The female breast is an organ of femininity and female beauty, intended for a woman to fulfill her natural “plan” - to feed children. But even in such an organ, neoplasms can form. They can be either benign or malignant. A common benign tumor of the mammary gland is fibroadenoma. Breast fibroadenoma can appear at any age of a woman, but most often it occurs between the ages of 20-35 years. Why do fibroadenomas grow in glandular tissue? Read our article on how to treat and prevent breast fibroadenoma.

Fibroadenoma of the breast. Reasons for changes in the gland

The cause of breast fibroadenoma formation is hormonal disorders. Throughout a woman’s life, hormonal changes occur in her body, which is natural and normal. But with an increased content of hormones or their deficiency, at some stage the breast tissue begins to immediately react. This is because breast tissue is the most sensitive to hormonal changes. Thus, with an increase in estrogen and/or a decrease in progesterone, the tissue undergoes hyperplasia and dysplasia.

Such hormonal imbalances in women are observed in the presence of diseases of the thyroid gland, pituitary gland, ovaries, adrenal glands, liver pathology, diabetes mellitus, obesity and the presence of an irregular menstrual cycle.

It was found that the use of hormonal contraceptives in girls under 23 years of age increases the risk of breast fibroadenoma.

Breast fibroadenoma during pregnancy deserves special attention. Changes in hormonal levels during pregnancy affect an existing fibroadenoma and provoke its rapid growth. This may interfere with normal breastfeeding. Therefore, before planning a pregnancy, women need to check their breasts for the presence of breast fibroadenoma and, if detected, remove them. If there were no changes in the glands before pregnancy, the risk of its occurrence also exists. In this case, it is inappropriate to act. All issues need to be resolved after completion of lactation.

Types and manifestations of breast fibroadenoma

As a rule, fibroadenoma does not have any clinical symptoms or manifestations. It can only be detected by palpating the breast and finding a small, dense “ball”, the size of which can vary from a few millimeters to several centimeters. The ball has clear boundaries and can be found in one breast or both. Breast fibroadenomas may increase before menstruation and then decrease again. Painful sensations can only be observed with phyllodes fibroadenoma of the mammary gland.

Types of fibroadenomas:

• Phylloid. This fibroadenoma grows very slowly and can go undetected for years. Then it can grow rapidly. This may cause discharge from the nipples. This is the only type of fibroadenoma that can cause pain. Due to the large size of the fibroadenoma, the skin on the chest may take on a bluish tint.
• Intracanalicular. This breast fibroadenoma is characterized by a loose consistency and lobular structure. There are no clear boundaries of fibroadenoma.
• Perikanalicular. With this fibroadenoma, connective tissue cells grow in the gland. In this case, a dense tumor localized from other tissues is formed, where calcium salts can sometimes be deposited (in older women). Then the diagnosis may sound like calcified fibroadenoma of the mammary gland.

The transformation of breast fibroadenoma into a malignant tumor is almost impossible. The risk of malignancy exists in women with phyllodes fibroadenoma of the gland. At the same time, surgeons claim that after removing the fibroadenoma and performing a biopsy, its malignant nature was sometimes revealed. This suggests that the nature of fibroadenomas is not fully understood, and perhaps in the future new information will appear about the causes and treatment of breast fibroadenomas.

Diagnosis and treatment of breast fibroadenoma. Removal of fibroadenoma

The diagnosis is made on the basis of examination, palpation, medical history, general and biochemical blood tests, analysis of sex hormone levels, mammography, ultrasound of the mammary glands, biopsy and cytological examination of neoplasm tissue.

Treatment of fibroadenomas, according to experts, currently does not require surgical intervention. Exceptions are phyllodes fibroadenomas, which need to be removed surgically only if they exceed 3 cm in length or are growing rapidly. Surgical intervention may also be required if a noticeable cosmetic and aesthetic breast defect appears. It is also recommended to remove fibroadenoma before a planned pregnancy to reduce the likelihood of lactation disruption. If pregnancy occurs, surgery is not performed.

Fibroadenoma removal is performed using two methods:

lumpectomy (resection of the adenoma with the capture of healthy tissue) is performed if the malignant nature of the neoplasm is suspected;

nucleation (removal of fibroadenoma only).

After the operation, a histological examination of the isolated material is performed. Unfortunately, removing fibroadenoma does not guarantee that fibroadenoma will not appear again, because hormones may still be out of order.

