Breast fibroadenomas
There are many types of breast lumps, fibroadenas are one of them.
Breast fibroadenomas are the most common type of benign breast lump. They're made up of fibrous connective tissues that support the mammary gland and lobes that have developed hyperplasia---an enlargement due to an increased rate of cellular reproduction.
Many women experience them as marbles and firm and able to be move easily around by pressing or pushing on the skin.
Fibroadenomas can be experienced during your breast self-exam and will show up on mammograms and ultrasounds. Women who are under 30s are most likely to develop a breast fibroadenoma, which may grow larger during pregnancy or breastfeeding.
Symptoms
Symptom of a fibroadenoma is a small lump in the breast which you may experienced during a self-exam. These lumps feel firm, round or ovale, smooth, rubbery texture , and are movable. Fibroadenomas are so mobile that sometimes these refer as “breast mice,” as they tend to run away from your fingers.
The masses may feel tender or painful, especially before your period, when they may swell due to hormonal level changes.
Most of these are between 1 and 5 centimeters in diameter , but giant fibroadenomas can be about 15 cm (5.9 inches) in size.
Causing factors
The exact cause of fibroadenomas is not well known. They seem to be influenced by estrogen level because they appear most often in women who do not hit menopause or pregnant women, or in women who hit menopausae and taking hormone replacement therapy.
Most fibroadenomas change in size during your monthly cycle ,because your hormone levels are changing. Therefore, during this period, the same adenoma can become more prominent or it may shrink in size where it is not easily palpable.
Risk Factors
Fibroadenomas are most common in women during puberty and who are under 30 years and in pregnant women. Fibroadenomas occur in 10% of all women.
Once you reach menopause, your risk goes down gradually unless you're using estrogen therapy.
Although fibroadenomas are more common in women in younger age, but it can be found in woman of any age.
Diagnosis
On a mammography, fibroadenomas appear as round or oval smooth edged masses. The borderline will be clearly shown, not blurry, and will not be invading the surrounding area. Sometimes they are accompanied by coarse calcifications. Fibroadenomas can appear like cysts or a well-contained tumor.
If you notice a lump during self exam or if an abnormality is seen on mammogram, a breast ultrasound is generally the next step. because dense tissue can make a lump more difficult to visualize.
On ultrasound, a fibroadenoma will be easier to deferentiate from other tissue because of the way it responds to sound waves. It will appear as a dark area with a definite outline. It will look homogeneous(similar all over), rounded or oval in shape, and may have smooth-edged bumps.
If ultrasound does not give a definite result, the next study may be magnetic resonance imaging.
Biopsy
There are Different types of biopsy procedures include FNAC ( fine needle biopsy), core-needle biopsy, and open biopsy( excisional biopsy). Which your healthcare provider choose will depend on the characteristics of the lump, its location, and other factors.
For better conclusion triple assessment( Physical, imaging, biopsy) is better way than biopsy alone.
Cautions
A breast biopsy only samples one part of a lump and therefore may not be adequate for ruling out cancer when diagnosing a fibroadenoma.
That is because breast lumps--- both benign and malignant, can be made up of different types of cells. In some cases, a breast biopsy has revealed a fibroadenoma but after removal, a pathologist has found cancer cells as well.
In women over age 35, a definitive diagnosis is more important due to an increased risk of breast cancer, so removal of the lump may be suggested.
Treatment
It's important to diffrentiate between the two types of fibroadenomas when choosing the best treatment options because of the difference in associated breast cancer risk.
Fibroadenomas are classified as either:
Simple: Most fibroadenomas are the simple they are more common in younger women. There is usually just one mass in your breast, with a well defined border and very uniform cells. A simple fibroadenoma genrally does not raise your risk for breast cancer.
Complex: Complex fibroadenomas are less common as compare to simple, and are more common as women with increasing age. While they may have a definite border,but it's what is inside this kind of fibroadenoma that makes it different from simple one. A complex fibroadenoma will not look well organized and uniform like a simple one. Even though complex fibroadenomas don't become cancerous, they may contain a collection of small cysts, calcifications, enlarged breast lobules, papillomas and diffrent hyperplasia. When atypical hyperplasia occurs, it may raise your risk of developing breast cancer.
Aside from fibroadenoma type, other factors may influence treatment option, such as:
Symptoms, especially discomfort and pain,
Emotional condition, such as worry about it being cancer
Be open and honest with your healthcare provider about what you're experiencing so it can be considered when weighing treatment options.
In considering all of this, your healthcare provider will recommend one of the following fibroadenoma treatment options.
Watch and Wait
Since fibroadenomas are not always making trouble and sometimes shrink on their own, just wait and watch on their progress is the least invasive way to handle them effectively. For this you have to examine it by own and by your doctor at regular interval.
Laser Ablation
In your Doctors office, an ultrasound-guided laser device is used to destroy the fibroadenoma, leaving behind only a tiny scar, no sutures, and no change in breast shape. You don't need general anesthesia and it's genrally an outpatient procedure, which means you can go your home in same day
Cryoablation
Cryoablation is relatively a fast, efficient way to freeze a fibroadenoma. In out paitent visit, the healthcare provider simply freezes the lump by extreme cold. This procedure takes approximately 30 minutes and results in a very small scar. It is kind of minimum invasive procedure.
Radiofrequency Ablation
This is a way to remove fibroadenomas without doing a lumpectomy. By Using local anesthesia and an ultrasound guidance, a 6- 8 mm incision is done above the fibroadenoma. Via this incision, a surgical wand is inserted and then tipped by a surgical knife that is heated by radiofrequency. This helps cut the breast tissue with minimum bleeding. Once it hit the target, small wires and robotic arms capture well the fibroadenoma and extracted it out.
Mammotome
Breast biopsy systems now used as a fairly non-invasive techniques to remove fibroadenomas. In less than 1 hour, under local anesthesia, a 6 mm incision is made over the fibroadenoma. Then, with an ultrasound guidance, a Mammotome probe is inserted into the lump, which vacuums out sections of the tissue. Recovery is relatively fast and your scar will be very small.
High-Frequency Focused Ultrasound
This is a relatively new treatment that has been used for fibroadenoma treatment, and sometimes, even for breast cancer. HFU appears to cause the selective and effective destruction of deep tissues without damaging adjacent healthy tissue.
Lumpectomy
Surgical removal can be performed especially when you're worried about a fibroadenoma. Depending on the size of the lump, a lumpectomy procedure may cause a change in your breast's size or shape. A new lump( fibroadenoma) may grow in the neighborhood of the first lump you removed,you should know that surgery is not a guarantee that you will never develop another fibroadenoma. your fibroadenoma should be very carefully examined by a pathologist and radiologist to make sure your diagnosis is correct.
Final words
While having a biopsy can be unsettling, it may end up being the best way to reduce worry about a fibroadenoma. Most breast lumps are not malignant, and this is the only way to conclusively determine what's causing your lump. This is to Keep in mind that there are many types of breast lumps, only one of which is a fibroadenoma. If you detect one, don't hesitate, get it checked out by your healthcare provider and follow the instructions given by him.
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