Leaf-shaped fibroadenoma of the mammary glands. Leaf fibroadenoma

This organ. Today we will talk about what breast fibroadenoma is.

The term comes from three words meaning fiber, gland and tumor. Fibroadenoma can develop in any gland, including the mammary gland.

This is a fairly common benign tumor. It begins to be detected in teenage girls; the incidence increases with age and reaches a maximum at the age of 30-40 years. Some scientists consider the pathology to be a nodal form of mastopathy.

Etiology of the disease

The causes of breast fibroadenoma are unknown. Some importance is attached to hormonal disorders, in particular, increased levels of female sex hormones - estrogens, but there is no exact confirmation of this. The following factors can provoke the development of a tumor:

• chest injuries, bruises;
• excessive insolation (tanning or visiting a solarium);
• premature termination of pregnancy;
• transferred ;
• mistakes during breastfeeding and its completion.

As a result of the action of an unknown factor, connective tissue cells and glandular structures that form the milk ducts begin to divide in the breast tissue. The cells retain their normal morphological characteristics, do not grow into surrounding organs, and do not metastasize.

Fibroadenoma can grow rapidly and have a soft consistency, in which case it is called immature. Such formations are more common in young girls. In women, mature fibroadenoma is more common - dense, surrounded by a capsule, practically not enlarging. The discovery of such a tumor at the age of over 40 years indicates its late diagnosis.

Symptoms

Most often, the pathology does not manifest itself at all. In some women, fibroadenoma hurts, this is due to concomitant mastopathy, which responds to hormonal fluctuations.

Symptoms of fibroadenoma of the mammary gland are determined by palpating it: in the upper outer quadrant, a small dense ball is felt, as if rolling into the tissue of the gland. The skin over it is not changed, there is no pain.

Although this formation does not bother the woman, if it appears, it is necessary to contact a gynecologist, surgeon or oncologist.

Macroscopic and microscopic characteristics

- This is a painless single node of dense consistency. It has clearly defined boundaries and a diameter of up to 3 cm. This tumor grows very slowly. The difference from cancer is the absence of decay and metastasis, that is, a benign course. Fibroadenoma does not have a true capsule, but during surgery it is easily removed (husked) from the breast tissue.

Multiple fibroadenomas are rare, and they are often gigantic in size. Such nodes can reach 20 cm in diameter.

If the knot is cut, it is seen that it has a gray-white color. It contains foci of calcification, hyalinosis (formation of cartilage tissue), and mucus. When examined under a microscope, it is clear that the adenoma consists of a connective tissue base and ducts of the mammary glands. Depending on the ratio of stroma and ducts, histological types of tumor are distinguished:

• intracanalicular - the expanding stroma compresses the glandular ducts, which turn into slit-like formations;
• pericanalicular - the gland ducts retain a rounded shape, they are surrounded by dense connective tissue, calcifications and calcification of the node are often formed.

Mixed type tumors are often found.

There is also such a thing as a leaf-shaped or phylloid tumor of the mammary gland. It usually arises from an intracanalicular tumor.

Leaf fibroadenoma differs in the structure of its base - the stroma. It has dividing cells that form layered structures that resemble leaves.

Found in women over 40 years of age. It grows quickly, often occupying most of the volume of the mammary gland; often recurs after surgical treatment. This formation tends to become malignant when dividing stromal cells undergo transformation. Degeneration of a phyllodes tumor into cancer is observed in 10% of cases.

1. The tumor stroma is represented by loose fibrous tissue
2. Glandular tubes are compressed by the stroma

Diagnostics

In most cases, the pathology is determined by the woman herself or her sexual partner by palpation (feeling) of the mammary gland. Fibroadenoma feels like a dense, smooth, painless node, quite mobile, that is, displaced relative to the skin. If such a symptom is detected, you should immediately contact a mammologist to rule out breast cancer.

The primary diagnostic methods are inspection, palpation and ultrasound examination of the mammary gland. Ultrasound usually clearly shows signs that can be used to preliminarily distinguish fibroadenoma from cancer.

It should be said that fibroadenoma with blood flow determined using ultrasound and Doppler sonography is a common condition. If the node exceeds 2 cm in size, blood flow in it can be determined in 75% of cases. Scientists have proven that the presence of blood flow in the node does not distinguish between fibroadenoma and breast cancer. In small nodules the blood supply is almost never determined.

Fibroadenoma can also be detected using. This X-ray examination is carried out annually on all women over 40 years of age as part of a medical examination of the population.