In all other cases of detection of breast fibroadenoma, it is recommended to register. To prevent the occurrence of fibroadenoma of the mammary glands, women are advised to promptly identify and correct hormonal imbalances, lose excess weight, and also include vitamin E and iodine in their diet. To detect fibroadenoma early, it is worth feeling your breasts monthly for the presence of rounded lumps. This will help to identify the process in time, which means it will be easier to deal with.

Fibroadenoma is a benign hormone-dependent tumor that develops primarily from breast tissue.

Being one of the forms of nodular mastopathy, it is most often detected in young (up to thirty-five years old) women and even fifteen-year-old girls. Fibroadenoma, which is asymptomatic, is often detected in women of much more mature age during a preventive examination.

Definition

There are two periods of time in every woman’s life during which she has a high probability of developing this type of fibroadenoma. The first period covers the period from twelve to twenty years. The second is from forty to fifty. It is these periods that are marked by the highest hormonal activity.

The basis for suspicion of the degeneration of a benign neoplasm into a sarcoma is the rapid growth of the tumor. If its size exceeds 1.5 cm, the patient is operated on, and the removed tissue is sent for histology. Only a laboratory test can confirm or refute a preliminary diagnosis.

Fibroadenoma not exceeding one centimeter is observed by the attending physician. To determine whether it is benign, the patient is sent for a biopsy or a puncture is performed.

Compatibility with IVF and pregnancy

Why is a tumor dangerous?

• Nodular forms of fibroadenomas are benign neoplasms that are not dangerous to the patient’s health. They should be removed only if there is positive dynamics, in order to prevent the tumor from reaching large sizes, since removal of a large node can lead to a noticeable cosmetic defect.
• The only danger is malignancy of phyllodes fibroadenoma, leading to the development of an extremely aggressive disease - breast sarcoma.

Diagnostics

A tumor can be diagnosed using:

• Palpation and clinical examination. Palpation allows you to determine the approximate parameters of the neoplasm (features of location, shape, consistency, contours, displacement).
• X-ray. It confirms the presence of a tumor that is different from its neighboring tissues and has clear boundaries.
• . This study makes it possible to clarify whether the neoplasm is fibrous or cystic.
• . Subsequent cytological analysis of the tissue taken will show the degree of benignity of the neoplasm.

Treatment methods

Having received morphological confirmation of the diagnosis:

• Dynamic observation. This tactic is appropriate for tumors that do not exceed two centimeters, do not bother the patient and do not increase in size.
• Hormonal therapy.
• Surgical removal. Removal of nodular fibroadenoma is performed by enucleating the tumor without removing adjacent tissues through an incision made along the edge of the areola. Removal of a leaf-shaped tumor is carried out by sectoral resection (along with the tumor, the surrounding affected tissue is also removed).

Prevention

• Specific methods for primary prevention of fibroadenoma have not yet been developed.
• Secondary prevention consists of regular examination of the mammary glands using ultrasound methods.

Video about the treatment of fibroadenoma:

Breast fibroadenoma is a common pathology accompanied by the formation of a lump in the breast. If left untreated, the disease can lead to complications. Since many women face a similar diagnosis, it is natural that they are interested in any additional information. So what is breast fibroadenoma? Is treatment without surgery possible or is surgery necessary? What treatments can modern medicine offer?

Breast fibroadenomas: what is it?

Today, this disease is considered quite common. Many patients leave the doctor's office with a diagnosis of breast fibroadenoma. What it is? This is a benign tumor that is formed mainly from glandular tissue.

The tumor is most often single; less often, multiple small tumors are found in the breast. They can be located both inside the milk duct and outside it. Fibroadenoma can have a homogeneous, lobulated or mixed structure. Some patients have mature tumors that have a dense structure and a protective elastic capsule, and they grow slowly. The formation of so-called immature fibroadenoma without a capsule is also possible - their consistency is soft, so they are prone to rapid, uncontrolled growth.

There is another variety - a leaf tumor, which has a layered structure. Such a tumor can also grow quickly. Moreover, in the presence of this particular type of fibroadenoma, there is a risk of malignant cell degeneration.

Reasons for the development of the disease

Why does breast fibroadenoma develop? Treatment without surgery is only possible in some cases, so first you should understand the risk factors. There is an opinion that with such a disease there is a hereditary factor, although this statement does not yet have a scientific basis.

However, researchers were able to find out that the formation of fibroadenoma is often associated with the development of other diseases. Internal causes include serious hormonal imbalances, which are especially common in women during puberty and pregnancy. A tumor in the breast can often appear against the background of liver diseases, gynecological diseases, including ovarian lesions. The list of reasons includes dysfunction of the pituitary gland and adrenal glands, diabetes mellitus, obesity, and thyroid problems.

