Fibroadenoma of the mammary glands is called a benign formation, which most often occurs in fairly young women (up to 30 years). After 40 years, such a disease is diagnosed much less frequently. If a pathology such as breast fibroadenoma is detected, treatment without surgery is still possible in some cases.

Reasons for the development of the disease

There is no exact reason that can provoke the development of the pathological process. However, experts identify a number of factors due to which changes occur in the tissues of the breast. First of all, these are hormonal fluctuations in the body. This also explains why the disease is diagnosed in young girls (the period of hormonal storms and puberty, the formation of the menstrual cycle). Stressful situations also have a negative impact on the body of a woman. Fibroadenoma of the breast can still occur through the use of drugs for abortion, abortion. It is worth noting that excessive physical activity, lack of sleep and rest provoke changes in the gland. Among the factors in which there is a high probability of the formation of tumors, there are also the following: problems in the work of gynecological diseases. how to treat? With this diagnosis, small seals form in the woman's chest. Some structural elements grow or develop incorrectly. A feature of such a tumor is that it can move freely. The sizes can be different: from several millimeters to several centimeters. The fibroadenoma of the breast consists of which the fibers of the fibrous structure surround. Most often, the pathological process is observed in one gland.

Types of fibroadenoma

There are three main types of breast fibroadenomas. The pericanalicular tumor has a dense consistency, sometimes it is possible to observe the accumulation of calcium salts in it. It is localized most often around the mammary ducts of the gland. Intracanalicular fibroadenoma has a looser structure, the contours are not clearly marked. Both of the first types are not prone to degeneration into malignant neoplasms. There is also a third type - leaf-shaped (or phylloidal) fibroadenoma of the mammary gland. Treatment without surgery in this case is hardly possible. This type is characterized by significant size and the ability to degenerate into cancer.

Symptoms of the disease

Very often the disease proceeds without any visible symptoms. On examination, a movable seal with a fairly dense structure can be found. In most cases, such tumors are discovered by women themselves, often by accident. Pain sensations are absent. An exception is leaf-shaped fibroadenoma. Symptoms, if present, are as follows: the skin of the breast becomes bluish, discharge from the nipple is possible, pain is felt in the affected area. There may be some increase in education during menstruation.

Diagnosis of breast fibroadenoma

First of all, the specialist palpates the glands of the patient. If seals are found, then further studies are needed to confirm the diagnosis. With the help of ultrasound, you can see a complete picture of the internal structure of the gland. To determine whether the process is benign, a biopsy is necessary. The doctor can take a tissue puncture with a syringe or excise a small area of ​​the tumor under local anesthesia. The sample is then sent for histological analysis. This makes it possible to determine the degree of tissue damage, make sure that there is no malignant process, and confirm the diagnosis of breast fibroadenoma. Treatment without surgery, surgery - these decisions are made only by a specialist.

Conservative methods of treatment of breast fibroadenoma

The essence of this technique is to stabilize the hormonal background. The patient is prescribed special drugs that normalize the level of hormones in the blood. It is also additionally recommended to take vitamin E. Experts advise to put your weight in order, as excess body weight can increase the risk of pathogenic processes in the gland. Conservative therapy also provides for the treatment of concomitant gynecological diseases. Women are prescribed iodine supplements. Such patients should be regularly monitored by a doctor. If the size of the tumor increases, new symptoms appear, then more radical methods are needed.

Will folk remedies help?

Is fibroadenoma treated with folk remedies? There are a considerable number of recipes for folk therapy to get rid of this disease. One of them is based on the use of walnut. An alcohol tincture is prepared from its partitions, which is taken once a day (a tablespoon). It is worth noting that walnut partitions are a good source of iodine (and a deficiency of this trace element is highly undesirable for women's health). Be careful with medicinal herbs. Licorice, clover - sources of estrogen. Their use is highly discouraged. But infusions of yarrow, juniper fruits produce a healing effect. In any case, you do not need to get involved in traditional medicine. Compresses, rubbing, which only contribute to the growth of the tumor, are categorically contraindicated. It would be best to contact a specialist who will tell you how to treat fibroadenoma correctly.

Removal of affected areas

If the size of the tumor is large enough, it tends to grow, the leaf-shaped form is diagnosed, or there are suspicions of oncology - in these cases, removal of the formation is necessary. Surgical intervention can be carried out according to two methods: resection of the tumor itself (nucleation) and removal of fibroadenoma with a certain amount of surrounding tissues (lumpectomy). The latter method is used in cases where the mammary gland is diagnosed (what it is, how to treat it, was discussed above). The operation is transferred quite easily, the scar is almost invisible. The woman stays in the hospital for one day, and then she is discharged. However, it is worth noting that the possibility of recurrence of education is 15%.