A puncture of the node is required, that is, it is punctured with a special needle and biopsy material is taken. The resulting tissue sample is examined under a microscope to rule out malignant degeneration. A more modern and accurate diagnostic method is trephine biopsy. It allows you to obtain several small “cylinders” from different parts of the tumor and make a more reliable diagnosis. Histological examination completely confirms the disease.

Treatment

Treatment of breast fibroadenoma is almost always performed surgically. Only with very small nodes (up to 5 mm in diameter) can observation be continued. The question of whether or not to remove breast fibroadenoma is decided by the doctor after examination, hormone tests, ultrasound examination and tissue biopsy.

Is it necessary to remove fibroadenoma before or during a planned pregnancy? The combination of conditions such as fibroadenoma and pregnancy can lead to malignant degeneration of the tumor. If this does not happen, difficulties may arise during breastfeeding, especially with large nodules or multiple nodes: milk will flow poorly through the milk ducts, and mastitis will also occur.

Therefore, it is advisable to remove the formation as early as possible, mainly at the planning stage. If the tumor grows rapidly during pregnancy, less traumatic interventions will be preferable. However, the question of the extent of the operation, especially during pregnancy, is not decided immediately, but only after observation and examination by several specialists. If the size of the node is small and there is no suspicion of cancer, surgical treatment is postponed and carried out after the birth of the child and completion of breastfeeding.

Contraindications for removal:

• fever and infectious diseases;
• cancer and other serious illnesses;
• woman's reluctance to undergo surgical treatment;
• blood clotting disorders, high degrees of arterial hypertension, poorly compensated diabetes mellitus and other conditions, after correction of which surgery becomes possible.

Surgery and rehabilitation

Surgery to remove breast fibroadenoma can be performed in two fundamentally different ways:

• enucleation (husking) – removal of only the nodule itself through a small incision near the nipple;
• sectoral resection - removal of the tumor with surrounding tissues in the form of a sector of the gland, most often performed when malignant transformation is suspected.

Depending on the volume, surgery is performed using local or intravenous anesthesia. It lasts about an hour. After removing the tumor, cosmetic sutures are applied to the skin, which allows you to achieve a good external result.

If the node is located superficially and there is confidence in its benign quality, it is possible to remove breast fibroadenoma with a laser . This is a low-traumatic operation, accompanied by rapid tissue healing and a good cosmetic effect. In addition to laser therapy, radio wave therapy can be used.

The postoperative period proceeds without complications, the woman does not experience pain. The patient usually leaves the hospital on the same day or the next day after the intervention, the sutures are removed after a week. A histological examination of the removed material under a microscope is required to exclude a cancerous process.

Rehabilitation after removal of fibroadenoma includes a mandatory consultation with a gynecologist. It is advisable to increase the content of animal protein and vegetables in the diet, avoid fatty foods and allergens (chocolate, citrus fruits, eggs). It is necessary to normalize weight and increase physical activity. Sometimes a consultation with a psychotherapist is required to help a woman understand her illness and cope with its consequences, especially with a large volume of surgery.

If a lump remains after removal, you should consult a doctor again. This may be a sign of suppuration of the mammary gland, the growth of a malignant tumor, or occur as a result of scarring of the suture. In any case, a thorough examination by a specialist is necessary, preferably the doctor who performed the operation.

Small scar after fibroadenoma removal:
1. after surgery
2. a month later

Forecast

When surgically removed, the tumor practically does not recur. Can fibroadenoma develop into cancer? This possibility exists, although the likelihood of malignant degeneration is low. Some doctors deny this possibility altogether, others talk about a 20-50% probability. The risk is especially high with the leaf-shaped form of fibroadenoma. The answer to the question whether a tumor can resolve without treatment depends on many conditions. More often, immature fibroadenomas in girls resolve on their own after the final establishment of the menstrual cycle. In mature women, such a tumor will not go away without treatment, but will slowly increase in size.

Prevention

Since the true causes of the disease are unknown, there are no specific preventive measures. To prevent the development of tumor processes, it is recommended to eat well, avoid strong emotional shocks and chronic nervous strain, and protect your mammary glands from bruises. It is recommended to limit visits to the solarium and natural tanning during the daytime.

