fibroadenoma

Fibroadenoma: description

Fibroadenomas are the most common benign breast lumps (breast) in women between the ages of 20 and 40 years. But they can also occur in older menopausal women and under hormone treatment. When women take the pill, they are less likely to develop.

A fibroadenoma arises from mammary and connective tissue and feels as rubbery as rough. Fibroadenoma pain usually does not affect those affected. They often discover the knot randomly when it is two to three inches tall. Usually it is a single node, but more rarely, several fibroadenomas can arise. In five to ten percent of cases, both breasts are affected.

Only rarely is the fibroadenoma larger than three centimeters. It can even regress itself with age. In young women, however, there is a special form that grows very quickly and can change the shape of the breast. Since it is a benign node, it is not necessary to remove the fibroadenoma from a medical point of view. In some cases and at the request of the patient it is possible to operate out a knot. Very rarely (in 0.1 to 0.3 percent of those affected) can arise from the fibroadenoma mammary carcinoma (breast cancer). Therefore, affected women should have the breast checked regularly by the gynecologist.

Fibroadenoma: symptoms

The fibroadenoma is usually asymptomatic. Women are therefore more likely to spot a rough knot in the chest. Sometimes several nodes are close together. If the gynecologist examines the breast at the annual check-up, almost no woman feels pain through the fibroadenoma. Sometimes, however, the fibroadenoma breast feels particularly tense, especially before the period. This is what some women find uncomfortable or slightly painful.

In rare cases, and usually in younger women, there is a fast-growing type of this nodule. Then the fibroadenoma can change mamma shape and size. The chest may bulge slightly and appear enlarged.

Fibroadenoma: causes and risk factors

Fibroadenoma cells are stimulated by female sex hormones (estrogens) to multiply. Increasing the concentration of these hormones, for example, under a hormone treatment or during pregnancy, many new glandular and connective tissue cells. They can form a tough knot, the fibroadenoma. Women take the pill for a long time, but it reduces the risk of it developing. If a fibroadenoma has been removed in the past, the surgery may leave residual cells in the chest and grow into a knot again.

Fibroadenoma: examinations and diagnosis

Most women notice a fibroadenoma itself as they palpate their breasts. To make the diagnosis, the doctor first asks for complaints and the history (history). The doctor must rule out that it is a malignant change (breast cancer). He checks if the breast shape has changed and scans the chest and the armpits. If he discovers a conspicuous nodule or another unclear alteration, the following investigations can follow:

sonography

With a special ultrasound device, one can usually clearly identify a fibroadenoma and differentiate it from other nodes. The doctor applies gel to the chest and armpit and systematically ablates the chest with the ultrasound head. This examination is not painful. At most the cold ultrasound gel can be perceived as unpleasant.

mammography

This is a special X-ray examination, which is carried out from the age of 50 for regular early breast cancer detection. For the x-ray, the breast is pressed between two plates. Most women find that painful. However, it is not harmful and necessary to spread the healthy mammary gland tissue and distinguish a malignant nodule from a fibroadenoma. Mostly, this examination gives a further diagnosis. For young women, mammography is rather inappropriate. Your breast tissue is so dense that you can hardly identify changes.

Magnetic resonance imaging (MRI)

In certain cases, magnetic resonance imaging is necessary to diagnose or rule out a fibroadenoma. These include women who have had breast surgery, silicone implants or breast cancer in the past. On MRI, changes in dense glandular tissue can be detected well. For the examination, patients sometimes receive a contrast medium injected into a vein. During the recording in the examination tube, they must be as motion-free as possible. Magnetic resonance imaging does not produce harmful radiation.

core biopsy

Despite the possibilities of investigation mentioned, it is sometimes not possible to obtain a clear result. In this case, a punch biopsy can make the diagnosis possible. This investigation is also carried out when one of the other investigations has led to a conspicuous result and should now be further clarified. Using a kind of pistol (similar to earring shooting), the physician removes a cylindrical piece of tissue from the knot. The breast is usually first anesthetized locally, so that no pain as possible. Subsequently, the tissue sample is examined under the microscope by a tissue specialist (pathologist). He can clearly determine if it is a fibroadenoma or another node.

Node removal (excision)

For larger fibroadenomas, rapid growth, and women older than 40 years, the doctor usually removes the entire nodule and has it examined in the laboratory.

Fibroadenoma: treatment

If the diagnosis fibroadenoma could be confirmed with one of the described examinations, from a medical point of view no further treatment is absolutely necessary. The fibroadenoma breast should only be examined regularly by the gynecologist. This allows him to quickly recognize when the tissue changes viciously and yet needs to be treated differently.

However, if the knot grows very fast and changes the shape of the breast, many women choose to have the fibroadenoma removed. If someone in the family has breast cancer, this small surgery is also recommended. Depending on where the fibroadenoma is located and how big it is, the surgery can change the shape of the breast. In addition, sometimes some fibroadenoma cells remain in the breast despite the surgery. These cells can then again form a node. Even after surgery, the breast should be thoroughly scanned once a month, as soon as possible after menstruation. The gynecologist explains to his patients how best to do this themselves.

Doctors often recommend having a fibroadenoma removed before getting pregnant. During pregnancy, the hormone balance changes. The hormones send a signal to the fibroadenoma cells to multiply. If the fibroadenoma grows faster, it can lead to discomfort. After a fibroadenoma has been removed, most mothers can breastfeed without any problems. However, it can come a little more frequently to a milk congestion.

Fibroadenoma: disease course and prognosis

A fibroadenoma is a benign tumor. If you do not remove it, it can remain the same size. During menopause, the proportion of female sex hormones in the body decreases, so that a fibroadenoma can even regress itself. On the other hand, if the hormone level rises, as during pregnancy or under hormone therapy, the fibroadenoma may also become larger. Incomplete removed nodes can regrow (recurrence).

Breast fibroadenomas do not increase the risk of developing breast cancer. However, if a woman has several of these nodes, malignant tumors are found more frequently in their environment. Only every 1000th to 3000th fibroadenoma transforms into a malignant tumor. Although this represents a very low risk, a woman should be with fibroadenoma regularly palpating her breast.