Modern methods of treatment

With the diagnosis of breast fibroadenoma, treatment without surgery is possible due to the use of a laser or low temperatures. Laser thermotherapy consists in precise aiming of the beam at the tumor and destruction of the formation. The shape of the breast does not change, only a small trace remains on the skin. This procedure does not require hospitalization of the patient. Cryotherapy is based on the freezing of pathogenic cells, the gradual death of the tumor. If a fibroadenoma is removed in this way, patient reviews indicate that a return to normal life occurs the next day. There are no cosmetic defects left. Also, modern methods of treatment include the use of radio waves.

Methods for the prevention of fibroadenoma

Any treatment involves lifestyle changes. First of all, it is worth keeping your own emotions under control and avoiding stressful situations. In addition, it is necessary to abandon abundant sunbathing and visits to the solarium. Of course, alcohol and cigarettes are strictly prohibited. Compresses, rubbing the gland can cause irreparable harm to a woman's health. There is no special diet to prevent changes in breast tissues, but it is still better to minimize fried, fatty foods. But legumes, green tea, cabbage will only benefit. Every woman should know how to properly examine her breasts. After all, it is the early detection of formations that is the guarantee that the disease will be overcome.

Fibroadenoma of the breast is a benign pathology.

It can occur at any age, but is usually diagnosed between 20 and 35 years of age.

Fibroadenoma is a type of nodular mastopathy, it is considered the most common pathology diagnosed by mammologists.

The danger of fibroadenoma is its possible transformation into oncology, which is why it is so important to detect the disease in time, observe it and, if necessary, operate on time.

Essence of pathology

Hormones are responsible for breast health:

• estrogen;
• progesterone;
• prolactin.

With a normal ratio of their concentration, all processes in the mammary gland proceed correctly and naturally. But as soon as a woman experiences a hormonal failure - puberty, pregnancy, menopause, pathological disorders - the balance of the connective and glandular tissue of the sternum is disturbed. That is, seals and knots are formed.

Fibroadenomas are classified as follows:

• foliate- a seal of knots that are woven together;
• intracanalicular- the tumor develops in the lumen of the ducts of the mammary gland;
• pericanalicular- fibrous tissue grows around the milk ducts;
• combined- combines the features of the last two forms.

Also, fibroadenomas are divided into:

• mature- there is a dense capsule;
• immature- the neoplasm is soft and prone to active growth.

NOTE!

Immature fibroadenomas in some cases can resolve on their own. They are most often diagnosed in adolescent girls and as the hormonal levels are regulated and the menstrual cycle is established, they may disappear. Mature fibroadenomas cannot resolve themselves.

Should the disease be treated?

It is certainly necessary to treat fibroadenoma, the question is different - what tactics should be chosen for therapy.

Mature forms of fibroadenoma do not respond to conservative treatment, so it is recommended to remove them surgically.

If the fibroadenoma is growing rapidly or there is a suspicion of oncology, the neoplasm must be removed with the help of surgery.

Leaf-like fibroadenoma has the most unfavorable prognosis in terms of oncology. The risk of transformation into a malignant process is 10%. Therefore, this form of pathology is removed surgically immediately after diagnosis.

Is treatment possible without surgery?

In some cases, with fibroadenoma, doctors recommend drug treatment.

Conservative therapy is prescribed for immature fibroadenoma or if there is no urgent need for surgical intervention. In the latter case, hormonal therapy is prescribed, which will restrain (or completely stop) the growth of the neoplasm and relieve symptoms.

However, it is possible to completely get rid of the disease with a medical method without surgery only with an immature form of pathology, in all other cases, surgery is needed to remove the tumor.

Since immature forms of fibroadenomas are not often diagnosed, doctors almost always prescribe surgical treatment. However, if the tumor is small and does not grow, the operation may not be rushed. In this case, doctors prescribe hormones - these can be drugs for internal use or local remedies. In addition, a woman is advised to change her lifestyle, balance her diet and take vitamins. If after six months of conservative therapy no positive dynamics is observed, the doctor raises the question of surgical removal of the neoplasm.

Diagnostic methods

To establish a diagnosis, the following measures are necessary:

• examination by a mammologist and palpation of the breast;
• Ultrasound - recommended for young patients, as well as women with small breasts. On ultrasound, the pathology looks like a neoplasm gives a rounded shadow with clear contours. The echogenicity of the neoplasm is reduced. In some cases, ultrasound diagnoses calcifications - the deposition of calcium salts. Leaf-shaped fibroadenoma on ultrasound is distinguished by scalloped edges and smoothed contours;
• mammography - performed for women after 40 years;
• puncture. They take a puncture mainly if there is a neoplasm for analysis of the contents;
• biopsy of breast tissue.

When diagnosing fibroadenoma, it must be differentiated from:

• cysts;
• cystadenopapillomas;
• oncology.

The photo below shows the stages of diagnosis of fibroadenoma and how it looks on ultrasound and mammography.