It is important to periodically perform breast self-examination. It is performed by a woman in front of a mirror 7-10 days after the start of menstruation, when the mammary gland is painless. Pay attention to the symmetry of the glands, the surface of the skin, the supraclavicular and axillary areas, the areola and the nipple. Then the entire gland is superficially probed in a spiral or radially outward from the center. After this, a deeper palpation of the entire gland tissue is carried out. It is convenient to do this by lubricating your hands with cream or lotion. You can conduct a self-examination of the glands in the shower, soaping your skin. The main thing is to do this regularly. This measure will help to recognize both fibroadenoma and malignant processes in time.

It is necessary to treat all gynecological diseases in a timely manner, including menstrual irregularities and. It is known that with these diseases the likelihood of developing fibroadenoma increases. Thus, regular visits to the gynecologist and self-examination become the key to a woman’s health.

The name leaf-shaped fibroadenoma of the mammary gland comes from its structure, which resembles the veins of leaves. The formation of fibroadenoma can begin at any age, but more often the disease occurs during hormonally active periods (puberty, menopause). Phylloid tumor is one of the benign breast formations, but it is also prone to malignant degeneration. This is a fibroepithelial neoplasm that is somewhere between a sarcoma and a simple fibroadenoma.

The formation can be from one to thirty centimeters in diameter. At the same time, the size of the neoplasm does not matter for the transition to a malignant form. A tumor can be very large, but benign, just as a small tumor can become malignant. The shape of the tumor is round or irregular oval. The formation can range from whitish-gray to pink. Fibroadenoma has clear contours, so it can be easily identified by palpation; there is no adhesion to surrounding tissues, which makes the leaf-shaped neoplasm mobile.

When the size of the fibroadenoma is more than five centimeters, cystic cavities and crevices form in it. If the size is even larger, then polyps grow inside the formation. When cut, the fibroadenoma has a lobular structure, with viscous mucus present inside the leaf-shaped tumor. Since this type of fibroadenoma can be benign, borderline or malignant, its growth rate cannot be accurately determined. In some cases, the pathology develops very slowly, sometimes, on the contrary, quickly and aggressively.

Reasons for development

The cause of leaf-shaped fibroadenoma may be one of the following:

• hormonal imbalance;
• tumor pathologies of the adrenal glands, thyroid gland or pituitary gland;
• presence of diabetes mellitus and obesity;
• fibrocystic mastopathy;
• metabolic disorder;
• ovarian oncology;
• excessive use of hormonal contraceptives;
• repeated abortions.

The growth of a leaf-shaped neoplasm, if it already exists, can provoke pregnancy and lactation. Women whose family has had cases of leaf-shaped fibroadenoma have a greater risk of encountering cancer.

Forms of the disease

According to the nature of the course, leaf-shaped fibroadenoma can be:

1. Benign – has a slow course, responds well to treatment, and has a favorable prognosis.
2. Borderline is a transitional form of fibroadenoma, which can develop slowly and then suddenly acquire an aggressive course.
3. Malignant – characterized by an aggressive course, metastasis and germination into surrounding tissues.

Based on size and macroscopic appearance, fibroadenoma is classified into:

• Tumor up to five centimeters - limited to the nearest structures, pink, white or gray. It has a lobed structure or looks like large grains.
• The neoplasm is more than five centimeters in size and has cracks and cavities made up of cysts, inside of which there is mucus and polyps.

Depending on the number of fibroadenomatous nodes, leaf-shaped pathology can be single or multiple.

Symptoms

Leaf-shaped fibroadenoma can be asymptomatic for several years; often the pathology is diagnosed already at an advanced stage.

With intensive growth of the formation, the following clinical picture occurs:

• The shape of the breast changes and its size increases. A large lump in the mammary gland can be felt through the skin; a severe lump leads to sagging breasts.
• The skin over the leaf-shaped neoplasm changes color (becomes red), becomes thinner and stretches. A bluish tint may appear, and ulcerative formations may appear.
• The nipples become asymmetrical, and there is a discharge of yellow or bloody fluid from them.
• A pain syndrome is felt in the mammary gland, which is difficult to relieve with analgesics.

Most often, fibroadenoma occurs in the upper outer quadrant of the gland.

A woman should conduct a monthly breast self-examination and, if there is the slightest suspicion of cancer, go to the doctor for a diagnosis.

For girls

The reason for the presence of a leaf-shaped tumor in young girls may be an increase in estrogen in the body. This phenomenon occurs during the period when the ovaries mature. After the hormonal levels return to normal, the tumor may stop growing and even decrease in size. Almost always, fibroadenoma that occurs in youth is diagnosed in an adult woman.

