General
Description:
Fibroadenomas
are the most common benign tumors of the female breast. They develop at any age
but are more common in young women, often teenagers, and are mistaken for
cancer.
It is a
benign breast growth (Pseudopsora/ Sycosis) that most commonly presents in
teenage girls and women under the age of thirty. The presence of a fibroadenoma
mass in a breast often causes women anxiety (Psora/ Pseudopsora) and concern,
partly because people associate any type of breast lump with cancer.
Fibroadenoma carries a very slight menace for future breast cancer, but the
majority of fibroadenoma are benign breast growths. They may be excised but
frequent recurrence is common.
The
fibroadenoma is the most common circumscribed benign solid tumor (Pseudopsora/
Sycosis) of the breast. As its name implies, it is composed of fibrous and
adenomatous elements. A rarer variation is the fibroadenolipoma, which is an
encapsulated lesion (Pseudopsora) that may represent a hamartoma (Pseudopsora/
Sycosis) and contains, as the name implies, fat, fibrous, and adenomatous
tissue elements. The fibroadenoma is hormonally sensitive (Psora) and is more
common in the young female. Beginning in the teenage years fibroadenomas are
the most commonly biopsied solid lesion (Sycosis) of the breast, and this
remains true through the mid 30s. As solid lesions they cannot be distinguished
from well-circumscribed malignancy by either physical examination or imaging
methods. Fibroadenomas are found frequently in postmenopausal women as well,
but because of their hormone sensitivity they usually involute and become
hyalinized. In some women this results in calcification (Psora), and these
calcifications are among the most distinctive mammographically. Fibroadenomas
do not become malignant, but frequently can grow to enormous size (giant
fibroadenoma), and a potentially malignant cystosarcoma phylloides (Cancerous)
cannot be distinguished from a fibroadenoma except that it usually grows very
rapidly.
Incidence
Nearly
90% of breast masses in women are the result of benign lesions and are usually
fibroadenoma in women in their 20s or 30s.
Symptoms
of Fibroadenoma
A
fibroadenoma tends to be sphere shaped, with a smoother surface (Sycosis) than
most malignant breast cancers (Cancerous). While malignant tumors tend to be
immobile (Sycosis), fibroadenoma growths move (Pseudopsora) easily within the
breast.
Fibroadenoma
growths are usually painless (Sycosis), but size and location of the growth can
cause breast tenderness or pain (Psora/ Pseudopsora). A fibroadenoma feels
slightly malleable or rubbery to the touch (Pseudopsora) when examined. While
younger women tend to have clearly defined fibroadenoma growths, older women
may present with breast calcification (Psora) rather than masses.
These
are usually isolated breast masses. In ten to fifteen percent of cases multiple
fibroadenomas may occur, and may be present in both breasts.
Clinical
Signs
- Palpable mass
for young women, feels like small, slipper marbles. (Psora/ Pseudopsora)
- Mammographic
density for older women.
- Mass is more
circumscribed and mobile than carcinoma. (Psora/ Pseudopsora)
Causes
of Fibroadenoma
Estrogen
sensitivity (Psora) is thought to play a role in fibroadenoma growth. Some
tumors may increase in size towards the end of the menstruation or during
pregnancy (Sycosis).
After
menopause, many fibroadenomas spontaneously shrink due to lower estrogen levels
(Psora/ Syphilis). Hormone therapy for postmenopausal women may prevent
fibroadenomas from shrinking.
Types
of Fibroadenoma
All
fibroadenoma are composed of glandular cells and fibroconnective, or stromal,
cells. The majority of fibroadenoma do not grow larger than one to three
centimeters, but some may grow to over five centimeters, in length.
These
unusually divided into two subcategories:
- Giant
Fibroadenoma- large
growths.
- Juvenile
fibroadenomas- in
teenagers are often referred to as juvenile fibroadenomas.
Pathophysiology
-
Exact
cause is unknown. It may possibly due to increased fat consumption (Psora).
- Composed of both
fibrous and glandular tissue (Pseudopsora/ Sycosis).
- More frequent
occurrence in upper outer quadrant of breast.
- Can grow as a
spherical nodule to a size from <1cm to 10-15cms. (Pseudopsora)
- Fibroadenomas
are hormonally responsive - increases in size may occur during late phases
of the menstrual cycle (Psora)
Histopathology
-
- Well presence of
both basement membrane and myoepithelial cells.
- Composed of 2
parts:
- Delicate
cellular fibroblastic stroma resembling stroma of intralobular tissue
- Glandular/cystic
spaces lined by epithelium and enclosed by stromal component.
Diagnosis
of Fibroadenoma
- Physical
examination.
- Mammogram.
- Breast
ultrasound.
- Biopsy.
- Fine needle
aspiration cytology.
While
biopsy is the only sure way to confirm fibroadenoma, young women in their teens
to mid twenties may not require a biopsy if the lump meets all the requirements
for a characteristic fibroadenoma mass.
Surgical
Treatment of Fibroadenoma
As
benign growths, fibroadenomas are not always removed from the breast. Instead,
the mass is left and carefully monitored for changes in shape and size. Whether
fibroadenomas are removed depends on a number of physical and psychological
factors. Viz.
- Tumor
size-
If tumor size or location causes pain or discomfort, then the fibroadenoma
may be removed.