Taking medication

There are many methods of conservative treatment of fibroadenoma, and it is not advisable to choose your own drugs. Any treatment should be prescribed only by a doctor and carried out under his supervision.

Fibroadenoma may be accompanied by additional diseases, therefore, complex diagnosis and treatment of concomitant ailments is important.

With a conservative approach to treatment, the doctor may prescribe the following remedies:

• Progestogel. This is a progesterone-based gel that is applied directly to the mammary glands. Applications are carried out twice a day. Treatment should be carried out daily or according to the scheme recommended by the doctor. This is a relatively safe drug, in this case progesterone has a local effect and is not absorbed into the blood;
• Mastodinon. These are tablets or drops, which include herbs and natural ingredients. The drug is not hormonal, and is effective only if there is an immature fibroadenoma. The tool helps to lower the level of prolactin;
• Duphaston. This is a progestogen - a synthetic hormonal drug. Reduces estrogen levels, therefore, tumor growth slows down. The remedy does not affect ovulation, and its intake does not affect body weight;
• birth control pills - Jess, Diana 35, Marvelon and others. This group of funds is assigned to women under 35;
• iodine preparations - Iodomarin, Iodine active etc. Reception of these funds is advisable when confirming iodine deficiency;
• vitamin E. It is prescribed in combination with hormonal agents;
• antibiotics. This group of drugs does not treat fibroadenoma, but is prescribed for inflammatory processes in the breast or in the genitals. Most commonly used Metronidazole, Ciprofloxacin, Ampicillin, Ceftriaxone.

Folk remedies

Despite the fact that traditional medicine cannot cure breast fibroadenoma, it is often used as an additional therapy to relieve symptoms and restore hormonal levels.

Most often assigned:

• upland uterus. This plant contains plant estrogens. To prepare a remedy, you need to pour a tablespoon of vegetable raw materials with a glass of boiling water, insist overnight, and then take two tablespoons before meals. You can also prepare an alcoholic tincture from this plant. To do this, pour two tablespoons of raw materials with a liter of vodka, leave for 10 days in a dark place and shake occasionally. Take a teaspoon before meals;
• red brush. This plant contributes to the normalization of hormonal balance. A tablespoon of the plant in a glass of boiling water. Infuse for 30 minutes, then take a tablespoon three times a day. Contraindications - hypertension, epilepsy, pregnancy;
• celandine. It has analgesic and antitumor effect. To prepare an alcohol tincture, you will need a tablespoon of a crushed plant and a glass of vodka. After 10 days, the product will be ready for use. The tincture is used according to the following scheme: day 1 - 1 drop dissolved in water, day 2 - 2 drops, and so on, until the number of drops reaches 15. Then you should continue taking the drug in this dosage for another month and a half. Celandine is a poisonous plant;
• hirudotherapy. A fairly effective method that has an analgesic, anti-inflammatory effect, and also dissolves scars in tissues, improving their permeability.

Homeopathy and dietary supplements

Homeopathy and dietary supplements have a mild effect on the human body and do not lead to severe complications that can often be observed when using synthetic drugs. These funds are easily tolerated and saturate the body with biologically active substances.

CAREFULLY!

It is recommended to use drugs from well-known pharmaceutical companies, and be wary of products that are imported from Asian countries - they may contain unknown plants, the effect of which can be unpredictable.

Mastodinone is the most popular homeopathic remedy for the treatment of fibroadenoma, however, it is not the only one. There is also Mammokalm - a preparation based on brown algae. It saturates the body with iodine, fatty acids and chlorophyll.

As for dietary supplements, the most popular drug is Indinol. Its action is aimed at suppressing the growth of hormone-dependent tumors, so it is included in the complex treatment of fibroadenoma. The drug is not hormonal, but it has a negative effect on the activity of estrogen, and, therefore, reduces the rate of progression of tumor processes in a woman's body.

Surgical intervention

Surgical treatment is prescribed in the following cases:

• the inability to determine the nature of the tumor based on the results of the tests. During the operation, the tissues are subjected to histological analysis, and after confirmation of the malignant process, the surgical intervention is expanded;
• leaf-shaped form of pathology;
• rapid growth of neoplasm;
• large tumor size - more than 3 cm;
• there is a pronounced cosmetic defect;
• pregnancy planning;
• the age of the patient is over 40 years old - at this age, the hormonal background changes, which increases the risk of developing malignant tumors.

Surgical removal of the neoplasm does not exclude the possibility of recurrence, especially if the hormonal imbalance has not been eliminated. Therefore, it is very important to treat not only fibroadenoma, but also the pathologies that provoked it.

Surgery is performed under local or general anesthesia, after removal of the neoplasm, a cosmetic suture is applied.