In pregnant women

This tumor is often diagnosed in pregnant women, since during this period the woman undergoes various examinations. As a rule, a leaf-shaped neoplasm occurs even before pregnancy, but during gestation it begins to grow more actively under the influence of hormones. Fibroadenoma does not affect pregnancy itself. Therapy is carried out after the woman gives birth.

In older women

The menopausal period occurs with a decrease in the production of estrogen in the body, which leads to an increase in education. Often during menopause, women suffer from endocrine pathologies, which also accelerate the growth of fibroadenoma in the breast. Every woman after fifty years of age should be examined by a doctor twice a year in order to promptly identify pathology.

Diagnostics

Diagnosis of leaf-shaped fibroadenoma of the mammary gland begins in the mammologist’s office. First, the mammary glands are examined and palpated. Diagnosis of the disease includes a blood test for tumor markers.

Instrumental diagnostic methods include:

• ultrasound examination - allows you to determine the presence of a cystic formation of a complex structure;
• Dopplerography - shows the condition of the vessels at the location of the fibroadenoma;
• mammography - a chest x-ray that shows the structure of the glands and the presence of a tumor;
• puncture biopsy - biomaterial is taken with a thin long needle and sent for cytology, as well as histology.

After a full examination, doctors draw up a treatment program that is individual for each patient.

Treatment

Therapy for leaf-shaped fibroadenoma of the mammary gland is varied and is chosen by the doctor individually for each patient. If the tumor formation is benign, slow and asymptomatic, then the doctor prescribes a wait-and-see approach. The patient must undergo examination every three months, which shows the growth of the formation over time. When the development of leaf-shaped pathology accelerates, conservative therapy is prescribed, consisting of taking hormonal drugs.

Fibroadenomas larger than one centimeter in diameter are removed surgically. Surgery is performed if the tumor is growing rapidly, the doctor suspects malignancy, and the formation is a cosmetic defect.

The operation can be performed in different ways, so the doctor may prescribe:

1. Enucleation is an incision in the chest through which the tumor is removed. The method is acceptable with full confidence in the benignity of the tumor cells.
2. Lumpectomy - a method of sectoral tissue resection is used in cases of tumor size less than three centimeters. During the operation, the doctor excises the leaf-shaped formation and part of the healthy gland. This operation reduces the risk of relapse.
3. Mastectomy - the doctor partially or completely removes the breast. The operation is performed for large tumors, multiple forms of fibroadenoma, and small breasts, which makes lumpectomy difficult.

A benign tumor does not affect the lymphatic system, so there is no need to remove regional lymph nodes. If the fibroadenoma had a borderline or malignant form, then chemical as well as radiation therapy is necessary.

Prognosis and prevention

With a leaf-shaped neoplasm in the mammary gland, the prognosis is usually good. If the tumor has become malignant, then prognostic data depend on the stage at which the fibroadenoma was detected.

A benign formation that is not completely removed can recur within six months after the operation. If fibroadenoma occurs again and again, doctors often decide to completely remove the breast. After such an operation, a woman can undergo mammoplasty from a plastic surgeon.

The following rules will help reduce the risk of a leaf-shaped tumor:

• timely treatment of gynecological diseases;
• periodic visits to an endocrinologist and treatment of endocrine diseases;
• taking hormonal medications only as prescribed by a doctor and in the required dosages;
• avoiding artificial termination of pregnancy;
• visiting a mammologist at least once a year.

Every girl or woman can independently detect the presence of a tumor at a very early stage if she palpates the mammary glands at least once a month after the end of her critical days.

First, the glands are examined in front of a mirror with hands down. Then the arms are raised up and thrown behind the head, alternately and together. At the last stage, it is necessary to carefully palpate every centimeter of the breast. If detected early, the prognosis is very good.

Leaf-shaped fibroadenoma of the mammary gland carries the potential danger of developing into a malignant neoplasm. Early diagnosis of this pathology can prevent such a serious complication, although the risk of the tumor becoming malignant is 3-5% of all existing cases. A special peak is observed in those age groups where the greatest hormonal surges occur, and this is in the period from 11 to 20 years and from 40 to 50 years.

What is this neoplasm?

Leaf-shaped fibroadenoma of the breast is a tumor, most often of a benign type and having a borderline state between fibroadenoma and malignant sarcoma. It belongs to the group of fibroepithelial neoplasms. Its name is justified due to the special structure in which leaf veins can be traced.

