Treatment of fibroadenoma

Fibroadenoma is a benign tumor located in the breast. The fact that fibroadenoma is benign does not mean that it does not need to be controlled and treated by a breast physician– there is always a risk of its degeneration (malignancy) into a malignant tumor.

Most often fibroadenoma is uncovered in women aged 20-30 and 40-50 years. In the second case it is difficult to distinguish fibroadenoma from breast cancer without additional diagnosis. The exact mechanism of development of the disease, as well as the causes that trigger it, are still being studied, but it is reliably established that the appearance of fibroadenoma is promoted by gynecological and endocrine diseases, childbirth, lactation, breast injuries and stress.

A woman can identify fibroadenoma during self-examination and palpation – it is a soft, elastic, painless and mobile seal with clear boundaries. At sizes up to 1 cm fibroadenoma can be easily confused with a cyst (cyst is a fixed and painful seal, unlike fibroadenoma, which is mobile and painless on palpation). At sizes up to 1 cm fibroadenoma can be easily confused with a cyst (cyst is usually a fixed and painful seal, unlike fibroadenoma, which is mobile and painless on palpation).

There are several types of  neoplasms:

• intracanalicular - growth occurs from connective tissue into the duct of the gland;

• pericanalicular – usually it grows around the duct of the breast;

• mixed - the process has the characteristics of both previously mentioned types. 

One more type which needs to be specified is the phylloid (leaf-shaped) fibroadenoma, which is characterized by very rapid growth and a tendency to breaking. Leaf-shaped fibroadenoma is able to grow quickly to several centimeters in diameter and needs to be removed. After all this form of the disease can turn into a malignant neoplasm - phylloid sarcoma.

It is important not to confuse fibroadenoma and fibroadenomatosis -despite similar names, they are two different diseases. Fibroadenoma is a benign neoplasm, and fibroadenomatosis is the overgrowth of connective tissues. 

Diagnosis begins with an initial check-up by breast physician, during which the doctor conducts an examination and palpation of the mammary glands, asks the patient about her symptoms. For the diagnosis of fibroadenoma in most cases an ultrasound of the mammary glands is prescribed, a biopsy (tissue sample for histological analysis) may be taken under the control of ultrasound.

For small (up to 1 cm), not growing fibroadenomas, the structure of which on ultrasound does not raise the doctor's fears, conservative treatment and their constant observation by a breast physician is possible. For fibroadenomas that have reached a size of 1.5 cm the only effective treatment is removal. Removal is also indicated if the tumor grows rapidly in size and in patients from the high-risk of cancer group. 

Removal of fibroadenoma is carried out by enucleation ("exfoliation"), during which only the tumor is removed. In some cases sectoral resection is indicated during which fibroadenoma is removed with the part of the breast. In determining the tactics of treatment the doctor chooses the most effective method, trying to preserve the maximum volume of the breast.

After removal of fibroadenoma the disease may develop again, that is why all patients have to be constantly observed by a breast physician to exclude recurrence of the disease.