Ways to remove the tumor:

• enucleation- used to remove small tumors with their absolute good quality;
• sectoral resection- performed to remove large benign and malignant neoplasms. Not only the tumor itself is removed, but also the tissues adjacent to it;
• laser burning- a gentle technique that takes 15 minutes and leaves behind a small seam that heals in a short time;
• radical method- Complete resection of the breast is performed in rare cases. It is prescribed for the huge size of the neoplasm - more than 8 cm, as well as for numerous seals that are scattered throughout the gland.

Preventive measures

To prevent the formation of tumors in the mammary gland, it is necessary to avoid prolonged exposure to direct sunlight. Irradiation with ultraviolet light in a solarium also provokes the appearance of neoplasms.

The formation of fibroadenoma helps to avoid a healthy diet and a properly selected diet, you also need to monitor weight and perform feasible physical activity. Manual therapy can also have a positive effect, but it should be used with caution.

A woman should periodically independently examine the mammary glands - palpate in a standing position and lying down. If seals are found, it is necessary to visit a mammologist.

After the age of 40, every woman should undergo preventive examinations by a mammologist once every six months.

Fibroadenoma Definition

Fibroadenoma is a benign tumor characterized by clear boundaries. This formation develops in women in the mammary gland, in the uterus, its cellular structure is soft and elastic. It consists of connective and glandular tissue, moves freely - the “float” symptom, is the main distinguishing feature of fibroadenoma.

The size of fibroadenomas can vary from 2 millimeters to 5 centimeters in diameter. Growth is influenced by steroid hormones (estrogens) produced by the ovarian follicular apparatus. In men, fibroadenoma of the prostate gland is observed.

Causes of fibroadenoma

To date, the causes of the development of such a tumor have not yet been precisely established. Experts believe that fibroadenoma in women is the result of a hormonal disorder. Its development is affected by diseases of the ovaries, liver, malfunctions of the endocrine system, and much more.

The formation of a tumor at an early age occurs due to a violation of the menstrual cycle. Also, fibroadenomas develop in women after artificial termination of pregnancy and the use of contraceptives. And during pregnancy, they increase in size.

Fibroadenoma in a man, in the prostate gland, occurs due to a violation of the production of a sufficient amount of male sex hormones, as a rule, it develops in older people. Other factors also become the cause of the formation of this neoplasm, for example: injuries and inflammation of the genitourinary organs, promiscuous or irregular sex life, poor blood supply. Also, the disease can develop due to heredity and physical inactivity.

Fibroadenoma Symptoms

With developing fibroadenoma, there are no obvious symptoms in women. As a rule, the disease is asymptomatic, manifested by a seal in the chest, which is detected during preventive examinations or by the women themselves during palpation. The tumor is dense, easily displaced in the tissues, has a smooth surface. But sometimes the pain still occurs in the chest.

With the development of this tumor, men are concerned about pain in the lumbar region and prostate gland, sexual dysfunction is characteristic during this period. Most often, men experience discomfort and often pain when urinating, problems can be manifested by an acute delay, a false urge, or a sluggish stream.

Diagnosis of fibroadenoma

When diagnosing fibroadenoma, if it has a small size, for example, up to 1 cm, then, when analyzing ultrasound data, it is often perceived as a cyst. The disease is detected at the age of 20 to 30 years, as well as in patients much older. Often cases of diagnosing fibroadenoma in girls in adolescence. In some cases, fibroadenomas can disappear on their own during puberty.

Fibroadenomas are divided into several types.

• Normal fibroadenoma is divided into pericanalicular, intracanalicular and mixed. This species is not predisposed to transformation into or sarcoma.
• Rarely, phyllodes or leaf-shaped fibroadenomas develop into sarcomas. Phylloid fibroadenoma can grow to large sizes and is characterized by rapid growth.

After a medical examination, a mammography method is used for diagnosis, which consists in an X-ray examination of the mammary gland, an ultrasound examination, a puncture, i.e. a biopsy. It is possible to identify this formation in men with a digital examination of the rectum.

Fibroadenoma treatment

To date, there is no more effective way to treat fibroadenoma than surgical removal. Indications for the removal of fibroadenoma is its rapid growth, when it doubles in size within 3-4 months. In this case, it is most likely a phyllodes tumor.

The operation is indicated if the tumor is large, for example, more than 5 cm, which leads to a cosmetic defect, and if it passes into the stage of a cancerous tumor.

Traditionally, two types of operations are used:

• Sectoral resection, performed for breast cancer, is the removal of the tumor along with some part of the breast tissue.
• Enucleation or enucleation of a tumor is an operation that is not a radical intervention procedure.

Operations are performed under general or local anesthesia. At the same time, the pathologist performs a histological examination in order to confirm whether to refute breast cancer or sarcoma. After removal, cosmetic sutures are applied.

