Does ultrasound distinguish between fibroadenoma and cyst. Distinctive features of breast cysts and fibroadenomas

Fibroadenoma among benign neoplasms of the mammary glands is diagnosed most often (95% of cases). The disease can occur in women of different ages. It is believed that in young girls, the formation of a tumor occurs as a result of the pathological development of glandular cells of the mammary gland. In women who are in menopause, the onset of the disease is due to hormonal imbalances. However, the exact cause of tumor formation and growth is unknown.

Fibroadenomas of the mammary gland in pregnant and breastfeeding women can be distinguished into a special group. They are called lactating; as a rule, they do not have a negative impact at this stage. However, during pregnancy, there may be an increased growth of education.

Tumors can be single or multiple; one- and two-sided. The size of the node is usually about 2-4 cm. Fibroadenoma is a dense, rounded formation with a predominant amount of fibrous tissue, which has a capsule and is not associated with adjacent tissues.

Leaf-shaped fibroadenoma is distinguished into a separate form. It has uneven contours and a heterogeneous structure; can transform into a malignant tumor, in contrast to the formations described above.

Clinical manifestations

Clinically, the disease is manifested by moderate pain and the presence of a palpable mass in the tissues of the gland. It is often relatively mobile, has clear boundaries and a densely elastic consistency. However, it should be said that with small sizes and in the case of massive mammary glands, palpation does not always reveal the presence of the disease. In these cases, accidental detection of a tumor during an ultrasound examination may be the only screening diagnostic method.

With ultrasound scanning, rounded, regular formations are visualized, often having a hypoechoic central zone. The fabric of increased density is located on the periphery. With large tumors, their shape may become irregular. In all cases, the capsule can be clearly identified.

With a prolonged course, certain changes occur in the structure: a more pronounced hyperechoic rim, a heterogeneous internal structure, the presence of calcifications.

Differential diagnosis with ultrasound should be carried out with malignant tumors, breast cysts and cystoadenopapillomas. In all cases of detection of pathology, an X-ray examination (mammography) is indicated. At the same time, there are no clear radiological criteria for distinguishing fibroadenoma from breast cysts.

If the doctor has some doubts about the correctness of the diagnosis, then a biopsy under ultrasound control should be performed, followed by a cytological examination. This method allows you to make a diagnosis absolutely accurately. In a number of situations, magnetic resonance imaging (MRI) of the mammary glands is performed.

Treatment

Treatment of breast fibroadenomas is surgical. Currently, the indications for removal are as follows:

• rapid tumor growth (increase in size and volume by two or more times in the last 3 months);
• large size of the formation, leading to deformation of the mammary gland and severe pain syndrome;
• the inability to accurately exclude the presence of a malignant tumor process; with onco-alertness, especially in persons with a burdened history;
• leafy fibroadenoma.

Removal of the tumor takes place under local anesthesia or anesthesia by exfoliation of the formation - enucleation. This type of operation is indicated for young women in the absence of suspicion of a cancerous process. More often, sectoral resection of the mammary gland is performed along with fibroadenoma. In this case, the removal of the tumor occurs together with healthy tissues within the anatomical and topographic unit - the sector.

During the operation, immediately after removal of the tumor, it is recommended to perform an express histological examination in order to exclude the malignant process and determine the tactics of surgical treatment. The prognosis is favorable, but it should be said that relapses are possible after removal.

A hand-detectable knot in the chest is a good reason for a complete examination. Fibroadenoma of the mammary gland refers to one of the variants of benign neoplasms, in which it is necessary to perform the entire volume of diagnostic studies in order to exclude oncology. The basis of successful treatment is organ-preserving surgery, which makes it possible to relieve a woman of a pathological formation in the breast with a guarantee.

Fibroadenoma of the breast - what is it

A lump with clear contours in the mammary gland in a young woman, revealed during examination, in most cases is a benign dyshormonal neoplasm.

Fibroadenoma is: a local proliferation of glandular tissue and connective tissue structures in the chest, which occurs against the background of endocrine disorders. Typical age is 20-25 years and during perimenopause: in both cases, problems are caused by hormonal disorders associated with age-related changes in the body or pregnancy.

After examination and confirmation of the benign quality of the process, it is necessary to remove the tumor so as not to create conditions for complications and to prevent dangerous consequences. An obligatory element of diagnostics is postoperative examination of a micropreparation to exclude oncology.

