Operation of leaf-shaped fibroadenoma. Phylloid fibroadenoma

- fibro-epithelial formation of the mammary gland, belonging to the group of potentially malignant tumors. The presence of a leaf-shaped tumor is manifested by a seal in the tissues of the mammary gland, sometimes of gigantic size; in some cases - pain and discharge from the nipple. Diagnostic tactics include ultrasound, mammography, puncture biopsy and cytological examination of the material. Treatment of a leaf-shaped tumor of the breast is only surgical and may include performing a sectoral resection, radical resection, or mastectomy.

General information

mammology is also found under the names of leaf-shaped fibroadenoma, intracanalicular fibroadenoma, giant myxomatous fibroadenoma, phyllodes fibroadenoma, etc. Like other two-component formations of the mammary gland (fibroadenoma), leaf-shaped tumor is characterized by proliferation of epithelial and connective tissue components with a predominance of the latter. Among fibro-epithelial formations of the mammary gland, the incidence of leaf-shaped tumor is about 1.2-2%.

A leaf-shaped tumor of the mammary gland is a difficult-to-diagnose formation with a tendency to intensive growth, recurrence, and malignant degeneration into sarcoma. Malignancy of the leaf-shaped tumor of the mammary gland is observed in 3-5% of cases.

Characteristics of leaf-shaped tumors of the breast

The international histological classification classifies a leaf-shaped tumor as a fibro-epithelial formation and distinguishes three possible forms - benign, borderline (intermediate) and malignant.

The macroscopic picture of a leaf-shaped breast tumor depends on the size of the formation. Tumors up to 5 cm in diameter are a solid formation of a grayish-white or pinkish color with a coarse-grained or lobed structure delimited from the surrounding tissues. The section shows slit-like cavities and small cysts containing a viscous mucus-like mass. The macrostructure of leaf-shaped breast tumors larger than 5 cm is always represented by cystic cavities and crevices filled with a gelatin-like secret, polypoid growths in cystic cavities.

Microscopically, the stromal (connective tissue) component predominates in the structure of a leaf-shaped breast tumor. The difference from breast fibroma is a more pronounced stroma with significant phenomena of nuclear polymorphism and proliferation of stromal cells.

A leaf-shaped tumor can be represented by a single or multiple nodes located in one or both mammary glands. Phyloid tumors are characterized by sudden, rapid growth; the size of leaf-shaped fibroadenoma is variable - from small nodules to 20 or more cm in diameter.

Causes of the formation of a leaf-shaped tumor of the breast

The etiology of leaf-shaped breast tumor is unclear. Its development is associated with hormonal imbalance, primarily with hyperestrogenism and a lack of progesterone. In this regard, the peaks in the detection of phyllodes fibroadenomas fall on the hormonally active transitional periods of women's lives: 11-20 years and, most often, 40-50 years. In isolated cases, leaf-shaped tumors of the mammary glands occur in men.

Provoking factors in the formation of leaf-shaped breast tumors can be pregnancy, abortion, lactation, fibrocystic mastopathy, as well as extragenital endocrinopathies and metabolic disorders - diabetes mellitus, adrenal and pituitary tumors, thyroid nodules, obesity, liver disease, etc.

Symptoms of a leaf-shaped tumor of the breast

For a leaf-shaped tumor of the mammary gland, a two-phase course is typical. Usually, after a long period of slow development, which sometimes lasts for decades, there comes a phase of sudden rapid growth. The average size of phyllodes fibroadenomas is 5–9 cm, although cases have been described when the tumor reached a diameter of 45 cm and weighed 6.8 kg. At the same time, the size of the leaf-shaped breast tumor does not have prognostic value - a small formation can be malignant and, on the contrary, a giant fibroadenoma can be benign.

Usually, a leaf-shaped breast tumor is detected by the patient herself or by a mammologist during palpation in the form of a dense node. With a large size of a leaf-shaped tumor, the skin over the mammary gland becomes thinner, acquires a purple-cyanotic hue with translucent dilated saphenous veins. There may be pain in the mammary gland, discharge from the nipple of the affected gland, skin ulceration.

A leaf-shaped tumor is more often localized in the upper and central quadrants of the mammary gland, and in large sizes it occupies most or all of the breast. Malignant leaf-shaped tumor of the breast usually metastasizes to the lungs, liver, bones; lymph node metastases are uncommon.

Diagnosis of a leaf-shaped tumor of the breast

On palpation, a leaf-shaped tumor of the mammary gland is determined as a seal delimited from the surrounding tissues with a lobed structure, consisting of several nodes merging with each other.

Carrying out a radical resection of the mammary gland, subcutaneous or radical mastectomy is justified in the case of a large size of the tumor or its malignant nature. Lymphadenectomy is usually not performed. After radical interventions, reconstructive mammoplasty is performed with own tissues or endoprostheses. Radiation and hormone therapy for leaf-shaped breast tumors are not indicated.