Modern methods of fibroadenoma removal include:

• Laser ablation is a non-surgical way to get rid of the tumor, without stitches and changes in the shape of the breast, only a tiny scar remains. The procedure is performed in the surgeon's office and does not require hospitalization.
• Cryoablation is a fast and effective method of freezing. This is the least aggressive procedure, in which the tumor is frozen inside the tissues, the tumor cells die, the tumor gradually shrinks and eventually disappears. Most patients return to their normal lifestyle the very next day. There are practically no complications, recovery is fast without cosmetic consequences.
• Radio wave removal of fibroadenoma, which includes local anesthesia and ultrasound control, an incision 6 - 8 mm above the fibroadenoma, exposure to radio frequency waves, separation of healthy tissues from tissues with pathology, capture of fibroadenoma with special instruments and removal.
• The method of mammotomy breast biopsy involves local anesthesia, an incision over the fibroadenoma, the introduction of a probe under ultrasound guidance, and the use of vacuum to remove the tumor. After such a manipulation, a quick recovery is noted, the scar is hardly noticeable.

Surgery is also required to remove the tumor in men.

Prevention of fibroadenoma

In order to prevent the disease, women need to avoid exposure to sunlight, less likely to expose the body to overheating when taking hot baths, and try not to get into stressful situations. Men are advised to observe the rules of personal hygiene, not to abuse alcohol. Taking your health seriously and visiting a doctor once a year should be the responsibility of every woman and man at any age.

Expert editor: Mochalov Pavel Alexandrovich| MD general practitioner

Education: Moscow Medical Institute. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".

Any neoplasm in the breast causes natural concern, but not all of them are associated with malignant tumors. So, 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 the glandular tissue (parenchyma) and connective tissue (stroma) of the breast.

ICD-10 code

N60.2 Fibroadenosis of breast

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 mobile "balls" are formed in the breasts of women due to various hormonal disorders. As doctors say, the mammary gland is a "target" for hormones.

Throughout life - from puberty up to menopause, including the menstrual cycle and periods of pregnancy - cyclical changes occur in the mammary glands, caused by fluctuations in the level of sex hormones. Particularly sensitive to the action of hormones are the cells of the epithelial and muscular tissue of the breast, 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 tissues, which is manifested by an increase in the mass of fibrous tissue.

Hormonal disorders, in particular, excessive 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 disorders.

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 rather dense round or oval node with clear boundaries that can be felt in the thickness of the soft tissues of the breast.

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

In most cases, a tumor in the mammary gland is discovered by women by chance - in the process of feeling the breast. Visually, only a large tumor can be detected. Moreover, it is painless on palpation. In general, there is no pain in fibroadenoma of the mammary gland. The exception is phyllodes fibroadenoma of the mammary gland.

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

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

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

Forms

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

Fibroadenoma of the breast during pregnancy

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

During the bearing of a child - against the background of a general hormonal restructuring of the woman's body - there is an acceleration of the growth of the existing benign tumor. The growth of the glandular tissue of the mammary glands is stimulated by estrogen, and the development of the mammary glands and preparation for lactation is stimulated 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, according to doctors, this disease does not adversely affect the course of pregnancy and the development of the fetus, they strongly recommend removing fibroadenoma when planning pregnancy.

Similarly, the opinion of gynecologists and about solving the problem - breast fibroadenoma and IVF. Both in preparation for in vitro fertilization and directly during it, they stimulate the woman's ovaries, so that a high blood level of estrogens (estradiol) 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 phylloidal (or leaf-shaped).

Pericanalicular fibroadenoma of the breast

With this type of tumor, proliferation of connective tissue cells in the lobules of the gland is observed. A tumor of dense consistency is formed, precisely limited from other tissues, with localization 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, according to the results of mammography, the so-called calcified breast fibroadenoma or calcified breast fibroadenoma can be diagnosed.

Intracanalicular fibroadenoma of the breast

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

Mixed fibroadenoma has features of both types of breast fibroadenoma.

Phylloid fibroadenoma of the breast

Particularly large (5-10 cm and even more) reaches the least common type of this pathology - leaf-shaped fibroadenoma of the mammary gland, it is also a phyllodes fibroadenoma of the mammary gland. This tumor is a marker for an increased risk of developing breast cancer.

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

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

By the way, when patients say that they have a nodular fibroadenoma of the mammary gland, it is obviously implied that the fibroadenoma of the mammary gland is a nodular form of mastopathy (mastopathy includes almost all benign pathological growths of breast tissue). And under the definition of "diffuse fibroadenoma of the mammary gland", most likely, we mean a diffuse form of mastopathy, one of the varieties of which is fibroadenosis. Its difference from breast fibroadenoma lies in the fact that in fibroadenosis, not only epithelial and fibrous tissues, 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, which developed from fibroadenoma, is in the range of 0.002-0.0125%. At the same time, experts do not hide the fact that the data of clinical analyzes and mammography results often show the presence of benign fibroadenomas, and during the surgical removal of neoplasms, 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, transformation into a malignant form, is, according to some data, 3-5%, according to others - 10%.

