Fibroadenoma of the breast is a benign (noncancerous) tumor. These tumors are commonly seen in young women. Multiple or complex fibroadenomas may indicate a slightly increased risk for breast cancer; the relative risk of patients with such fibroadenomas is approximately twice that of patients of similar age without fibroadenomas. Some researchers suggest a link between the hormone estrogen and fibroadenoma development based upon this information as well as the fact that the tumors occur in postmenopausal women taking estrogen, but not in those that do not receive such hormone replacement therapy. Fibroadenomas are more common in younger women and may become tender in the days before a period or grow bigger during pregnancy . Even without treatment, approximately 10 percent of fibroadenomas fully recede each year. A fibroadenoma is diagnosed through mammogram, physical exam, fine-needle aspiration and, at times, a biopsy Even if the cell sample shows benign (non-cancerous) cells, your doctor may still recommend a final procedure to confirm this result, called a "surgical biopsy." In immunosuppressed patients, the etiology of multiple or growing fibroadenomas appears to be related to Epstein-Barr virus infection. Several different diagnostic tests aid doctors in providing an accurate diagnosis. Fibroadenoma variants include juvenile fibroadenomas, occurring in female adolescents, and myxoid fibroadenomas, occurring in persons with Carney complex.
Radiologists must be familiar with a variety of benign breast conditions to confidently distinguish malignant disease from benign disease. Approximately 10 to 15 percent of affected individuals have multiple fibroadenomas. The solid masses are most prevalent in young women between the ages of 15 and 30 and tend to grow larger in women that are pregnant. In some of these tumours the ductal component manifests intraductal epithelial hyperplasia, although the proliferation lacks changes suggestive of ductal carcinoma in situ. The cause of these tumors is unknown. Approximately 10% of fibroadenomas disappear spontaneously each year, and most stop growing after they reach 2-3 cm. Fibroadenomas may involute in postmenopausal women, and coarse calcifications may develop. In cases where pain or tenderness occurs due to the tumors or the tumors grow unusually large, however, excision may be recommended. The tumors recur in about 20 percent of patients.
The typical fibroadenoma is a round or ovoid, rubbery, discrete, relatively movable, nontender mass 1–5 cm in diameter. It is usually discovered accidentally. Clinical diagnosis in young patients is generally not difficult. In women over 30, cystic disease of the breast and carcinoma of the breast must be considered. Cysts can be identified by aspiration or ultrasonography. Fibroadenoma does not normally occur after the menopause, but may occasionally develop after administration of hormones. Particularly in older women the echo structure may be more heterogeneous due to fibrosis and calcifications. In such cases there may be posterior shadowing. Consequently, it is very important that any lump detected in the breast is brought to the attention of a medical professional. At this point, your doctor will evaluate all of the test results, including the mammogram, physical exam, and results from the cell sample. Carney complex is an autosomal dominant neoplasia syndrome that includes skin and mucosal lesions, myxomas, and endocrine disorders.
Causes of Fibroadenoma
The common causes of Fibroadenoma :
Symptoms of Fibroadenoma
Some common symptoms of Fibroadenoma :
Treatment of Fibroadenoma
No treatment is usually necessary if the diagnosis can be made by needle biopsy or cytologic examination. Excision or vacuum-assisted core needle removal with pathologic examination of the specimen is performed if the diagnosis is uncertain. Cryoablation is being attempted as an alternative to excision. It is usually not possible to distinguish a large fibroadenoma from a phyllodes tumor on the basis of needle biopsy results.
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