menopause.
• Heredity.

How to treat breast fibroadenoma?

Is it necessary to remove fibroadenoma? Usually the formation does not manifest itself in any way, so the need for surgery is questioned. The likelihood of a tumor transforming into cancer is negligible. The only type of fibroadenoma that has a risk of degeneration into sarcoma is a leaf-shaped (phylloid) tumor. This fibroadenoma is a cross between a benign and a malignant tumor. According to statistics, 10% of phyllodes tumors transform into cancer. Therefore, leaf-shaped fibroadenoma must be removed.

The decision about surgery is made by the doctor after conducting diagnostics, which includes:

• palpation;
• Ultrasound of the mammary glands;
• mammography;
• biopsy.

Depending on the degree of development, education is divided into:

• Immature fibroadenoma. It occurs in adolescence and lacks a capsule. Therefore, the tumor is easily amenable to conservative treatment.
• Mature fibroadenoma. Diagnosed in adult women, it has a capsule, so treatment with medications is ineffective.

If a tumor is discovered after childbirth, this is not a contraindication to breastfeeding. On the contrary, changes in hormonal levels during this period can have a positive effect and the fibroadenoma will decrease in size or disappear completely.

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Conservative treatment of fibroadenoma

Conservative therapy consists of dynamic observation and hormonal treatment. Dynamic observation is used in cases of small tumor size (up to 1 cm) and absence of symptoms.

If the formation grows, given its hormone-dependent nature, drug treatment is prescribed. It is worth remembering that after treatment the tumor does not go away without a trace. Hormonal therapy can only stop the growth of education. In most cases, conservative therapy does not bring positive results and the disease progresses.

Surgical treatment of fibroadenoma

Removing fibroadenoma is the only way to get rid of the disease. The operation is performed under local anesthesia.

Indications for removal:

• Leaf-shaped fibroadenoma.
• Suspicion of cancer.
• Increasing the size of education.
• Cosmetic defect (adenoma spoils the appearance of the breast).
• Pregnancy planning.
• Menopause period.
• Temperature increase. The temperature with fibroadenoma indicates that inflammation has begun.

Not all women who had fibroadenoma removed achieved a complete cure. After surgery, it is important to restore hormonal levels to prevent relapse.

How is fibroadenoma removed? In medicine, several types of tumor removal surgery are used:

• Enucliation. This is the desquamation of a small tumor. The method is used when the benign nature of fibroadenoma leaves no doubt. Recovery after such an operation occurs quickly.
• Sectoral resection. The tumor and tissue around it are removed. The method is used for large tumors if there is a suspicion of an oncological process. A cosmetic suture is placed at the incision site. After surgery, the woman experiences pain until the breasts heal.
• Laser coagulation. Used to remove fibroadenoma of any size. The advantage of the method is the speed of the procedure (1 minute) and easy recovery. After the tumor is removed, the woman feels a slight pain in the suture area for some time, which goes away within a day.

If multiple fibroadenomas are diagnosed or the tumor is large, then complete removal of the mammary gland is performed. Although such cases are very rare, the disease is usually diagnosed at an early stage. After surgery, the removed fibroadenoma is sent for histology to exclude an oncological process.

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Postoperative period

The duration of rehabilitation depends on the type of surgery. On average, the recovery period lasts 8-10 days.

The most common complications after surgery:

• Inflammation and suppuration in the area of ​​the sutures.
• Pain in the back, between the shoulder blades.

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• Do not take water treatments for 2-3 days after surgery.
• Avoid physical exercise for up to 10 days.
• For 15-20 days, do not visit the bathhouse, sauna, solarium, or sunbathe.

To reduce postoperative scars after 10-12 days, the sutures need to be lubricated with special gels (Contractubex). Duration of use ranges from one month to six months.

Important! After the operation, all functions of the mammary glands are preserved.

Prevention of breast fibroadenoma

An operation to remove a tumor eliminates only the consequence, not the cause of the disease, and therefore does not guarantee the recurrence of the tumor. In order to avoid relapse, preventive measures should be taken:

• Bring it back to normal, that is, cure diseases that cause increased estrogen production.
• Refuse .
• Avoid stress and excessive physical activity.
• Do not expose the body to prolonged heat (bath, sauna). While on the beach, you need to protect your breasts from direct sunlight.
• Adjust your diet. This involves reducing the amount of animal fats in the diet and increasing the amount of plant foods.
• Regularly undergo preventive examinations with a gynecologist and mammologist.

Almost every fifth woman of reproductive age is diagnosed with fibroadenoma. The tumor does not pose a direct threat to the patient’s life. However, it can increase in size and impair quality of life. In addition, there is a risk of the formation degenerating into cancer. In most cases, doctors recommend surgically removing the fibroadenoma.

is a disease that mainly affects women, but men can also be affected. The location of the lesion in women is the breast, and in men it is the prostate gland.