So women who have a leaf-shaped fibroadenoma of the breast may face such a problem as fibroadenoma and breast cancer. Moreover, in women with a family history of breast cancer, the risk of oncology is 3.7% higher 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 news: the effects of breast fibroadenoma removal in the form of a scar on your breast become almost invisible a few years after the operation.

And now about the sad. Removal of breast fibroadenoma is not identical to recovery. The reason for the appearance of a tumor in the breast is associated with a hormonal imbalance. The tumor was excised, 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 detected in adolescent girls during puberty, and in mature women after 45-50 years.

Now 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 (ultrasound), biopsy and cytological examination of tumor tissues.

Ultrasound signs

An ultrasound examination of a fibroadenoma of the mammary gland 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 cyst of the mammary gland. But to determine whether a benign fibroadenoma or malignant, ultrasound is not able to.

Biopsy

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

A needle on a syringe penetrates the tumor and “pumps out” a certain amount of tissue from it. Despite the minimally invasiveness of this method, the reliability of the puncture results is considered insufficiently high. And the doctor can and should resort to an incisional biopsy, in which a small fragment of the tumor tissue is excised under local anesthesia. The resulting sample is sent for histological examination.

Histology

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

In the course of a cytological (cellular) study of neoplasm samples, the nature and intensity of proliferation of parenchyma and stroma cells included in the “body” of breast fibroadenoma are determined.

The cytology of breast fibroadenoma is also important for the differential diagnosis of other benign tumors of this organ. A cytological study 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 right with this disease. It is recommended to consume 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 refuse: the use of fatty foods (fatty foods cause increased secretion of bile, and bile is a source of steroid hormones); the use of legumes (beans, peas, beans) and natural coffee.

Treatment of fibroadenoma of the breast

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

In addition, the operation is performed if the tumor length exceeds 30 mm or intensively increases (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 the quality of life of a woman.

Removal of breast fibroadenoma is recommended for those over forty, as well as 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 of breast fibroadenoma is used in all other cases? Doctors say: against this disease, all medicines are powerless. And all other patients need to live in peace, get registered with the dispensary, regularly visiting their doctor.

Surgical treatment

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

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

Breast fibroadenoma exfoliation (nucleation) is the removal of the tumor itself (without surrounding tissues). This operation lasts no more than 60 minutes, is done under local (or general) anesthesia. In the course of surgical intervention, an emergency histological examination of the removed formation 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 - after 8-9 days from the day of the operation. Doctors warn that the place of the scar can ache for several months.

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

Laser removal of breast fibroadenoma

Fibroadenomas of the mammary glands can be removed with a laser - the method of laser-induced thermotherapy. The laser device, accurately aimed at the tumor with the help of ultrasound control, destroys the pathological formation in the mammary gland (under local anesthesia). Two months later, a new connective tissue is formed 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 laser removal of breast fibroadenoma, patients recover very quickly.

In large Western clinics, breast fibroadenoma is removed by cryoablation (cryolysis), that is, using extremely low temperatures of liquid nitrogen to destroy tumor tissue. Cryoablation has long established itself as a safe and highly effective treatment for cancerous tumors of the prostate, kidney and liver. According to leading experts

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 the puncture of the skin on the chest is only 3 mm and grows quickly.

Conservative treatment

Fibroadenoma is not amenable 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, the conservative treatment of breast fibroadenoma is as follows:

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

Regarding the use of hormonal drugs, you should definitely consult a doctor. Remember: the mammary gland is a “target” for hormones.

Although there are positive opinions about the advisability of hormone 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.

Duphaston treatment

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 it from growing and thickening, which are provoked by excessive production of estrogens in the body.

This drug is used in case 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 removal of the uterus and menopause syndrome, duphaston is used if necessary to neutralize the proliferative effect of estrogens on the mucous membrane of the uterine cavity. The drug may cause breakthrough bleeding. Duphaston is contraindicated in 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 walnut partitions. Rather, alcohol tincture on them, which is used for many diseases, for example, in the pathology of the thyroid gland, gastrointestinal tract, diseases of the joints.

Walnut partitions are a source of iodine, with a deficiency of which mastopathy, myoma and adenoma develop. It is necessary to take a bottle of dark glass with a capacity of 0.5 liters, fill it with partitions by 1/3, fill it with vodka to the top, close it tightly and leave it to insist for 20-25 days. Ready tincture should be taken in a 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 with 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 wellness course is a week. After a week break, repeat the same.

For a glass of hot water, you will need equally corn stigmas, yarrow herb, juniper fruit. Pour the raw materials with water, boil for 10 minutes and insist for 35-40 minutes (covered with a lid). Three times a day, drink the infusion after meals - a quarter cup for 10 days.

It's important to know!