Prognosis for leaf-shaped tumor of the breast

A feature of leaf-shaped tumors of the breast is their frequent tendency to relapse: according to observations, benign phyllodes fibroadenomas recur in 8.1% of cases, borderline - in 25%, malignant - in 20%.

Relapses often occur within a period of several months to 2-4 years; at the same time, the transition of a benign form to an intermediate or sarcomatous one is possible. Expansion of the scope of intervention (mastectomy) leads to a decrease in the risk of developing local recurrences of a leaf-shaped breast tumor.

Leaf-shaped fibroadenoma of the breast potential danger development into a malignant neoplasm. Diagnosis of this pathology early dates is able to prevent such a serious complication, although the risk of transition to a malignant tumor is 3-5% of all available cases. A special peak is observed in those age groups where the greatest hormonal surges occur, and this is in the period from 11 to 20 years and from 40 to 50 years.

What is this neoplasm?

Leaf-shaped fibroadenoma of the breast is a tumor, most often of a nominal benign type and having a borderline condition between fibroadenoma and malignant sarcoma. It belongs to the group of fibro-epithelial neoplasms. Its name is justified because of the special structure in which leaf veins are traced.

If we consider this neoplasm, from the point of view of description, then we can distinguish the following characteristic:

Fibroadenoma foliaceus can be 1 to 35 cm in size and have round shape or irregular oval.
The tumor is greyish-white to pink in color and is very mobile and demarcated from surrounding tissues.
If a leaf-shaped neoplasm is larger than 5 cm, it always has gaps, as well as cystic cavities.
When considering a leaf-shaped fibroadenoma in a section, you can see a mass of mucus of a viscous nature, it is also prone to the presence of both one nodule and several.
If the neoplasm is large, then polypoid growths are possible in the cystic cavities.
The structure of the tumor is expressed as lobular, and in itself there is no own capsule.
If we compare leaf-shaped fibroadenoma with ordinary adenoma, then in the first case the structure of the tumor will be more complex, and the presence of a large number of stromal cells (connective tissue component) will also be noted.

In addition, as already mentioned, leaf-shaped fibroadenoma is able to regenerate and in this regard it is customary to distinguish 3 forms of such a tumor:

border;
malignant;
benign.

Such a neoplasm is prone to rapid growth, or it is possible for a tumor to develop for a long time, which is then replaced by sudden growth. As a result, there may be differences clinical symptoms such a pathology.

Causes of this pathology

There is no disease without a cause.

As in any other cases, with leaf-shaped fibroadenoma, a number of factors can be distinguished that provoke the development of a pathological neoplasm:

hormonal imbalance associated with a lack of estrogen and progesterone;
the presence of tumor-like processes in the pituitary and adrenal glands;
diabetes;
nodes that develop thyroid gland;
mastopathy, pronounced fibrocystic character;
lactation period and pregnancy;
diseases of the liver and other organs;
metabolic disease;
the presence of tumors on the ovaries;
obesity;
frequent use hormonal drugs emergency or conventional contraception;
frequent abortion intervention;
overweight, etc.

Such causes are observed in most people, however, in this case, you need to understand that they are all subject to diagnosis and timely treatment. In addition, you need to learn to keep proper nutrition and follow the daily routine.

If the patient has a chronic course of the provoking factor, one should try to prevent relapses to prevent the formation of leaf-shaped fibroadenoma.

Symptoms

If the tumor is large enough skin over it become thinner, while acquiring a bluish tint. Because of this phenomenon, the saphenous veins become visible, which are also dilated.

When considering the two-phase clinical course of this pathological neoplasm, one can single out a slow development that can last for years, and then begin to grow rapidly.

Moreover, in the above example, the size of the neoplasm for the transition to a malignant nature does not matter. Even in the case of a large size, it can be benign, and if small, it can be malignant, which tends to metastasize.

With this disease, general symptoms can be distinguished that develop against the background of the presence and growth of a tumor-like neoplasm:

When feeling the chest, dense spherical lumps can clearly stand out.
The chest with this disorder hurts, and the nature of the pain and its intensity depends on the size and location of the leaf-shaped fibroadenoma.
Some women may notice discharge from the nipple.
With rapid growth, there is a deterioration in well-being and the possible appearance of weakness, dizziness, etc.

How is diagnosis and treatment carried out?

In order to correctly diagnose this pathology, this moment There are several stages and methods involved in such a study:

Consultation with a doctor, where the patient's history is collected, examination and palpation of the mammary glands are performed.
After that, ultrasound and a biopsy of the neoplasm may be prescribed, where a small piece of the tumor is taken and, with the help of a histological examination, a conclusion is made about the nature of the neoplasm.
Another additional method diagnosis is mammography.

