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Fibroadenoma

Synonym: (fibro)adenoma of the breast
German: Fibroadenom

1 Definition

The fibroadenoma is the most common benign neoplasm iin the region of the female mammary gland (app. 75% of women). It frequently occurs in the form of a nodule of 1,5-2cm with a soft structure. The risk of degeneracy is extremely low.

2 Causes

Until now, a concrete cause for the occurence of a fibroadenoma has not been found. hormonal disorders are seen as the most probable cause. Thus, there often is a dysbalance between the concentrations of progesterone and estradiol. Mammary gland tissue dispersed during the embryonic phase is stimulated to proliferation under the influence of estrogens. In the tumor itsself, the progesterone receptor is increased while the estrogen receptor is low. Further possible causes are:

3 Epidemiology

Fibroadenomas particularly often occur in young women between the ages of 20 and 30 years, but they can basically occur from puberty on. Around 8% of the women develop a fibroadenoma in the course of their lives.

4 Histology

Fibroadenomas usually measure up to 10 cm in diameter. Larger fibroadenomas are possible, but rare. The slice plane is white and riddled by yellowish-pink glandular spots.

Under the optical microscope, you can see a loose connective tissue stroma whose cells have spindle-shaped nuclei. The tissue is riddle by mammary duct-like structures. The epithelium of the duct structures is regular and has an intact basement membrane. There are few mitosis figures.

Depending on the growth of the connective tissue stroma, the duct structures are round and regular (pericanalicular fibroadenoma) or compressed and irregular (intracanalicular fibroadenoma).

5 Symptoms

Fibroadenomas are individual, sligthly hardened tumors of the breast that are movable against the underlayer. They grow under hormonal influence in the late phase of the menstrual cycle and during pregnancy. After menopausis, most fibroadenomas show a corresponding regression (reduction in sizem calcification).

Fibroadenomas usually donít cause pain or other symptoms. Often, it is discovered by chance during mammography.

Fibroadenomas can transform into a cystosarcoma (phyllodes tumor) and into a sarcoma of the stroma.

6 Diagnostics

7 Differential diagnosis

The most important differential diagnosis is breast cancer. Furthermore, you need to consider mastopathic cysts.

8 Therapy

An excision is not requires if:

  • The punch biopsy can assure the diagnosis of a fibroadenoma
  • The mass is smaller than 3cm and otherwise insuspicious in imaging.

If, in spite of this, a removal is required or requested by the patient, the fibroadenoma can easily be cut out of the remaining breast (enucleation).

Surgery is indicated if:

  • > 3cm in size, rapid growth, > 40y, requested by patient

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