Pain in the mammary gland is just the case when a visit to the doctor needs to be planned as soon as possible. In a healthy state, a woman’s body, if it should experience pain, is only from love anguish or spiritual disappointment, all other pains are the result of the development of the disease, which should be paid close attention and urgent measures should be taken.

This organ. Today we will talk about what is breast fibroadenoma.

The term comes from three words for fiber, gland and tumor. Fibroadenoma can develop in any gland, including the mammary gland.

This is a fairly common benign tumor. It begins to be detected in adolescent girls, with age the incidence increases and reaches a maximum at the age of 30-40 years. Some scientists consider pathology a nodal form of mastopathy.

Etiology of the disease

The causes of breast fibroadenoma are unknown. Certain importance is attached to hormonal disorders, in particular, an increased level of female sex hormones - estrogen, but there is no exact confirmation of this. The following factors can provoke the development of a tumor:

• chest injuries, bruises;
• excessive insolation (tanning or visiting a solarium);
• premature termination of pregnancy;
• transferred;
• errors in breastfeeding and its completion.

As a result of the action of an unknown factor, cells of the connective tissue and glandular structures that form the milk ducts begin to divide in the breast tissue. Cells retain their normal morphological characteristics, do not grow into surrounding organs, do not metastasize.

A fibroadenoma may grow rapidly, have a soft texture, in which case it is called immature. Such formations are more common in young girls. In women, mature fibroadenoma is more common - dense, surrounded by a capsule, practically not increasing. The detection of such a tumor over the age of 40 indicates its late diagnosis.

Symptoms

Most often, the pathology does not manifest itself. In some women, fibroadenoma hurts, this is due to concomitant mastopathy, which responds to hormonal fluctuations.

Symptoms of fibroadenoma of the mammary gland are determined by probing it: in the upper outer quadrant, a small dense ball is felt, as if rolling into the tissues of the gland. The skin over it is not changed, there is no pain.

Although this formation does not bother a woman, when it appears, it is necessary to contact a gynecologist, surgeon or oncologist.

Macroscopic and microscopic characterization

- This is a painless single node of a dense consistency. It has clearly defined boundaries and a diameter of up to 3 cm. This tumor grows very slowly. The difference from cancer is the absence of decay and metastasis, that is, a benign course. A fibroadenoma does not have a true capsule, but during surgery it is easily removed (husked) from the breast tissue.

Multiple fibroadenomas are rare and often gigantic. Such nodes can reach 20 cm in diameter.

If the knot is cut, it can be seen that it has a gray-white color. It contains foci of calcification, hyalinosis (formation of cartilaginous tissue), mucus. When viewed under a microscope, it can be seen that the adenoma consists of a connective tissue base and ducts of the mammary glands. Depending on the ratio of stroma and ducts, histological types of tumors are distinguished:

• intracanalicular - the growing stroma compresses the glandular ducts, which turn into slit-like formations;
• pericanalicular - gland ducts retain a rounded shape, they are surrounded by dense connective tissue, calcifications and calcification of the node are often formed.

Mixed type tumors are often found.

There is also such a thing as a leaf-shaped, or phyllodes tumor of the mammary gland. It is usually formed from an intracanalicular tumor.

Leaf fibroadenoma differs in the structure of its base - the stroma. It has dividing cells that form layered structures resembling leaves.

Found in women over 40 years of age. It grows rapidly, often occupying a large part of the volume of the mammary gland; often recurs after surgery. This formation tends to become malignant when the dividing stromal cells undergo transformation. The degeneration of a phyllodes tumor into cancer is observed in 10% of cases.

1. Tumor stroma is represented by loose fibrous tissue
2. Glandular tubes are squeezed by the stroma

Diagnostics

In most cases, the pathology is determined by the woman herself or her sexual partner by palpation (palpation) of the breast. Fibroadenoma is felt as a dense, smooth, painless knot, quite mobile, that is, displaced relative to the skin. If you find such a symptom, you should immediately contact a mammologist to rule out breast cancer.

The primary diagnostic methods are examination, palpation and ultrasound examination (ultrasound) of the breast. On ultrasound, signs are usually clearly visible, by which one can first distinguish fibroadenoma from cancer.

It should be said that fibroadenoma with blood flow determined by ultrasound and Doppler sonography is a common condition. If the node exceeds 2 cm in size, the blood flow in it can be determined in 75% of cases. Scientists have proven that the presence of blood flow in the node does not distinguish between fibroadenoma and breast cancer. In small nodules, the blood supply is almost never determined.

Fibroadenoma can also be detected using. This x-ray examination is carried out annually for all women over 40 years of age as part of the medical examination of the population.

A puncture of the node is mandatory, that is, it is punctured with a special needle and biopsy material is taken. The resulting tissue sample is examined under a microscope, excluding malignant degeneration. A more modern and accurate diagnostic method is trephine biopsy. It allows you to get several small "cylinders" from different parts of the tumor and make a more reliable diagnosis. Histological examination fully confirms the disease.