If we consider this neoplasm from a description point of view, we can highlight the following characteristics:

1. Leaf-shaped fibroadenoma can reach a size from 1 to 35 cm and have a round or irregular oval shape.
2. The tumor has a shade from grayish-white to pink, it is very mobile and has demarcations from the surrounding tissues.
3. If a leaf-shaped neoplasm reaches a size greater than 5 cm, it always has cracks, as well as cystic cavities.
4. When examining a leaf-shaped fibroadenoma in section, you can see a mass of viscous mucus; it is also prone to the presence of one or several nodules.
5. If the neoplasm is large, then polyp-like growths are possible in the cystic cavities.
6. The structure of the tumor is expressed as lobular, and it itself does not have its own capsule.
7. If we compare leaf-shaped fibroadenoma with a regular adenoma, then in the first case the structure of the tumor will be more complex, and the presence of a large number of stromal cells (connective tissue component) will be noted.

In addition, as already mentioned, leaf-shaped fibroadenoma can degenerate and in this regard it is customary to distinguish 3 forms of such a tumor:

• border;
• malignant;
• benign.

Such a neoplasm is prone to rapid growth, or the tumor may develop over a long period of time, which is then replaced by sudden growth. In this regard, the clinical symptoms of this pathology may differ.

The causes of this pathology

There is no disease without a cause.

As in any other cases, with leaf-shaped fibroadenoma, a number of factors can be identified that provoke the development of a pathological neoplasm:

• hormonal imbalance associated with a lack of estrogen and progesterone;
• the presence of tumor-like processes in the pituitary gland and adrenal glands;
• diabetes mellitus;
• nodes developing on the thyroid gland;
• mastopathy, expressed fibrocystic nature;
• lactation period and pregnancy;
• diseases of the liver and other organs;
• metabolic disorders;
• the presence of tumors on the ovaries;
• obesity;
• frequent use of hormonal emergency or conventional contraception;
• frequent abortion procedures;
• excess body weight, etc.

Such causes are observed in most people, however, in this case, you need to understand that all of them are subject to diagnosis and timely treatment. In addition, you need to learn to adhere to proper nutrition and maintain a daily routine.

If the patient has a chronic course of the provoking factor, one should try to prevent relapses to prevent the formation of leaf-shaped fibroadenoma.

Symptoms shown

If the tumor reaches a sufficient size, the skin over it becomes thinner, acquiring a bluish tint. Because of this phenomenon, the saphenous veins become visible, which are also dilated.

When considering the two-phase clinical course of this pathological neoplasm, one can distinguish a slow development that can last for years, and then begin to grow rapidly.

Moreover, in the given example, the size of the tumor does not matter in any way for it to become malignant. Even if it is large, it can be benign, but if it is small, it can be malignant, with the ability to metastasize.

With this disease, one can identify general symptoms that develop against the background of the presence and growth of a tumor-like neoplasm:

1. When you feel your breasts, dense spherical lumps may clearly stand out.
2. With this disorder, the chest hurts, and the nature of the pain and its intensity depends on the size and location of the leaf-shaped fibroadenoma.
3. Some women may notice discharge from the nipple.
4. With rapid growth, there is a deterioration in well-being and the possible appearance of weakness, dizziness, etc.

How is diagnosis and treatment carried out?

To correctly diagnose this pathology, at the moment there are several stages and methods consisting in such a study:

1. A consultation with a doctor, where the patient’s medical history is collected, and the mammary glands are examined and palpated.
2. After this, an ultrasound and biopsy of the tumor may be prescribed, where a small piece of the tumor is taken and, using histological examination, a conclusion is drawn about the nature of the tumor.
3. Another additional diagnostic method is mammography.

Based on the data obtained, a decision is made on the method of treating the tumor.

Most often this is a surgical intervention, which has the following indications:

• the wish of the sick woman herself;
• suspicion of malignant neoplasm;
• rapid tumor growth;
• pronounced cosmetic defects.

If we consider the methods of surgical operation, we can distinguish the following types:

1. Enucleation. In this case, the neoplasm itself is removed directly by peeling.
2. Sectoral resection. With this method of surgical intervention, a certain segment of the mammary gland is removed along with the leaf-shaped fibroadenoma, or in case of repeated relapse, amputation of the mammary gland itself is possible.