Based on the data obtained, a decision is made on the method of treating the tumor.

Most often, this is an operative intervention, which has such indications:

the wish of the sickest woman;
suspicion of a malignant neoplasm;
rapid tumor growth;
pronounced cosmetic defects.

If we consider the methods of surgical operation, then we can distinguish the following types:

Enucleation. In this case, the neoplasm itself is removed by husking.
sectoral resection. With this method of surgical intervention, a certain segment of the mammary gland is removed along with leaf-shaped fibroadenoma, or, with repeated recurrence, amputation of the mammary gland itself is possible.

Leaf-shaped fibroadenoma of the breast has its own symptoms and pathogenesis of development. In order to prevent the worst consequences of this disorder, it is necessary to respond in time to the manifested clinical severity and consult a doctor for a diagnosis in case of the slightest suspicion of a pathology.

Fibroadenoma of the mammary gland or phylloid tumor is a fibroepithelial formation and a borderline form between normal fibroadenoma and sarcoma, arises from intraductal fibroadenoma. The leaf-shaped tumor got its name because of a certain structure resembling leaf veins. This fibroadenoma belongs to the group of potentially malignant tumors.

Characteristic

A leaf-shaped tumor is a clearly demarcated seal with a lobed structure that does not have its own capsule. Fibroadenoma is usually very mobile and does not adhere to the skin. In the section, a dense focus contains a viscous mass of mucus and consists of slit-like cavities with small cysts. A large tumor has polypoid growths in the cystic cavities. This type of tumor may contain one or more nodules. Compared with the usual fibroadenoma, the leaf-shaped tumor has a more complex structure and a greater polymorphism of stromal cells.

Leaf type fibroadenoma can occur in women of any age, but the periods of hormonally active age are considered the most frequent: 11-20 years, 40-50 years. Quite rarely, such an education is found in men. This neoplasm is prone to rapid development, degeneration into a malignant tumor and relapses. With a large size of leaf-shaped breast fibroadenoma, the skin of the breast becomes thinner, with clearly visible dilated saphenous veins and a bluish tinge of the affected area of the chest.

Leaf tumor is divided into 3 main forms:

benign;
malignant;
border or intermediate.

The size of a leaf-shaped tumor of the breast varies between 1-35 cm, which does not matter, because even the smallest neoplasm can be malignant. Fibroadenoma foliaceus may be accompanied by chest pain and discharge from the nipple. Breast cancer can metastasize to the bone system, liver, or lungs.

Causes

It has not yet been possible to find out the exact causes of the occurrence of a phyllodes tumor, but usually a leaf-shaped fibroadenoma and its appearance is associated with an imbalance in estrogen performance and a decrease in progesterone. The factors provoking its occurrence are considered to be the following:

pregnancy;
lactation;
repeated abortions;
fibrocystic mastopathy;
diabetes;
obesity;
thyroid tumor;
ovarian tumors;
fibroadenoma of the uterus;
pathological processes of the liver;
other processes that cause hormonal imbalance in the body.

Flow this disease has a staging, at the beginning the process of development of education can proceed covertly and without obvious symptoms. A leaf-shaped tumor can be in a frozen state for a long time, but various factors can provoke its growth, among which there is pregnancy. Fibroadenoma of the mammary gland of the leaf-like type can develop slowly, the terms of its growth sometimes reach up to 10 years.

Diagnostics

To accurately determine the type of tumor and its nature, you need to undergo a series of examinations, including ultrasound, palpation, mammography, dopplerography, puncture biopsy and cytological examination of the material.

Palpation reveals compaction, delimitation of the tumor, the number of nodes. Ultrasound of the breast reveals a hypoechoic connection with multiple fluid cavities and crevices, resembling a cabbage head in structure. Doppler ultrasound reveals a network of various veins and arteries surrounding the fibroadenoma. Mammography determines the form of fibroadenoma, its structure and intensity of development. Cytological assessment of the tumor is needed in the preoperative time.

Treatment

With leaf-shaped fibroadenoma, radiation and hormone therapy, the operation of lymphadenectomy, during which lymph is removed, is also not performed. A benign leaf-shaped tumor with a diameter of no more than 1 cm does not require urgent treatment, it is enough to be regularly observed and examined using ultrasound and mammography tests. With an increase in benign phyllodes fibroadenoma or its increased growth, an “enucleation” operation is performed - exfoliation of the tumor or “quadrantectomy”, removing a quarter of the mammary gland.

Fibroadenoma of a malignant nature with rapid growth and large size requires immediate surgical intervention. Such an operation is performed by sectoral resection - the removal of a cancerous formation along with its surrounding tissue.