Treatment

Breast fibroadenoma is almost always treated with surgery. Only with very small nodes (up to 5 mm in diameter) can observation be continued. The question of whether or not to remove breast fibroadenoma is decided by the doctor after examination, hormone testing, ultrasound and tissue biopsy.

Is it necessary to remove fibroadenoma before a planned pregnancy or during it? The combination of conditions such as fibroadenoma and pregnancy can lead to malignant degeneration of the tumor. If this does not happen, difficulties may arise during breastfeeding, especially with large node sizes or multiple nodes: milk will not flow well through the milk ducts, mastitis will also occur.

Therefore, it is desirable to remove the formation as early as possible, mainly at the planning stage. With the rapid growth of the tumor during childbearing, less traumatic interventions will be preferable. However, the question of the scope of the operation, especially during pregnancy, is decided immediately, but only after observation and examination by several specialists. With a small node size, no suspicion of cancer, surgical treatment is postponed and carried out after the birth of the child and the completion of breastfeeding.

Contraindications for removal:

• fever and infectious diseases;
• oncological and other serious illnesses;
• unwillingness of a woman to undergo surgical treatment;
• blood clotting disorders, a high degree of arterial hypertension, poorly compensated diabetes mellitus and other conditions, after the correction of which, the operation becomes possible.

Operation and rehabilitation

The operation to remove breast fibroadenoma can be carried out in two fundamentally different ways:

• enucleation (husking) - removal of only the nodule itself through a small incision near the nipple;
• sectoral resection - removal of a tumor with surrounding tissues in the form of a sector of the gland, more often performed if a malignant transformation is suspected.

Depending on the volume, the surgical intervention is performed using local or intravenous anesthesia. It lasts about an hour. After removal of the tumor, cosmetic sutures are applied to the skin, which allow achieving a good external result.

With a superficial location of the node, confidence in its good quality, it is possible to remove breast fibroadenoma with a laser . This is a low-traumatic operation, accompanied by rapid tissue healing and a good cosmetic effect. In addition to laser therapy, radio wave therapy can be used.

The postoperative period proceeds without complications, the woman does not experience pain. The patient usually leaves the hospital on the same day or the next day after the intervention, the sutures are removed after a week. A histological examination of the removed material under a microscope is mandatory to exclude a cancerous process.

Rehabilitation after removal of fibroadenoma includes a mandatory consultation with a gynecologist. It is desirable to increase the content of animal protein, vegetables in the diet, to refuse fatty foods and allergens (chocolate, citrus fruits, eggs). It is necessary to normalize weight, increase physical activity. Sometimes a consultation with a psychotherapist is required to help a woman realize her illness and cope with its consequences, especially with a large volume of surgery.

If a seal remains after removal, it is necessary to consult a doctor again. This may be a sign of suppuration of the mammary gland, the growth of a malignant tumor, or occur when the suture is scarred. In any case, a thorough examination by a specialist is necessary, preferably the doctor who performed the operation.

Small scar after fibroadenoma removal:
1. after surgery
2. a month later

Forecast

With surgical removal, the tumor practically does not recur. Can fibroadenoma turn into cancer? Such a possibility exists, although the probability of malignant degeneration is low. Some doctors generally deny such a possibility, others talk about a 20-50% probability. The risk is especially high in the leaf-shaped form of fibroadenoma. The answer to the question of whether education can resolve without treatment depends on many conditions. More often, immature fibroadenomas in girls resolve on their own after the final establishment of the menstrual cycle. In mature women, such a tumor will not go away without treatment, but will slowly increase in size.

Prevention

Since the true causes of the development of the disease are unknown, there are no specific preventive measures. To prevent the development of tumor processes, it is recommended to eat well, avoid strong emotional upheavals and chronic nervous strain, protect your mammary glands from bruises. It is recommended to limit visits to the solarium and natural tanning during the daytime.

It is important to periodically conduct self-examination of the mammary glands. It is performed by a woman in front of a mirror 7-10 days after the onset of menstruation, when the mammary gland is painless. Pay attention to the symmetry of the glands, the surface of the skin, supraclavicular and axillary areas, areola and nipple. Then the entire gland is superficially probed in a spiral or from the center along the radii outward. After that, a deeper probing of the entire tissue of the gland is carried out. It is convenient to do this by lubricating your hands with cream or lotion. You can conduct a self-examination of the glands and in the shower, lathering the skin. The main thing is to do it regularly. Such a measure will help to recognize both fibroadenoma and malignant processes in time.

It is necessary to treat all gynecological diseases in time, including menstrual irregularities and. It is known that with these diseases, the likelihood of developing fibroadenoma increases. Thus, regular visits to the gynecologist and self-examination become the key to a woman's health.