Leaf-shaped fibroadenoma of the mammary gland has its own symptoms and pathogenesis of development. To prevent the worst consequences of this disorder, you need to respond in time to the clinical manifestations and consult a doctor for diagnosis in case of the slightest suspicion of pathology.

Fibroadenoma is a benign tumor that can develop in the tissues of any organ, including the female mammary glands.

Despite the fact that in general this formation is not considered oncological, some of its types have a high risk of malignancy (malignancy) and are potentially dangerous to human life.

These include leaf-shaped fibroadenoma of the mammary glands, which is quite rare, but requires special attention.

Leaf-shaped fibroadenoma occupies a middle position between ordinary fibroadenoma and breast sarcoma. It consists of fibrous and glandular tissue and can reach different sizes - small formations are up to 5 cm in diameter, and giant ones extend beyond the boundaries of the mammary gland.

The formation has clearly defined boundaries, a lobular structure and a tendency to sudden, uncontrolled growth. A small leaf-shaped fibroid is usually localized in the upper quadrant of the breast, and over time can occupy most of one or both breasts.

Tumor localization

This type of tumor is observed in all age groups, but there are two peaks of incidence that are associated with active hormonal changes in the female body - 11-20 and 40-50 years. In representatives of the stronger sex, leaf-shaped fibroadenomas occur in isolated cases.

There are three main types of leaf-shaped formations: benign, borderline (not yet cancerous, but quite aggressive tumors) and malignant. It is important to note that due to their specific structure and good blood supply, even benign fibroadenomas can degenerate into borderline and malignant ones.

Leaf-shaped fibroadenoma is diagnosed quite rarely - the frequency is 2% of all fibrous formations, and malignancy of the formation occurs in 3-5% of cases, and the malignant tumor quickly metastasizes to nearby organs.

Causes

The exact reasons for the development of leaf-shaped fibroadenoma are not clear - the tumor is associated with hormonal imbalance (excess estrogen and lack of progesterone).

Factors that can provoke such changes include:

• tumor diseases of the ovaries and uterus;
• inflammatory and infectious diseases of the pelvic organs;
• dysfunction of the endocrine system;
• diabetes mellitus;
• frequent abortions;
• late pregnancy;
• refusal of breastfeeding;
• mammary gland injuries;
• liver diseases;
• abuse of hormonal contraceptives;
• obesity.

If there is a hereditary predisposition to the formation of tumor diseases of the mammary gland and one of the factors favorable for the growth of leaf-shaped fibroadenoma, even a normal pregnancy can cause the disease.

Symptoms

The danger of leaf-shaped fibroadenoma of the mammary gland is that in the early stages it grows slowly and practically does not make itself felt.

This is followed by a stage of active and dynamic growth.

Symptoms that may indicate the presence of a mass include:

• pain, discomfort and feeling of fullness in the mammary gland;
• changes in the skin (thinning of the skin, bluishness or redness);
• strengthening the pattern of saphenous veins;
• sometimes – fever, weakness, deterioration of general condition.

If the process of malignancy of the tumor begins, the woman may feel pain that is not relieved by conventional medications, fatigue, and loss of appetite.

The size of a leaf-shaped tumor does not have any prognostic significance - small nodules may turn out to be malignant, or, conversely, giant fibroadenomas are often benign.

Fibroadenomas are the result of hormonal imbalance in a woman’s body. can be detected during self-examination.

Read what myxedema is and how it manifests itself.

Most often, fibroadenoma of the mammary glands must be removed. You can read about the indications for surgery.

Diagnostics

Most often, leaf-shaped fibroadenoma is diagnosed accidentally, by the woman herself or by a doctor during a routine examination. If a lump or small nodule is detected in the breast tissue, it is necessary to consult a mammologist as soon as possible and undergo a comprehensive diagnosis, consisting of an external examination, palpation of the mammary glands and laboratory techniques.

1. Ultrasound. Ultrasound examination allows you to determine the size of the formation and distinguish it from other types of formations.
2. Mammography. The examination shows the contours of the tumor and gives a complete picture of its structure.
3. Needle biopsy. Determines the type of disease (benign, borderline, malignant) and makes it possible to differentiate fibroadenoma from sarcoma.

Leaf-shaped fibroadenoma of the mammary gland - ultrasound photo

Leaf-shaped fibroadenoma is practically indistinguishable from cystic formations, sarcoma and other similar pathologies, so a biopsy is required to clarify the diagnosis.