Fibroadenoma is a benign tumor. Due to the fact that treatment is necessary.

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Causes of the disease

The main reasons for the appearance of a tumor are:

1. Presence of relatives with a similar pathology (genetic factor).
2. Hormonal imbalance in the body.
3. Lack of childbirth.
4. Excess weight.

Forms of the disease

When diagnosed with fibromyoma, the compactions themselves can be multiple or single. This fact gives the doctor the choice of treatment method for the disease.

Based on the number of neoplasms, two are distinguished:

1. Diffuse. It is characterized by a large number of seals that can be felt throughout the chest in the form of seals similar to grains. It can affect one breast or both. This form is the most common.
2. Localized. With this form of the disease, the formations are localized in one breast, its edges are easily palpable. The skin at the site of the lesion acquires a bumpy structure.

Methods of treating the disease

After conducting and passing the tests, the doctor prescribes treatment.

If the disease is detected early, treatment methods are available in which the tumor can completely resolve. The following conservative methods are used:

1. Therapy with homeopathic medicines. This is not the main treatment, but more of an aid in reducing pain in the mammary gland. For this purpose, drugs such as Galium-Xeel, Lymphomyosot, Schwef-Heel are used.

Doctor's advice: You need to take granules or liquid according to the scheme regularly and for a long time.

2. Treatment is carried out using liquid nitrogen. The method receives positive reviews for its effectiveness. It is carried out quickly, under local anesthesia, on an outpatient basis. Under the influence of nitrogen, the tumor freezes and dies.
3. Hormonal treatment. Additionally, drugs are prescribed to regulate the menstrual cycle, non-steroidal anti-inflammatory drugs and antidepressants. Since vitamin E stimulates the production of prolactin, its use is also advisable. It is also recommended to bring your weight back to normal, since excess weight provokes the development of various pathological processes in the mammary gland. The main drugs for treating the disease are Duphaston and Femoston.

Note: Hormonal drugs are prescribed only by a doctor. He also selects the dosage necessary for each specific case.

4. Laser ablation. This procedure does not leave marks on the skin of the breast, is quite gentle and completely replaces the need for a full-fledged operation. After the manipulation, the tumor completely disappears.

Traditional methods of treatment

The mammary glands are especially popular.

Before using them, you should consult your doctor, because some inflammatory processes (for example, purulent mastitis) cannot be heated.

Herbal remedies for oral administration:

1. Take 15 grams of knotweed grass and pour 200 ml of boiling water. Let stand for 10-15 minutes. Take 100 ml 2 times a day before meals.
2. Buy echinacea inflorescences at the pharmacy. Pour 100 g of flowers with 100 grams of regular vodka. Place in a cool, dark place and wait 2-3 days. Take the prepared tincture 3 times a day in diluted form. To do this, add 15 ml of medicinal infusion to 50 ml of water.
3. Walnut partitions are useful for normalizing hormonal levels. They are filled with alcohol and left for 10 days. The tincture is used for internal administration, 15 ml in the morning after meals.
4. A decoction of chamomile, licorice, wheatgrass, marshmallow and fennel will also be useful. Mix all herbs in equal proportions. Take 1 tablespoon of the mixture and add 0.2 liters of boiling water. It is necessary to leave for no more than 15 minutes, strain and drink all the liquid, dividing it into three doses. The course of treatment is 3 weeks. Every day you need to prepare a new portion of the medicinal infusion.
5. In order to slow down the growth of the formation, the following collection option is used: watch grass, mint, valerian root and hop cones are taken in a ratio of 2:2:1:1, mixed and one tablespoon of the collection is poured into 300 ml of boiling water. Allow to stand for 30 minutes and use 150 ml for internal use 3 times a day before meals. It is necessary to complete a course of treatment for 14 days.

Therapeutic for external use

Take a metal container and pour 200 ml of regular refined sunflower oil into it and add a piece of wax the size of a matchbox.

Place over low heat and heat until the wax dissolves and a homogeneous mass is obtained. Boil the egg hard, chop finely and add to the oil and wax.

Cook until foam forms and do not forget to stir. Remove from heat and wait until the foam has completely settled. Continue cooking and set aside until the cooking time reaches half an hour.

Strain the finished mixture through a bandage or gauze and let cool. Apply the ointment 2 times a day to the affected area of ​​the chest. This remedy is recommended to reduce tumors and prevent surgery.

Be attentive to your body, undergo regular examinations with a gynecologist to identify any type of disease at an early stage of development. Remember that it is easier to prevent any disease than to spend money and time on its treatment.

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