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Breast adenoma is a lesion which is made up of lactation glands which are enclosed in a pocket, which gives it a particular hardness. Breast fibroadenoma is extremely common and very common; it can occur during an emotional shock or local trauma or even during a hormonal imbalance between progesterone and estrogens secreted by the breast. all the women still settled. The age of predominance of fibroadenoma varies between 15 and 35 years.
Fibroadenoma appears as a small swelling that the patient feels when in contact with her breast, quite close to the skin, sometimes deeper.
The finding causes a certain astonishment and sometimes anxiety, but it is a relatively supple, indolent benign tumor that does not adhere to the surrounding area or deform the surface of the breast. The clinical examination followed by mammography and ultrasound provide formal proof, eliminating a cyst which is hollow on additional examinations, and other sometimes calcified tumors which could suggest a more worrying histology. In some relatively rare cases, the fibroadenoma can become large, sometimes reaching the size of a lemon!
Clearly, this form of fibroadenoma warrants surgery to remove it. In practice, this is quite easy, because the fibroadenoma is surrounded by a membrane which allows cleavage without creating too much damage to the peripheral tissue.
The best test is a biopsy which removes a small fragment of the lesion so that it can be examined histologically. This examination thus provides proof of the benignity of this small tumor, the volume of which can reach the size of a cherry – or even an apricot!
In some cases, there may be several adenofibromas in the parenchyma of the mammary gland. Not all of them are necessarily palpable and it is the ultrasound and radiographic examination that will reveal them.
To give you an idea of how fibroadenoma is built, imagine the foliage of a tree which, instead of growing nobly in all directions, is wrapped in a plastic cloth where all the leaves and all the branches condense, you You will thus understand the mechanism of fibroadenoma formation.
Can a fibroadenoma disappear without surgery?
The answer is yes ! This happens very frequently. Fibroadenoma can grow at certain times due to unexpected stress or following an unexpected hormonal surge. Occasionally, some patients have described the providential disappearance of the fibroadenoma which becomes impalpable, barely invisible on x-rays, which of course brings great relief to worried patients.
In certain cases, I observed patients long after a period where the fibroadenoma had disappeared, and who again presented the same symptoms, even after several years.
Other patients have several small, disseminated adenofibromas, for which surgical removal is not very convenient. In these cases, they are instead advised to use hormonal treatment, which has reasonable chances of success in these particular cases of small lesions.
The photographs attached to this file show you the presence of a fibroadenoma the size of half an apricot in contact with the shell of a silicone gel breast prosthesis. It is likely that this adenofibroma caused a fibrous reaction all around the prosthesis.
In these cases, if there is no indication to wait for the disappearance of the fibroadenoma by hormonal treatment, generally or by application of a percutaneous hormonal gel applied locally, an exploratory intervention proves to be appropriate. necessary. The problem then becomes knowing where to place the scar so that it is as inconspicuous as possible. In some cases we are even obliged to make a scar directly above the palpable fibroadenoma. Once removed, the fibroadenoma must be analyzed to certify its benignity.
The ideal is a clinical examination repeated by your gynecologist, a self-palpation by the informed patient is also possible, but contains a potential for anxiety because the lesion always evolves too slowly according to the patient’s wishes… X-rays are also sufficient to assess the evolution of these fibroadenomas, without it being essential to perform a CT scan or an MRI, to avoid too much X-ray irradiation.
Is it necessary to operate on a benign breast fibroadenoma?
No way ! Just monitor them regularly. Many patients have had adenofibromas since their adolescence; their entire genital life will be marked by the appearance and disappearance of these small breast tumors which are strictly benign.
It is only when there is significant psychological distress that it is appropriate to proceed to surgical exploration in patients who may be subject to the fear of a cancerous tumor change because there are breast cancers in their family.
The rule is in fact the benignity of the breast adenoma.
Are there any options other than surgery to treat breast fibroid adenoma?
Some medical teams have suggested carrying out targeted cryotherapy after having verified by a biopsy that it is indeed a benign fibroadenoma. Cryotherapy consists of freezing the lesion with a transcutaneous injection which creates a reduction in temperature to minus 180 degrees, which will create the involution of the lesion with virtually no visible scar. But some other teams prefer a small operation with a short scar so that they can analyze the entire lesion once removed.