Treatment

Since leaf-shaped fibroadenoma of the mammary gland carries a high risk of malignancy, the only treatment for this formation is surgery. The exception is small (up to 1 cm) benign formations, which require regular monitoring by a specialist, mammography and ultrasound.

Immediate surgery is especially necessary for women who are planning a pregnancy, since hormonal changes in the body can trigger the process of growth or malignancy of the tumor.

Conservative therapy (hormonal treatment) in cases of leaf-shaped fibroadenoma is ineffective, and the use of folk remedies is dangerous not only for health, but also for life. Radiation therapy is also not used for this diagnosis.

Removal of breast fibroadenoma

For leaf-shaped fibroadenoma, the following types of operations are performed (the choice is made depending on the stage of the disease and the size of the formation):

• enucliation, or enucleation of the formation - removal of fibroadenoma through a small incision in the chest, surrounding tissues are not affected;
• sectoral resection - removal of the tumor along with surrounding tissues approximately 3 cm from the edge of the formation (the appearance of the breast remains practically unchanged);
• quadrantectomy - removal of the area of ​​the mammary gland in which the fibroadenoma is located (about a quarter of the total volume), usually accompanied by radiotherapy;
• radical mastectomy - complete removal of the breast along with its surrounding tissue.

In the case of tumor malignancy, the same treatment principles apply as in the treatment of cancer. If necessary, after surgery, mammoplasty is performed (restoring the shape and appearance of the mammary glands) using your own tissue or prostheses.

Leaf-shaped fibroadenoma tends to recur, which usually occurs from several months to five years after surgery, and the benign form often degenerates into borderline, and borderline into malignant.

To avoid relapse of the disease, a woman should regularly visit a doctor for an external examination of the mammary glands and undergo a mammogram every six months.

There are currently no preventive measures to prevent the disease. To reduce the risk of developing fibroadenoma, you need to monitor the health of the reproductive system, undergo preventive examinations and have a regular sex life.

The prognosis for a diagnosis of leaf-shaped fibroadenoma depends on the main characteristics of the tumor. Due to its specific characteristics, it is considered potentially dangerous, but timely contact with a mammologist will help avoid operations that deform the mammary gland.

Video on the topic

18.05.2017

Leaf-shaped fibroadenoma of the mammary glands is a neoplasm of the fibroepithelial group.

At the initial stage of development, the neoplasm is benign, but without timely treatment there is every chance of developing into a malignant tumor.

Leaf-shaped fibroadenoma acts as a transitional stage from simple fibroadenoma to a malignant tumor of the connective tissue of the mammary gland. Therefore, specialists need to accurately differentiate leaf-shaped fibroadenoma from other similar gynecological pathologies and begin adequate therapy in a timely manner.

Leaf-shaped fibroadenoma is also called leaf-shaped tumor of the mammary glands, phyllodes or giant myxomatous fibroadenoma.

Pathology can develop regardless of the patient’s age. At risk are people with hormonally active periods, that is, the age of puberty (from 11 to 22) and the onset of menopause (from 37 to 52).

Fibroadenoma can be suspected by lumps in the mammary glands of different sizes, sometimes they can be gigantic. It is by size that leaf-shaped fibroadenoma is divided into two groups:

• The diameter of the neoplasms does not exceed 50 ml. The neoplasm has a coarse-grained or lobular structure, grayish-white in color. Fibroadenoma does not intersect with adjacent tissues.
• Diameter more than 50 ml. It differs from the first case in the presence of cystic cavities filled with gelatin-like liquids. The surface of the neoplasms is dotted with polyps. They develop suddenly and rapidly. This is due to the good blood supply to fibroadenomas.

Leaf-shaped fibroadenoma can be single or multiple. If there are many neoplasms present in the connective tissues, they can affect two mammary glands at the same time.

Leaf-shaped fibroadenomas have three stages of development:

1. Benign. At this stage, tumors do not metastasize and develop slowly.
2. Transitional. The neoplasms grow invasively and do not metastasize. In such compactions, a secondary change often forms, for example: hemorrhage, degeneration, necrosis or tumor decomposition.
3. Malignant. Neoplasms consist of uncontrollably dividing cells. They can metastasize to nearby tissues.

They can be distinguished by their symptoms. Depending on the stage of development of leaf-shaped fibroadenoma, the treatment method is selected.