Hello. I have a lump in my chest, undergoing examination. Why does fibroadenoma in the mammary gland hurt? Irina, 25 years old.

Hello Irina. The small knot does not cause pain. A large tumor compresses tissues (blood vessels, nerves), causing pulling pain or discomfort. The presence of pain syndrome indicates a large size of the neoplasm and the need for surgical intervention.

Benign nodulation options

An important factor in therapy is the exact definition of the type of nodular mastopathy. Fibroadenoma of the breast can be:

1. Leafy;
2. Intracanalicular;
3. Perianalicular;
4. Involutive.

The type of tumor determines the therapeutic tactics and prognosis for recovery: in most cases, it is necessary to remove the neoplasm, but in some situations conservative treatment methods can be used. For each patient, the mammologist will select an individual therapy regimen.

Leafy fibroadenoma in the chest

The phyloid (leaf-shaped) variant is the most unfavorable from a prognostic point of view. Typical features of the common benign form of mastopathy include:

• rapid node growth;
• the presence of pain syndrome with a large size of the neoplasm;
• layered structure;
• high risk of malignancy (about 10%);
• detection of pathology in women of any age;
• frequent combination with gynecological diseases (leiomyoma, ovarian cysts, infertility).

The small knot does not hurt, so the detection of a tumor in the chest occurs by chance - during a doctor's examination or a preventive ultrasound scan. The size of the fibroadenomatous node of the leaf-shaped structure can rapidly increase, which is manifested by typical symptoms (the node begins to hurt, the tumor is difficult to miss). It is important to consult a doctor in a timely manner: in this case, you cannot do without surgery.

Intracanalicular tumor

Benign growths of fibrous tissue inside the milk ducts are the basis for a shapeless tumor. The intracanalicular type of neoplasm is characterized by:

• the presence of a knot without clear contours;
• slow growth;
• diffuse changes in the chest.

The risk of malignant transformation is low, but it is impossible to exclude the likelihood of breast cancer, so the mammologist will perform all the necessary diagnostic tests at the stage of preparation for the operation.

Perianalicular neoplasm

The formation of a node around the milk ducts creates conditions for neoplasm with the following signs:

• a tumor dense in structure;
• well-defined boundaries;
• the appearance of the disease in women of age;
• the formation of calcifications.

Involutionary processes

In women in menopausal age, as the function of the ovaries fades and the hormonal influence in the mammary glands decreases, typical changes occur.

Involutive fibroadenoma is a node consisting of fibrous and adipose tissue, and is formed according to a mixed type (pericanalircular, intracanalicular). Against the background of natural processes of replacement of glandular structures, a neoplasm is formed, which rarely poses a danger to a woman.

Hello. I am being observed by a mammologist; there is a small benign nodule in my chest. Can I sunbathe with breast fibroadenoma? Maria, 41 years old.

Hello Maria. You can sunbathe, but even in the absence of breast problems, it is better to protect the mammary glands from ultraviolet radiation. If you have fibroadenoma, you should avoid topless tanning.

Differences between cysts and fibroadenomas

With a conventional palpation of the breast, it is impossible to distinguish between a cyst and a node. When carrying out diagnostic studies, the mammologist will necessarily assess the structure of the tumor. A cyst from a fibroadenoma is distinguished by the following features:

• consistency (the knot is dense, the cyst is soft-elastic);
• the presence of pain (large cystic tumors provoke the onset of pain);
• Ultrasound signs (hypoechoic structure with adenoma, hyperechoic - with a cyst);
• the influence of hormonal changes (pregnancy, abortion, age-related endocrine disorders can become the impetus for the occurrence of nodular pathology in the chest).

The result of using all diagnostic methods will be an accurate diagnosis: removal of the tumor is carried out according to indications, therefore it is necessary to identify the structure of the neoplasm in the breast at the preoperative stage.

Hello. Can small fibroadenoma resolve on its own? Ekaterina, 35 years old.

Hello Ekaterina. With a node size of up to 1 cm against the background of hormonal correction, fibroadenoma in the mammary gland may disappear. With a large node size (from 2 cm or more), the tumor must be removed with the help of an operation.

