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Fibroadenoma is a well-known formation in the area of the mammary gland, which in most cases appears in girls under 35 years old. Despite the fact that this is a benign tumor, it is completely unpredictable, which still gives rise to controversy and reflection. However, most medical staff still believe that this is a precancerous disease and strongly recommend removing it without fail, regardless of its size.
Reasons for the formation of breast fibroadenoma
Fibroadenoma is formed from connective and glandular tissues. Thus, this is a separate extension of the breast area in the form of a round node, which has clear edges, it is mobile and does not connect to the adjacent tissue in any way. Its value can vary from 0,5 cm to 10 cm in circumference. In practice, the name fibroma can also be found, but simple fibrous nodes do not happen so often, since epithelial glandular tissue penetrates into them.
It is proved that it is the hormonal failure in the female body that is the cause of this formation. This is evidenced by the development of fibroadenoma at the stage of puberty, when the level of estrogens rapidly increases, as well as after the abortion procedure and hormonal treatment. Ovarian cysts with hormonal activity that push the mammary glands to mature and mutate earlier can also cause this tumor.
If such a tumor is already present, then during pregnancy and by the end of the menstrual cycle, it expands in size, and shrinks with the advent of menopause. In other words, this fibroadenoma changes depending on the behavior of hormones in the woman’s body, as, in fact, the mammary glands behave.
With early generative maturation in girls who are 10 to 12 years old, fibroadenomas are often found, so parents are simply obliged to take their child to a gynecologist and conduct an examination of the mammary glands.
Clinical signs of fibroadenoma and detection
Usually, a woman can find a fibroadenoma on her own with careful palpation of the breast, but this is possible only when the tumor grows to 1,5-2 cm, or when it is in close proximity to the skin. In women with large breasts, the tumor is very difficult to detect, so it is rarely possible to do this.
Fibroadenoma, when palpated, looks like a knot with a rounded shape, quite dense, mobile and not connected to the skin. If it has grown and is large, then the tumor may be painful.
With self-checking, the node can be found both in one and in both glands. These signs indicate that most likely this tumor is benign, but no one can guarantee that it is. Therefore, any changes in the mammary glands are an excuse for an examination by a mammologist. The specialist must palpate the glands, and only after that he prescribes an examination. The following breast imaging methods are used:
- mammography;
- Ultrasound;
- CT, MRI;
- positron emission tomography.
For pregnant and lactating mothers, in order to avoid strong exposure, diagnostics are carried out using non-radiation methods: infrared and electrical impedance mammography or conventional ultrasound.
If there is even the slightest suspicion of a malignant tumor, a puncture biopsy is done under ultrasound control, a part of the tumor is taken and transferred to the study.
It is also necessary to conduct a study to find hormones, oncomarkers and oncogenes, these studies are necessary in order to exclude a malignant process or determine what its probability is. A complete gynecological examination is also mandatory.
All diagnostics and studies are very important, because you need to know exactly what method of surgery is needed, whether it is necessary to implement the removal of the entire mammary gland or only the tumor node.
If you suddenly find seals in the chest, in no case should you self-medicate, listening to the advice of friends or other people, apply compresses, various devices and belts in the hope that the tumor will disappear. On the contrary, all this favors its increase.
Modern methods of fibroadenoma removal
The modern technique for eliminating breast fibroadenoma is interpreted as a possible oncology, and therefore is subject to immediate elimination. In fact, this surgery is different from the removal of the mammary gland in a cancerous tumor, since the organ itself is preserved.
The only exception is leaf-shaped fibroadenoma – it is distinguished by instantaneous growth, large size and high admissibility of transition to cancer.
In such situations, a complete removal of the breast is performed and there is no need to treat lymphostasis of the hand as a result of a mastectomy, since the axillary lymph nodes remain intact, as in a cancerous formation.
If it is a fibroadenoma of a standard form, then there are several options for operations.
Firstly, with a sectoral resection of the breast, one lobe of the mammary gland is removed along with the tumor inside. This technique is applicable if the tumor size is 2 cm or more.
The operation is done in a hospital and takes about 30 minutes. The stitches are removed after 7-8 days. This method is the most reliable, because not only the formation itself is removed, but also the healthy tissue that surrounds it, so relapse is almost impossible.
However, plastic surgery is still necessary in order to give the breast a natural shape and volume.
Secondly, node enucleation is used only for small fibroadenomas. The doctor makes a small incision over the formation or along the border of the areola, through which the tumor is removed, then the wound is sutured. This method of operation is performed on an outpatient basis, and the stitches are removed after 5 days.
Thirdly, laser removal is used for any size of the neoplasm using specialized equipment under the control of ultrasound or tomography, as well as cryodestruction or radioablation. These techniques are minimally invasive, they are performed with the help of a puncture and do not have cosmetic defects.
The weak side of these methods is that it is not possible to send this node for laboratory research, because it quickly decomposes. It is for this reason that before the operation it is necessary to make a diagnostic puncture to confirm the absence of cancer.
Fibrous mastopathy and fibroadenoma are completely different concepts and diagnoses. Breast fibrosis is amenable to conservative treatment and resorption, and fibroadenoma will not disappear on its own, and one cannot do without surgery.
Rehabilitation period
Usually, after the operation, the patient is asked to apply cold to the chest for 1-2 hours, since the ice has a vasoconstrictive effect and relieves the formation of a hematoma. As after any surgery, the patient may experience pain, which will decrease as the wound heals.
With local anesthesia, pain may appear 1-3 hours after the operation.
They should not be strong and can be suppressed by the most common painkillers (analgin, spasmalgon, ketonal and others). With general anesthesia, the pain may be more pronounced.
It is also quite possible the appearance of edema and serous discharge. If the pain increases every day, swelling and volume of secretions increase, body temperature rises, this indicates complications, namely, inflammatory infiltrate, hematoma, suppuration, seroma. Therefore, throughout the entire rehabilitation period, it is necessary to be under the supervision of a doctor.