Breast fibroadenoma – causes, diagnosis, treatment
Fibroadenoma is a widespread benign tumor that develops predominantly in young women and occasionally in adolescents. At first, it is a dense, painless, displaceable formation and can be quite large, especially in adolescents.
Approximately 14-25% of patients have multiple and bilateral fibroadenomas. Fibroadenoma is the most common benign breast tumor.
Cytological examination of the material obtained during puncture is an accurate and reliable method for diagnosing fibroadenomas. Cytological criteria for the differential diagnosis of fibroadenomas and cancer, as well as leaf-shaped tumors (cystosarcoma) are well known.
Views on the treatment of fibroadenomas, especially in young women, are contradictory. The choice of treatment should be the result of a joint decision made by the patient and the doctor.
Fear of a malignant tumor and death dominates in women with breast tumors, but with benign tumors there are fairly regular physical studies of the mammary glands and mammography. As with all nodules of the mammary gland, an accurate diagnosis should be established based on the results of cytological examination of material obtained by puncture, or histological examination of material obtained during an open biopsy.
Hindle studied 498 biopsy-confirmed fibroadenomas and did not reveal a single case of combining them with breast cancer (BC). He concluded that observation plays a major role in the management of such patients.
At histological examination, fibroadenomas contain both epithelial and stromal components. In general, the epithelial component is represented by clearly formed iron-like and ductal structures lined with cubic or cylindrical epithelium. Possible various degrees of epithelial hyperplasia.
The stromal component is represented by connective tissue containing different amounts of collagen. On the background of fibroadenoma, malignant tumors rarely develop. The prognosis in such cases is favorable. Treatment should be carried out using the same approaches that are used in the treatment of CIS or infiltrative cancer that develops in the breast tissue in the absence of fibroadenomas.
The most common malignant tumor that occurs on the background of fibroadenoma is the lobular CIS of the mammary gland, however, cases of intraductal cancer, infiltrative ductal cancer and infiltrative lobular cancer have been reported.