Combination of fibroadenoma and pregnancy

Conception and bearing of a fetus is a pronounced effect on the hormonal system of a woman. Pregnancy creates conditions for the growth of the existing fibroadenoma, but does not cause the appearance of a benign tumor in the breast.

At the stage of pregravid preparation, it is necessary to do all the necessary examinations (ultrasound of the mammary glands, mammography) in order to timely detect a small neoplasm. This is especially true for women with infertility - the preparation program for in vitro conception (IVF) includes mandatory examinations of all female reproductive organs.

Fibroadenoma of the mammary gland during lactation may increase in size, which is explained by the pronounced effect of hormones on the glandular tissues. When feeding a baby, you need to carefully monitor the mammary glands and contact a specialist in time: in some cases, it is difficult to independently distinguish lactostasis from a growing fibroadenoma.

Hello. What does fibroadenoma look like on ultrasound? Sophia, 44 years old.

Hello Sophia. On the monitor of the ultrasound machine, the doctor will see a volumetric formation in the mammary gland with a hypoechoic structure and clear contours. When conducting ultrasound, one can only assume the presence of fibroadenoma - an accurate diagnosis is made on the basis of a puncture or biopsy of the tumor.

Diagnosis of the disease

When a woman complains about the presence of a node in the chest, the mammologist will assess the following symptoms:

• the presence of pain syndrome;
• the size of the neoplasm;
• the consistency of the tumor;
• changes around the node;
• reaction of axillary lymph nodes.

The detection of a node of any size is an indication for a complete examination, including the following research methods:

• ultrasound scanning of the mammary glands;
• dopplerometry (assessment of vascular blood flow);
• mammography (x-ray of the breast);
• MRI (for any doubts about the diagnosis).

In young women, ultrasound is preferred; at an older age, mammography is more commonly used. Fibroadenoma of the mammary gland by American doctors belongs to type 2 according to ACR (a benign neoplasm with a large amount of fibrous component - up to 50%).

None of the diagnostic methods can guarantee the absence of cancer in the mammary gland, so the mammologist will prescribe an invasive study - a puncture of the node. The diagnostic operation is performed under ultrasound control: the doctor punctures the nodule in order to aspirate cells from the tumor. Cytological examination after puncture allows you to identify dangerous cells or exclude cancer.

The optimal diagnostic method is fibroadenoma biopsy: during the operation, under local anesthesia, partial or complete removal of the neoplasm is performed, after which the micropreparation is examined in a histological laboratory. Only the result of histology can guarantee the good quality of the nodule in the breast. ICD-10 code for breast fibroadenoma - D24.

Therapeutic tactics for breast fibroadenoma

The most important question that arises at the examination stage is whether it is necessary to remove the fibroadenoma? Conservative treatment methods are ineffective for any form of nodulation in the chest, so the doctor will suggest an operation.

Hello. What are the complications after removal of fibroadenoma from the breast? Anastasia, 35 years old.

Hello Anastasia. In the early postoperative period, inflammation may occur in the wound area (seroma, suppuration of sutures). Some women have a predisposition to keloid scars, which will cause an ugly suture to form. In the long term, a relapse is possible - the re-formation of fibroadenoma in the chest.

Surgical methods - to remove or not

The main conditions for choosing the optimal method for removing the neoplasm are:

• the size of the tumor;
• localization (close under the skin or deep in the tissues);
• planning pregnancy;
• the risk of oncology.

Hello. Can benign fibroadenoma develop into cancer? Alla, 29 years old.

Hello Alla. If a leaf-shaped fibroadenoma is detected and the operation is abandoned, the probability of malignant transformation is about 10%. That is why the doctor will suggest surgery to remove the nodule from the chest.

The approach to each patient is individual: the surgeon, with the proven good quality of the process, will always perform an organ-preserving intervention.

Hello. What size of fibroadenoma is an indication for surgery to remove the tumor? Angelina, 41 years old.

Hello Angelina. With a tumor size of 3 cm or more, it is necessary to perform an operation to remove the tumor.

The indications for surgery are:

1. Phyloid type of tumor;
2. Size over 3 cm;
3. A rapid increase in the size of the neoplasm in a short period of time;
4. Preparation for the desired conception or IVF;
5. The presence of a risk of oncology.

