Removal of a fibroadenoma
A fibroadenoma is a benign change in the female breast. A development into a breast cancer is only described in very few individual cases. Therefore a removal of a fibroadenoma is generally not necessary.
Nevertheless, there are some situations in which a removal can be considered. For example, it is rare that without the removal of a node in the breast and the subsequent histopathological examination, it is not possible to distinguish clearly between a benign finding (for example a fibroadenoma) and a malignant finding (for example a breast cancer). In such cases, removal and examination of the tissue should be considered.
In most cases, however, a minimally invasive biopsy of the breast is sufficient. Very large fibroadenomas and several fibroadenomas in one breast can be cosmetically disturbing if they change the shape of the breast or become visible on its surface. In such cases, removal may be considered.
Even if fibroadenomas grow strongly or change strongly due to hormonal influences within the female cycle or during pregnancy, a removal can be reasonable. For some women the knowledge of a lump in the breast is psychologically very stressful and can be accompanied by strong fear. Even then, the removal of a fibroadenoma can be justified.Various techniques are available for the removal of fibroadenomas.
Which technique is appropriate depends on various things. For example, the location of the fibroadenoma in the breast (for example, the depth), the size and the reason for the removal all play a role. The size of the breast and the expected cosmetic result are also taken into account when choosing the procedure.
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Surgery for a fibroadenoma is mainly performed if it is cosmetically disturbing and impairs the image of the breast, if a clear diagnosis is not possible without surgery or if the fibroadenoma is psychologically very stressful. There are several different methods that can be used for this. The most common method is the removal (excision) of the fibroadenoma through a minor operation.
For this purpose, the fibroadenoma is usually localized in the breast using ultrasound and then cut out. The place where the incision is made in the skin depends on the size of the fibroadenoma, the number of fibroadenomas to be removed and their location in the breast. The least possible impairment of the appearance of the breast by the scar and the removed tissue is always taken into consideration.
Modern techniques and incisions can usually achieve very good cosmetic results. Other techniques use strong heat or cold to destroy the fibroadenoma. In the so-called cryoablation, a probe is used to create a strong cold at the fibroadenoma, which leads to the destruction of the fibroadenoma.
In this case, no tissue is removed, so the technique is not suitable for cases in which a histopathological examination of the fibroadenoma is required. This technique does not require general anesthesia and requires a very small incision in the skin, which results in a smaller scar. As a rule, no operating room is required, so cryoablation can also be performed in surgeries.
In studies, the strong reduction in size led to the fibroadenoma not being palpable in many patients after therapy. Fibroadenomas can also be treated with intense heat. As in cryoablation, a probe is brought to the fibroadenoma.
By means of laser, ultrasound, microwaves or radio waves, the tissue is heated locally and thus destroyed. Mamma is the Latin term for the female breast and is often used in medical terminology. The mamma is composed of fatty tissue, connective (supporting) tissue and glandular tissue.
Its size and shape depend on the relationship between these types of tissue and their structure. The size and shape of the glandular tissue changes according to the menstrual cycle and especially during pregnancy and breastfeeding. During this period, changes in the hormone balance and other messenger substances cause the glands to transform and prepare for milk production.
The glands become larger and more numerous and, among other things, the additional stimulus of sucking the baby at the mammary gland eventually leads to milk production. Fibroadenomas consist of both connective tissue and parts of the glandular tissue. The exact mechanism of the formation of these nodular structures has not yet been clarified.
Like the glandular structures of the mamma, fibroadenomas can also vary somewhat in size and composition due to hormone effects within the female cycle. During pregnancy, too, there can be strong changes in size (usually increase in size). With the menopause, the hormone balance of the woman changes.
The concentrations of female hormones (including estrogen) decrease and the cycle-dependent changes in the sexual organs come to a standstill. This also has effects on the mamma. The amount of glandular tissue decreases and the relative amount of fat increases (so-called involution).
Similar to the female breast (mamma) in general, the fibroadenomas are also affected. Due to the lower influence of the female sex hormones, the size of the fibroadenomas can decrease. This can also lead to the fact that they are no longer palpable.
If a fibroadenoma causes complaints, these can also disappear during and after the menopause (peri- and post-menopausal). Therefore, especially during this period, surgical therapy should be critically evaluated against a wait-and-see approach. After the menopause, fibroadenomas occur much less frequently.
This can also be explained by the changes in the mamma. The glandular tissue parts become less and thus also the initial tissue of the fibroadenomas.In addition, female hormones also lack an important growth stimulus. Taking hormones during this time counteracts these mechanisms and thus increases the probability of the development of new fibroadenomas, or existing fibroadenomas can grow. Space demands after menopause should be clarified particularly carefully because of the higher proportion of malignant changes.
