Treatment of fibroadenoma

A lump in the breast often causes concern, even if it does not hurt and does not change for a long time. One of the common causes of such changes is fibroadenoma of the mammary gland. Usually, it has a benign nature, but it requires examination, because it is impossible to accurately determine the type of formation and choose the correct tactics based only on external signs.

If you have noticed a nodule in the breast or changes that were not there before, consult a doctor. At the «Oxford Medical» medical center in Kyiv, you can undergo the necessary diagnostics and receive individual recommendations regarding further observation or treatment. To make an appointment for a consultation, use the online appointment form on the website or call the contact center.

A fibroadenoma — is a benign formation that consists of the glandular and connective tissues of the mammary gland. Most often, it occurs in young women, has clear boundaries, and moves easily during palpation. Usually, such a nodule does not hurt, but it can increase under the influence of hormonal changes. Its benign nature can be confirmed only after an examination by a doctor.

According to the WHO classification, depending on the structural features, a fibroadenoma can be:

• intracanalicular — connective tissue grows inside the ducts, compresses them, and changes their shape;
• pericanalicular — connective tissue grows around the ducts, which retain a rounded shape;
• mixed — combines the features of the intracanalicular and pericanalicular types.

Doctors at «Oxford Medical» note: it is important to distinguish a phyllodes adenoma, which is also called a phyllodes tumor, from an ordinary fibroadenoma. It may have similar signs, but differs in structure and growth pattern. Such a formation can increase rapidly and reach significant sizes, so it requires thorough diagnostics and appropriate treatment tactics.

The exact causes of the appearance of fibroadenoma in the breast have not been definitively established. Its development is associated with increased sensitivity of breast tissue to estrogen and other hormonal changes. That is why such formations are most often detected in adolescents and women of reproductive age.

Factors that may influence the appearance or growth of fibroadenoma include:

• the period of puberty;
• young reproductive age;
• hormonal changes during pregnancy and breastfeeding;
• hormone replacement therapy after menopause.

During pregnancy, breastfeeding, or hormone therapy, an already existing nodule may increase, and after menopause — decrease. At the same time, breast injuries, physical exertion, and wearing tight underwear are not considered direct causes of fibroadenoma.

Tenderness is not typical, but sometimes discomfort intensifies before menstruation. Large formations may change the shape of the breast or cause a feeling of pressure.

Doctors at «Oxford Medical» warn: it is impossible to independently determine the nature of the lump based on external signs. If the nodule appeared recently, is increasing, or is accompanied by changes in the skin or nipple, it is necessary to consult a mammologist and undergo an examination.

Diagnosis begins with a consultation with a mammologist. The doctor examines and palpates the mammary glands, after which the necessary scope of examinations is determined.

In accordance with the recommendations of the American College of Radiology, the following may be prescribed to establish the diagnosis:

• ultrasound of the mammary glands — helps determine the size, location, contours, and structure of the nodule;
• elastography — an ultrasound examination method that makes it possible to assess the stiffness of the tissues of the formation and supplements data about its structure and nature;
• mammography — makes it possible to examine the tissues of the mammary glands in more detail (it is more often prescribed to women over 40 years of age);
• core needle biopsy — involves taking tissue samples for histological examination (it is performed if the formation has atypical signs, increases rapidly, or the imaging results do not provide an unambiguous answer);
• hormone tests — may be recommended in cases of menstrual cycle disorders or other signs of hormonal changes.

Not all of the listed examinations are required in every case. The doctor determines the diagnostic approach individually based on the results of the examination and the initial assessment.

In most cases, a confirmed fibroadenoma does not require treatment. Most often, an observation approach is chosen. Surgical treatment of breast fibroadenoma is performed only when there are appropriate indications.

Conservative Treatment

Conservative tactics involve monitoring the condition of the fibroadenoma. The first follow-up ultrasound is usually performed after 6 months. If the size and structure of the nodule do not change, subsequent examinations may be scheduled after 12 and 24 months.

If the diagnosis is confirmed by a core needle biopsy, and the results of the histological examination correspond to the ultrasound or mammography data, frequent follow-up examinations may not be necessary. In this case, it is sufficient to undergo routine screening according to age.

If hormonal disorders are detected, the doctor may prescribe their correction. The treatment regimen is selected individually based on the results of tests and a consultation with the appropriate specialist. If the nodule has begun to increase or discomfort has appeared, it is necessary to consult a doctor without waiting for the next scheduled examination.

Surgical Treatment

Surgery may be recommended if:

• the fibroadenoma is more than 3 cm in size and continues to increase;
• the size of the formation is 5 cm or more and causes noticeable deformation of the mammary gland;
• the data from repeated ultrasound examinations confirm that the nodule is growing rapidly;
• the formation causes pain or constant discomfort;
• atypical cells have been detected in tissue samples;
• it is impossible to confidently distinguish a fibroadenoma from a phyllodes tumor.

Most often, enucleation is performed — the fibroadenoma is removed while preserving the healthy tissues of the mammary gland as much as possible. If the formation has atypical signs or there is a suspicion of a phyllodes tumor, a sectoral resection may be required — removal of the nodule together with part of the surrounding tissues.

The operation is performed under local or general anesthesia. The type of anesthesia is chosen taking into account the size, number, and location of the nodules, as well as the extent of the intervention. The removed tissues are necessarily sent for histological examination for final confirmation of the diagnosis.

Surgical treatment of fibroadenoma at «Oxford Medical» is performed by experienced doctors in a modern inpatient facility. Preference is given to organ-preserving methods that make it possible to remove the formation while preserving the healthy tissues and natural shape of the mammary gland as much as possible. Patients are provided with full medical support — from preparation for the operation and histological examination to follow-up examinations during the recovery period.

To maintain breast health and prevent fibroadenoma, it is recommended to:

• perform breast self-examination every month, preferably 5–7 days after the start of menstruation;
• undergo a preventive examination by a mammologist once a year;
• consult a gynecologist in cases of menstrual cycle disorders and other signs of hormonal changes;
• not take hormonal medications without a doctor’s prescription;
• undergo breast ultrasound or mammography according to age and the doctor’s recommendations;
• follow the schedule of follow-up examinations when fibroadenoma has been detected.

Doctors at «Oxford Medical» note: if a lump, changes in the shape of the breast or nipple, discharge, or other unusual symptoms are detected during self-examination, it is necessary to consult a mammologist without waiting for a scheduled examination.

The price of fibroadenoma removal depends on its size, the location of the formations, the selected method of surgery, the type of anesthesia, and the duration of the stay in the inpatient facility. The need for surgical intervention and its method are determined by the doctor after diagnostics have been performed.

You can review the prices for doctors’ consultations here in advance. Make an appointment with a mammologist at «Oxford Medical» at a time convenient for you through the online appointment form or by calling the contact center.

The information is for informational purposes and does not replace a doctor’s consultation.

Sources:

• American Society of Breast Surgeons and Society of Breast Imaging
• American College of Radiology
• Chinese Society of Breast Surgery