The main operations used to treat breast fibroadenoma are:

• removal of the node with the capsule (enucleation);
• sectoral resection (excision of a part of the gland along with the tumor);
• cryoablation (removal of the subcutaneous nodule with cold);
• targeted destruction of neoplasms with a laser;
• radio wave removal of the tumor.

In standard operations (enucleation and resection), the doctor will use anesthesia; when using high-tech techniques, anesthesia is not required or the use of local anesthesia is sufficient.

Hello. How is the operation to remove the fibroadenoma? Inessa, 37 years old.

Hello, Inessa. For a large tumor, the doctor will perform a sectoral resection. The operation is performed under general anesthesia. It is necessary to remove the node with the obligatory excision of a part of healthy tissue (at least 1 cm from the edge of the tumor). After that, the wound is sutured, and the removed tissue is sent for histology.

Postoperative period

With any variant of tumor removal, in most cases, the postoperative period proceeds without any particular difficulties - when using a laser, cryotherapy or radio waves, you do not need to be in the hospital (after the procedure, the doctor will let you go home in a few hours).

Standard surgical intervention involves medical supervision on the first day after surgery. Regardless of the method of surgical intervention, an important stage in the postoperative period is to obtain the result of the histology of the removed tissues: in the absence of oncology in the biopsy, there is no need to worry about the consequences.

Hello. After the operation to remove fibroadenoma, I still have a lump in the mammary gland. What is it and what should be done? Daria, 43 years old.

Hello Daria. Fibroadenoma is a variant of mastopathy. After the operation, connective tissue scars are formed in the glandular tissue, which arise on the basis of diffuse changes. There is nothing wrong with that - you need to be regularly monitored by a mammologist for preventive purposes.

Fibroadenoma treatment without surgery

Conservative methods of treatment are ineffective - it is possible to treat with hormonal pills only in cases where involutive processes are identified or a single small node is determined (no more than 1 cm).

But even in these situations, regular monitoring by a doctor with an ultrasound or mammography at least 2-3 times a year is necessary. Treatment with folk remedies using local and general methods (compresses, infusions, herbal preparations) is ineffective: it is impossible to cure breast fibroadenoma with non-traditional therapies.

Hello. Preparing for the operation. What not after removal of fibroadenoma from the right breast? Inna, 38 years old.

Hello, Inna. In the next month after the operation, it is necessary to strictly follow the doctor's recommendations - to give up physical activity and sports, wear special underwear, not go to the bathhouse and sauna, take medications prescribed by the doctor.

You can ask your question to our author:

Hello girls. Today I had to undergo a breast puncture, I am writing a review on fresh memories.

Full name of the procedure: percutaneous diagnostic puncture of the mammary gland under the control of ultrasound with cytological examination.

Price: 2300 rubles. The price varies depending on the clinic.

I'll tell you briefly why I had to go through this procedure:
Once a year I do an ultrasound of the mammary glands. Usually, small cysts were found that did not require treatment, according to the advice of a mammologist. This time, on the left breast, the doctor drove the apparatus for a long time, and then gave out a phrase that hit me like a bolt from the blue: "A focal formation in the left mammary gland, probably a fibroadenoma." It’s already dark in my eyes. Let's understand it in terms:

Cyst

A cyst is a small cavity in the breast tissue filled with fluid. Most cysts in mastopathy are of ductal origin, that is, they are modified locally dilated ducts, which contain accumulated ductal contents (most often a light translucent liquid). They can be asymptomatic, manifesting only when the cyst is inflamed or overflowing with fluid (in the form of a slightly painful elastic seal). More often they manifest themselves in the form of a feeling of heaviness, discomfort, more pronounced in the outer quadrants of the mammary glands, increased tension in the chest in the second half of the menstrual cycle. In 90% of cases, cysts are insignificant up to (6-10 mm) and do not cause any harm.

In simple terms, a cyst is a liquid, and if it is small, you can leave it alone.

Fibroadenoma

Fibroadenoma is a benign tumor that originates from the connective tissue of the breast. Fibroadenoma rarely degenerates into cancer (becomes malignant).

