What is it and why does it appear
Fibroadenoma grows from the connective and glandular tissue of the lobule. Essentially, this is a limited node with a clear capsule that moves freely in the tissue of the gland - for this mobility it is sometimes called a “mouse”. The growth of fibroadenoma depends on hormonal levels, so it is typical for women of reproductive age, can increase during pregnancy and often decreases after menopause.
The reason for the appearance does not come down to one factor. Fluctuations in estrogen, hereditary predisposition, and endocrine disorders are important. It is important to understand: fibroadenoma does not arise from a bruise, uncomfortable underwear or a “cold chest”.
How does she show herself?
- Dense round knot with clear boundaries, easily moves under fingers
- Most often painless; sometimes slightly sensitive before menstruation
- The size is usually from 1 to 3 cm, but large nodes are also found
- The skin over the node is not changed, the nipple is not retracted, there is no discharge
- There may be one, or there may be several nodes, including in both glands
Separately, a leaf-shaped (phylloid) tumor is distinguished. Outwardly, it is similar to fibroadenoma, but it grows faster, reaches larger sizes and can recur, and in some cases behave malignantly. That is why a rapidly growing node is always a reason for a biopsy, and not for observation.
Survey
The purpose of the examination is to distinguish fibroadenoma from a cyst, an area of mastopathy and a malignant tumor. These states cannot be distinguished by sensations.
- Осмотр онколога-маммолога, пальпация желёз и лимфоузлов.
- УЗИ молочных желёз — оценивают форму, контуры, структуру и кровоток узла.
- Маммография — после 40 лет и при неоднозначной картине на УЗИ.
- Биопсия с гистологическим исследованием — при размере более 2–3 см, быстром росте, нечётких контурах или любых сомнениях.
When is surgery needed?
It is not necessary to remove every fibroadenoma. Indications for surgery are formulated quite specifically:
- Size greater than 2–3 cm or noticeable growth on follow-up ultrasounds
- Suspicion of a leaf-shaped tumor
- Ambiguous or alarming biopsy result
- Deformation of the gland, due to which the node is visible externally
- Planning pregnancy with a large node - against the background of hormonal changes, it can grow
- The patient’s severe anxiety, interfering with life, with the discussed risks of the operation
The operation is a sectoral resection: the node is removed along with the capsule through a small incision, often under local anesthesia or short anesthesia, usually with a one-day hospital stay. The removed tissue is necessarily sent for histological examination, which finalizes the diagnosis.
What's next
After removal, fibroadenoma does not return in the same place, but in some women, over time, new nodes appear in another part of the gland - this is a feature of the tissue, and not a consequence of an “unsuccessful operation.” Therefore, observation by a mammologist continues: ultrasound once a year until the age of 40, then according to the scheme determined by the doctor.