- Patient
concerns and anxieties- If a woman is uneasy with the
idea of a breast mass remaining untreated, the fibroadenoma may be removed
to alleviate her anxiety.
A
fibroadenoma may be removed under local anesthetic, either through surgery or
through the use of a fine needle. If a biopsy is required to rule out
malignancy, the entire fibroadenoma may be removed.
Complications
of Fibroadenoma
- Women with
fibroadenoma have a slightly higher risk of breast but not by a
significant amount.
- Very rarely,
cancerous cells are found in fibroadenoma biopsy samples, but almost all
fibroadenoma are benign.
- Complications
from fibroadenomas are not uncommon. Biopsies and fibroadenoma removal,
like all surgical procedures, carry the risk of bleeding, scarring, and
post-operative infection.
- After a
fibroadenoma is removed, its recurrence is quite common.
- Homoeopathic
Treatment of Fibroadenoma
-
- Calcarea
carbonica
Breasts
are hot and swollen. Chronic cystic mastitis. Blunt duct adenosis; best remedy
for fibroadenoma. Lump in breast is hard, nodular and tender to touch in the
beginning. Then the pains are reduced and the lump turns to be hard due to
calcification. Calcarea acts best when the tumours are calcified. These breasts
are swollen and tender before menses. Deficient lactation. The breasts are
distended in lymphatic women. Patient complains of profuse sweating around the
genitalia with dirty smell . Inflammatory condition of the breast. With breast
condition patient has the mental symptoms due to sufferings. Patient is
anxious, tired and weak, both mentally and physically.
Calcarea
fluorica
This
remedy is indicated in the fibroadenoma of the breast. Lump in the breast which
is hard, movable with clear margins which are sharp in nature, or their edges
are sharply defined. Most commonly they are solitary, very rarely multiple.
Occurs in young patients usually unmarried. Nodules are in upper right
quadrants. The patient is sad and depressed due to financial condition.
Confused due to melancholic condition of mind. Patient is chilly, and she is
very sensitive to cold air, cold wind and cold atmosphere in general. Genitals
are sore. Urine is copious and offensive. Pain at the tip of the urethra while
urinating and after the act. Pain in back extending to sacrum.
Conium
maculatum
Mammary
glands are hard and sore. A typical carcinoma of the breast, that is, scirrhous
adenocarcinoma, which begins in the ducts and ends in the parenchyma. As the
stage advances the Cooper's ligament shortens and thus it produces the notch.
Sometimes the condition is associated with the inflammation of the breast
tissue. The region is hard and nodular, tender to touch. Burning and stinging
pains in the breast. The skin over the tumour is adherent. Occasionally there
is discharge of pus from the nipple. The lesion is hard, almost cartilaginous.
The edges are distinct, serrated and irregular; associated with productive
fibrosis.
Baryta
carbonica
Inflammation,
induration and enlargement are the fundamental pathogeneses of this drug. The
mammary gland is enlarged and there is a lump, which is hard. There is very
sensitive to touch. The glands which are enlarged are tender with infiltration.
The women of late twenties are affected. These patients present with hard but
not serrated mass with firm rubbery consistency. Their edges are sharply
defined. Most commonly the tumours solitary. or occasionally are multiple. They
are differentiated from cancer by smooth rather than irregular lobulations. A
bloody discharge from nipple is indication of this drug. All the glands of the
body are very sensitive to cold and they are worse by taking cold. The skin
over the gland becomes ulcerated. It is seen that this remedy works better in
Paget's disease of nipple which is supposed to be primary carcinoma of the
mammary gland.
Hydrastis
Canadensis
These
patients have the tendency to indurated glands. Swelling of the mammary glands.
Fat necrosis and glandular cell myoblastoma are common in this remedy. Fat
necrosis tumour is probably post-traumatic. Patient complains of pain and
tenderness. The lesion is fixed to the breast tissue, which sometimes causes
dimpling of the overlying skin. Engorged nipples, cracks and discharges of watery
fluid or there is serosanguinous discharge. The patient is weak and emaciated,
fainting due to improper assimilation or defective assimilation. All-gone
sensation or empty feeling in the stomach, not relieved by eating. Chronic
catarrhal condition of the membrane of the stomach. Patient is thirstless.
Obstinate constipation, colicky and crampy pain in the abdomen. Liver is
enlarged and tender.
IodiumThis
remedy predominantly acts on the enlargement of the mammary glands which may be
either neo-plastic or malignant. The mucous membranes of the glands and the
breast tissue are inflamed. The breast tissues are hypertrophied, enlarged,
hard and nodular. Emaciation of the patient due to malabsorption. The tumours
are well differentiated. They have a discrete capsule. Small lesions present
leaf-like intracanalicular protrusions and large lesions have cystic space.
Inflammation of the lesions, ulceration occasionally, excoriating and acrid
discharge from the nipple or from the lesion. Oedematous swelling of the affected
breast.
Lapis
albusThe main action of this remedy is on the the glands of mammary
region. These glands have the tendency to turn malignant. Remarkable results
are observed in scrofulous condition of the glands. Fibroid tumours, intense
burning pains in the parts. The tumours have pliability and a kind of softness
rather than hardness. The margins are clear. The glands are elasticity, exactly
the reverse of Calc. fluorica.