But fibroadenoma is already a benign tumor. It is also not particularly dangerous, you should not panic (easy to say), but fibroadenoma cannot be treated with conservative methods. Small fibroadenomas less than 1 cm are subject to observation and ultrasound control every 3 months. If there is a tendency to growth, surgery is indicated. Fibroadenomas up to 2 cm can be removed by vacuum (without general anesthesia)!Some information about this method:

Stress, ecology, trauma, genetic predisposition, abortion and taking strong medications - the reasons for the appearance of a tumor in the chest are becoming more and more, while the disease is getting younger just before our eyes. Today, very young girls are often diagnosed. Fortunately, medicine does not stand still - thanks to innovative methods, patients with a benign tumor in the breast (fibroadenoma) can be offered modern sparing methods of treatment, namely - vacuum aspiration biopsy.

The complex name hides a minimally invasive, gentle intervention that does not imply hospitalization of the patient. The procedure is carried out within an hour on an outpatient basis. Under the control of ultrasound, the surgeon makes a puncture (in the armpit or in the fold under the mammary gland), inserts a biopsy needle and removes a tumor up to 2 cm in size. The technology of vacuum removal is carried out on the EnCor apparatus (made in the USA). The procedure is carried out without anesthesia, under local anesthesia - after the intervention of 2 hours of observation in the day hospital and the patient can go home.

Let's finish with the theory and move on to the conclusion of the ultrasound doctor, which was as follows: "focal formation of the left breast 5 by 7 mm (probably fibroadenoma)".

Probably! But not exactly, therefore, the mammologist sent me to a breast puncture in order to unambiguously determine the nature of education. Also, the mammologist warned that the procedure can be painful, since the focus is in the nipple region.

More details about the procedure and what it is for:

Puncture of the mammary glands is an invasive diagnostic method that involves taking small samples of tissue and fluid from the breast through a puncture using a biopsy needle, syringe, or robotic instrument. The resulting material is sent to the laboratory and subjected to cytological examination. The method is the most productive and reliable for determining the nature of the formations identified by ultrasound and mammography. It with a high degree of probability helps to determine the presence or absence of cancer cells in the punctate.

The main task of the procedure is to distinguish malignant neoplasms from benign ones. The doctor prescribes such an analysis when he detects a change in the structure of the skin of the breast, ulcers, discharge from the nipple and other signs, if other studies cannot confirm or deny the nature of these manifestations. In 80% of cases, cancer cells are not found in the biopsy sample, so do not worry prematurely with such an appointment.

Contraindications to the procedure:

The procedure is invasive, but preparation for it is minimal: nmust be tested for blood clotting (blood is taken from a finger). No more manipulations were required from me.

How was the procedure, feelings during and after:

I went into the office with the analysis (done in the same clinic an hour before the puncture) and the result of the ultrasound. She signed the consent, stripped to the waist, lay down, disinfected the area. Oh, how I was afraid, but in vain. The doctor, under ultrasound control, found a lesion and, with a quick, almost imperceptible movement, drove a thin needle. I was expecting 7 Egyptian executions, but it didn't hurt at all, the injections in the gluteus muscle were even more painful. Since the formation is small, the doctor drove the needle inside for 30 seconds, looked for the focus with a needle (it also did not hurt), and when he found it, he immediately made it clear that this was not a fibroadenoma, but a cyst with thick contents. The fence itself lasted a couple of seconds. During the fence, a tingling was felt, but it was quite tolerable even for a person with a low pain threshold. Then the puncture was covered with a bandage and a plaster and that's it, no pain or discomfort. After this procedure, be sure to lie down for a while. As I felt great, after 5 minutes I was released. On the day of the procedure, you cannot visit baths, saunas, physical activity is excluded.In total, I spent no more than 10 minutes in the office. The puncture area after the procedure does not bother, does not hurt, only a small dot remains at the injection site.

Summary: diagnostic puncture of the mammary gland is a necessary procedure, when in doubt, it helps to clarify the diagnosis. Girls, the procedure is quick, painless, no need to be afraid! It really doesn't hurt, I hope my review will morally cheer you up if someone has to undergo this procedure.

Many women have a fear of fibrocystic disease, which is quite reasonable. Fibrocystic breast disease can take on many types and forms, differing in their symptoms and methods of treatment. Let's consider the most common ones.