Risk factors include hormonal therapy, including improper use of oral contraceptives. Sometimes the disease develops in women who often undergo abortion procedures. Living in poor environmental conditions, constant stress, nervous exhaustion, breast injuries, abuse of solariums, frequent hot baths or showers - all this can trigger the formation of fibroadenoma.

What symptoms are accompanied by the disease?

What signs are accompanied by breast fibroadenoma? Symptoms, treatment and diagnosis are closely related. Unfortunately, this disease rarely causes any obvious external deterioration, so for a long time women do not even suspect that there is a problem.

In most cases, a tumor is discovered accidentally during an examination by a doctor. Sometimes women themselves discover an elastic seal in the nipple area. Occasionally, the pathology is accompanied by the appearance of transparent discharge from the nipples. Sometimes ulcers and cracks form on the nipple and areola. Occasionally, patients also complain of pain when pressed.

What does the diagnostic process look like?

Many women are interested in questions about what breast fibroadenoma is. Diagnosis, treatment, indications for surgery are important points that are worth paying attention to.

During visual inspection and palpation, the doctor may notice a compaction. The presence of a tumor is confirmed by mammography and ultrasound. These procedures make it possible to determine the exact location, size and contours of the tumor. Patients give blood samples for analysis, in particular, check their hormone levels. If a malignant tumor is suspected, a biopsy is performed followed by cytological analysis.

Breast fibroadenoma, treatment without surgery: reviews and treatment regimen

Are patients always recommended to undergo surgery? Are there other ways to get rid of such a pathology as breast fibroadenoma? Treatment without surgery is possible, but only in some cases. For example, conservative treatment is allowed if the patient is a teenage girl and the tumor does not have a dense capsule.

In some cases, doctors decide not to surgically remove a tumor in women during menopause, since hormonal changes at this time often slow down or even stop the growth of fibroadenoma. If the tumor is small and does not grow in size over time, surgery may not be necessary.

Naturally, a woman with such a diagnosis should be constantly monitored by a doctor, periodically undergo tests and examinations. Treatment without surgery is possible only if there is no suspicion of malignant tissue degeneration.

Patients with fibroadenoma are prescribed replacement therapy - they are prescribed hormonal medications based on progesterone. As a rule, this makes it possible to stop the growth of the tumor. There are other drugs to treat breast fibroadenoma. Women are often prescribed products containing iodine and vitamin E. If the tumor appears against the background of some other disease, then this is the first thing that is treated.

When is surgery necessary?

In some cases, surgery is simply necessary. Surgical intervention is prescribed when a large tumor forms, as well as when it grows rapidly. Fibroadenoma is also removed for women when planning pregnancy. The fact is that while carrying a child, the hormonal background of the expectant mother undergoes significant changes, which can lead to rapid growth of the tumor and blockage of the gland ducts. The indication for the procedure is the presence of malignant cells in cytological analysis of tissues.

The operation is quite simple - as a rule, the doctor carefully removes the tumor, but in some cases it is necessary to excise the surrounding tissues (for the leaf form of the tumor).

There are also so-called conditionally non-surgical methods for treating breast fibroadenoma. For example, a tumor is removed using freezing (cryodestruction), a laser beam, or high-frequency exposure.

Postoperative recovery

Not only the operation itself is important, but also the rehabilitation period. During this time, patients are advised to follow a proper diet, avoid stress, and follow a proper work and rest schedule. In addition, you also need to take medications. The range of drugs is determined individually for each patient.

If there is a hormonal imbalance, taking progesterone medications is indicated. To prevent complications, patients take antibiotics and anti-inflammatory drugs in the first few days after surgery. In some cases, immunomodulators are indicated, as well as vitamin complexes and drugs that improve liver function.

Traditional methods of treatment

Traditional treatment of breast fibroadenoma is possible only with the permission of a doctor. After all, first you need to carry out a diagnosis. For example, if there are malignant cells in the breast, self-medication can lead to serious complications.

However, herbal medicine is used, especially when it comes to the conservative treatment of fibroadenoma. Decoctions of licorice root, fennel, chamomile flowers, marshmallow, pomegranate peels and oak bark are considered effective - they are taken orally. These products help to gradually normalize hormonal levels.

For external use, you can prepare a decoction of verbena. A napkin or gauze bandage is then dipped in it and applied to the affected breast. For the same purpose, some traditional healers recommend making honey cakes (a tablespoon of melted honey is mixed with 1-2 tablespoons of flour), which can also be applied to the affected area.