Causes of leaf-shaped fibroadenoma

Experts have not determined exactly why leaf-shaped fibroadenoma of the mammary gland begins to develop. But there are certain factors that activate the process:

• impaired functioning of the endocrine system and thyroid gland;
• genetic predisposition;
• puberty;
• pregnancy;
• one or more instrumental abortions;
• physical and nervous overload;
• severe stressful situations;
• pathological disease of the ovary or adrenal gland;
• diabetes and obesity;
• incorrect oral contraceptives;
• contraceptives;
• various injuries of the mammary glands, improper massage;
• solariums, sunbathing or other thermal exposure.

The main factor that provokes the rapid growth and division of connective tissue cells is disrupted hormonal levels. Due to hormonal imbalance in the female body, the level of estrogen increases significantly.

Basically, this occurs when a girl begins puberty, or when a woman is pregnant.

Symptoms

When leaf-shaped fibroadenoma begins to develop, a woman may notice the first signs.

1. When feeling the breast, you can notice a small lump; when pressing on it, the woman does not experience pain or unpleasant sensation.
2. The sizes of the seals range from 10-30 ml. Without timely treatment, tumors grow and increase in size.
3. No matter what position the breast is in, the lumps can be clearly felt. Phylloid fibroadenoma can only be felt in a supine position.
4. As a rule, leaf-shaped fibroadenoma appears in the form of one compaction, but the appearance of several neoplasms is possible.

For a long time, a fibroadenoma may stand in one place and not grow, but this does not indicate that over time it can completely resolve.

When a patient aged 40 years or older is diagnosed with nodular fibroadenoma, the neoplasm is most likely malignant.

Often nodular fibroadenoma of the mammary gland is diagnosed in combination with diffuse mastopathy. This occurs due to improper production of female hormones. When several diseases are diagnosed at the same time, cysts subsequently form, which are filled with clear liquid.

Modern diagnostics

In addition to palpating and external examination of the breast, the specialist prescribes several more examinations of the mammary glands in order to accurately diagnose and prescribe adequate treatment.

1. Ultrasound examination of the breast. Using ultrasound, doctors will be able to differentiate a fibroadenoma from a cyst. Also visible on the screen are neoplasms with a heterogeneous structure, different cavities and numerous gaps. Ultrasound examination examines the structure and exact diameter of the seal. Often, when Doppler ultrasound is additionally prescribed, this is one of the types of ultrasound that studies the network of blood vessels responsible for feeding the tumors.
2. Mammography. An x-ray of the mammary glands is taken, which will show the neoplasm, its size and edges. Allows you to determine the exact outline of the compaction (remember that leaf-shaped fibroadenoma does not have an exact shape, it can be round, oval or semicircular). The lobular structure is also determined.
3. Needle biopsy. This study allows specialists to study the composition of tumor cells. Doctors collect connective tissue from the tumor and conduct a cytological examination.
4. Histological examination. This event is carried out after the fibroadenoma is removed, this will allow an accurate diagnosis to be made.

For an adequate course of treatment, specialists must accurately distinguish leaf-shaped fibroadenoma of the breast from other pathologies. It is also necessary to accurately determine the process of development of fibroadenoma, or more precisely, whether it will develop into a malignant tumor.

Is breast fibroadenoma dangerous?

Nodular fibroadenoma is not dangerous to a woman’s health. The seal is removed only when it develops with positive dynamics.

The tumor is removed so that it does not reach a larger size, because when a node with a large diameter is removed, a scar may remain. The phylloid form of breast fibroadenoma is considered dangerous; it leads to breast sarcoma (a rapidly growing malignant neoplasm).

Treatment

Doctors select a treatment method depending on the size of the lumps. When the lump does not exceed 10 ml, it is not removed, but the patient is under the strict supervision of doctors who monitor the dynamics of the tumor and periodically prescribe mammography and ultrasound.

In another case, leaf-shaped fibroadenoma is removed through surgery.

The operation is performed in the following cases:

• rapid growth and increase in tumor diameter;
• cosmetic defects;
• the size of the neoplasm exceeds 50 ml;
• planned pregnancy.

To remove phyllodes fibroadenoma, doctors prescribe enucleation (doctors remove the tumor and make a small incision) and resection. After surgery, there are no scars left on the female breast.

When doctors perform a sectoral resection, they remove the lump and surrounding soft tissue.

When an operation is performed, biomaterial is taken for histological examination, which will determine whether the neoplasm is degenerating into a malignant tumor (sarcoma). If leaf-shaped fibroadenoma of the mammary glands is surgically removed, then the chance of recurrence is reduced to zero.