Breast cyst

Usually, the cyst is characterized by a smooth, round outline and delimitation from the rest of the breast tissue. If fibroadenoma mainly affects young women, then the problem of cyst formation is encountered at the age of over 35. At this time, the risk of degeneration of a benign process into breast cancer increases. The manifestation of cystic neoplasms can be represented by single, group lesions. Cysts may not cause painless sensations, or vice versa, they may be accompanied by severe pain. The manifestations of this disease depend on the dynamics of cyst growth. As it develops, it begins to create painful growths, squeeze the surrounding tissues, and cause discomfort.

Fibroadenoma of the breast

Fibroadenoma is a fibrocystic disease of the mammary gland, characterized by the fact that it is localized and develops exclusively in the mammary glands. In terms of its size, breast fibroadenoma can be completely different: for some it reaches several millimeters in diameter, and for others - several centimeters. Visually, the neoplasm looks like a knot with round, well-defined outlines, which are poorly visible due to the connective tissue capsule. During growth, it captures areas of healthy, undamaged tissue. Using palpation, you can feel the density of the tumor. In the context, it has a grayish tint.

How to distinguish between two pathological processes?

• Patient age... If young women and young girls are ill with breast fibroadenoma, then cystic neoplasms often occur in the premenopausal period.
• The severity of the pain syndrome. With fibroadenoma, there is practically no pain, and with a breast cyst, the manifestation of pain depends on the severity of the process and the size of the neoplasm.
• Dependence on hormonal levels. Fibroadenoma is directly related to the process of hormonal imbalance in the body of a young woman, which began during puberty; during menstruation, they rapidly increase in size and depend on the level of estrogen. During pregnancy and lactation, fibroadenomas can become very large. A breast cyst refers to the consequences of other types of mastopathy and is not associated with the level of hormones in the patient's blood.
• Punctate content. The main diagnostic sign of a cyst is the liquid content that is obtained by puncture. With fibroadenoma, obtaining an aspirate is almost impossible.
• Medical tactics. A breast cyst can be treated using conservative methods such as puncture and attempts at gluing the lumen. Fibroadenoma of the breast is treated only promptly.

Many women have a fear of fibrocystic disease, which is quite reasonable. Fibrocystic breast disease can take on many types and forms, differing in their symptoms and methods of treatment. Let's consider the most common ones.

Breast cyst

Usually, the cyst is characterized by a smooth, round outline and delimitation from the rest of the breast tissue. If fibroadenoma mainly affects young women, then the problem of cyst formation is encountered at the age of over 35. At this time, the risk of degeneration of a benign process into breast cancer increases. The manifestation of cystic neoplasms can be represented by single, group lesions. Cysts may not cause painless sensations, or vice versa, they may be accompanied by severe pain. The manifestations of this disease depend on the dynamics of cyst growth. As it develops, it begins to create painful growths, squeeze the surrounding tissues, and cause discomfort.

Fibroadenoma of the breast

Fibroadenoma is a fibrocystic disease of the mammary gland, characterized by the fact that it is localized and develops exclusively in the mammary glands. In terms of its size, breast fibroadenoma can be completely different: for some it reaches several millimeters in diameter, and for others - several centimeters. Visually, the neoplasm looks like a knot with round, well-defined outlines, which are poorly visible due to the connective tissue capsule. During growth, it captures areas of healthy, undamaged tissue. Using palpation, you can feel the density of the tumor. In the context, it has a grayish tint.

How to distinguish between two pathological processes?

• Patient age... If young women and young girls are ill with breast fibroadenoma, then cystic neoplasms often occur in the premenopausal period.
• The severity of the pain syndrome. With fibroadenoma, there is practically no pain, and with a breast cyst, the manifestation of pain depends on the severity of the process and the size of the neoplasm.
• Dependence on hormonal levels. Fibroadenoma is directly related to the process of hormonal imbalance in the body of a young woman, which began during puberty; during menstruation, they rapidly increase in size and depend on the level of estrogen. During pregnancy and lactation, fibroadenomas can become very large. A breast cyst refers to the consequences of other types of mastopathy and is not associated with the level of hormones in the patient's blood.
• Punctate content. The main diagnostic sign of a cyst is the liquid content that is obtained by puncture. With fibroadenoma, obtaining an aspirate is almost impossible.
• Medical tactics. A breast cyst can be treated using conservative methods such as puncture and attempts at gluing the lumen. Fibroadenoma of the breast is treated only promptly.