Proper diet during and after therapy

A proper diet is very important, so patients are advised to visit a nutritionist to create an individual diet. However, several general recommendations can be identified. Patients are advised to avoid fatty foods, as they stimulate the production of steroid compounds in the body. It is worth limiting the amount of animal fats and, if possible, removing legumes, sunflower oil, baked goods and flour products from the diet.

The menu should include fish, cabbage, fresh juices and fruit drinks, seafood, as well as fresh fruits and vegetables - all this will help saturate the body with iodine and vitamin E. You need to give up cigarettes and alcohol. In addition, it is recommended to limit the amount of coffee and black tea you consume - it is better to give preference to green tea leaves.

Are there methods of prevention?

Is it likely that the patient will develop breast fibroadenoma again? Treatment without surgery does not provide a 100% guarantee that the tumor will completely disappear. But after surgical removal, relapse is very rare - the tumor can only appear in the other breast.

There are no specific methods of prevention. However, women are recommended to self-examine and palpate the mammary glands at least once a month. If during the procedure you find a nodule or lump under the skin, you should immediately consult a doctor. And you should not refuse routine medical examinations, during which the disease can be detected at an early 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 medications. Remember: the mammary gland is a “target” for hormones.

Although there are positive opinions about the advisability of hormonal therapy in the treatment of breast fibroadenoma, since, in principle, taking some hormones for the sake of suppressing others should balance the hormonal background in order to “fight back” new tumors.

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!

Pain in the mammary gland is exactly the case when you need to plan a visit to the doctor as quickly as possible. In a healthy state, a woman’s body, if it should experience pain, is only from love pains or emotional disappointments; all other pains are the result of the development of an illness, which should be paid close attention to and emergency measures taken.

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.

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.

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 studies 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 in the wound area (seroma, suppuration of sutures) may occur. 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:

1. Phylloid type of tumor;
2. Size more than 3 cm;
3. Rapid increase in the size of the tumor in a short period of time;
4. Preparation for the desired conception or IVF;
5. There is a risk of cancer.

The main operations used to treat breast fibroadenoma are:

• removal of the node with the capsule (enucleation);
• sectoral resection (excision of part of the gland along with the tumor);
• cryoablation (removal of a subcutaneous node with cold);
• targeted destruction of a tumor with a laser;
• radio wave tumor removal.

During standard operations (enucleation and resection), the doctor will use anesthesia; when using high-tech techniques, anesthesia is not required or the use of local anesthesia is quite sufficient.

Hello. How is surgery to remove fibroadenoma performed? Inessa, 37 years old.

Hello, Inessa. For a large tumor, the doctor will perform a sectoral resection. The operation is performed under general anesthesia. It is necessary to remove the node with mandatory excision of part of the healthy tissue (at least 1 cm from the edge of the tumor). After this, the wound is sutured, and the removed tissue is sent for histology.

Postoperative period

With any option for tumor removal, in most cases the postoperative period proceeds without any particular difficulties - when using laser, cryotherapy or radio waves, you do not need to be in the hospital (after the procedure, the doctor will let you go home a few hours later).

Standard surgical intervention involves medical supervision on the first day after surgery. Regardless of the surgical technique, an important stage of the postoperative period is obtaining the histology result of the removed tissue: if there is no oncology in the biopsy, you don’t have to worry about the consequences.

Hello. After surgery to remove fibroadenoma, I was left with a lump in the mammary gland. What is it and what should I do? Daria, 43 years old.

Hello, Daria. Fibroadenoma is a variant of mastopathy. After surgery, connective tissue scars are formed in the glandular tissue, resulting from diffuse changes. There is nothing wrong with this - you need to regularly see a mammologist for preventive purposes.

Treatment of fibroadenoma without surgery

Conservative treatment methods are ineffective - treatment with hormonal pills is possible only in cases where involutive processes are identified or a single small node (no more than 1 cm) is identified.

But even in these situations, regular monitoring by a doctor is required with ultrasound or mammography at least 2-3 times a year. Treatment with folk remedies using local and general methods (compresses, infusions, herbal preparations) is ineffective: it is impossible to cure breast fibroadenoma with non-traditional types of therapy.

Hello. I'm getting ready for surgery. What is not allowed after removal of fibroadenoma from the right breast? Inna, 38 years old.

Hello, Inna. In the next month after the operation, you must strictly follow the doctor’s recommendations - refuse physical activity and sports, wear special underwear, do not go to the bathhouse or sauna, and take medications prescribed by the doctor.

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