A leaf-shaped tumor is also dangerous in that it is prone to relapses, the terms of which range from a month to 5 years. Benign fibroadenoma of the mammary gland is able to degenerate into a borderline or malignant form. In case of repeated recurrence, the entire mammary gland is removed. After radical measures, mammoplasty can be performed both with the help of one's own tissue and with endoprostheses.

Fibroadenoma foliaceus is insidious disease, the course of which is characterized by unstable and sudden development, which can lead to malignancy of the tumor. With early detection, the prognosis of treatment is quite favorable. Therefore, women are advised to undergo a timely examination by a mammologist and regularly examine their breasts by touch in order to identify and prevent development dangerous fibroadenoma leaf-type mammary gland, as well as avoid surgical interventions that deform the mammary gland.

This organ. Today we will talk about what is breast fibroadenoma.

The term comes from three words for fiber, gland and tumor. Fibroadenoma can develop in any gland, including the mammary gland.

It's pretty common benign tumor. It begins to be detected in adolescent girls, with age the incidence increases and reaches a maximum at the age of 30-40 years. Some scientists consider pathology a nodal form of mastopathy.

Etiology of the disease

The causes of breast fibroadenoma are unknown. A certain importance is attached to hormonal disorders, in particular, elevated level female sex hormones - estrogens, but there is no exact confirmation of this. The following factors can provoke the development of a tumor:

chest injuries, bruises;
excessive insolation (tanning or visiting a solarium);
premature termination of pregnancy;
transferred;
errors at breastfeeding and its completion.

As a result of the action of an unknown factor, cells of the connective tissue and glandular structures that form the milk ducts begin to divide in the breast tissue. Cells retain their normal morphological characteristics, do not grow into surrounding organs, do not metastasize.

A fibroadenoma may grow rapidly, have a soft texture, in which case it is called immature. Such formations are more common in young girls. In women, mature fibroadenoma is more common - dense, surrounded by a capsule, practically not increasing. The detection of such a tumor over the age of 40 indicates its late diagnosis.

Symptoms

Most often, the pathology does not manifest itself. In some women, fibroadenoma hurts, this is due to concomitant mastopathy, which responds to hormonal fluctuations.

Symptoms of fibroadenoma of the mammary gland are determined by probing it: in the upper outer quadrant, a small dense ball is felt, as if rolling into the tissues of the gland. The skin over it is not changed, there is no pain.

Although this formation does not bother a woman, when it appears, it is necessary to contact a gynecologist, surgeon or oncologist.

Macroscopic and microscopic characterization

- This is a painless single node of a dense consistency. It has clearly defined boundaries and a diameter of up to 3 cm. This tumor grows very slowly. The difference from cancer is the absence of decay and metastasis, that is, a benign course. A fibroadenoma does not have a true capsule, but during surgery it is easily removed (husked) from the breast tissue.

Multiple fibroadenomas are rare and often gigantic. Such nodes can reach 20 cm in diameter.

If the knot is cut, it can be seen that it has a gray-white color. It contains foci of calcification, hyalinosis (formation of cartilaginous tissue), mucus. When viewed under a microscope, it can be seen that the adenoma consists of a connective tissue base and ducts of the mammary glands. Depending on the ratio of stroma and ducts, histological types of tumors are distinguished:

intracanalicular - the growing stroma compresses the glandular ducts, which turn into slit-like formations;
pericanalicular - gland ducts retain a rounded shape, they are surrounded by dense connective tissue, calcifications and calcification of the node are often formed.

Mixed type tumors are often found.

There is also such a thing as a leaf-shaped, or phyllodes tumor of the mammary gland. It is usually formed from an intracanalicular tumor.

Leaf fibroadenoma differs in the structure of its base - the stroma. It has dividing cells that form layered structures resembling leaves.

Found in women over 40 years of age. It grows rapidly, often occupying a large part of the volume of the mammary gland; often recurs after surgery. This formation tends to become malignant when the dividing stromal cells undergo transformation. The degeneration of a phyllodes tumor into cancer is observed in 10% of cases.

1. Tumor stroma is represented by loose fibrous tissue
2. Glandular tubes are squeezed by the stroma

Diagnostics

In most cases, the pathology is determined by the woman herself or her sexual partner by palpation (palpation) of the breast. Fibroadenoma is felt as a dense, smooth, painless knot, quite mobile, that is, displaced relative to the skin. If you find such a symptom, you should immediately contact a mammologist to rule out breast cancer.

The primary methods of diagnosis are inspection, palpation and ultrasound procedure(ultrasound) of the breast. On ultrasound, signs are usually clearly visible, by which one can first distinguish fibroadenoma from cancer.

It should be said that fibroadenoma with blood flow determined by ultrasound and Doppler sonography is a common condition. If the node exceeds 2 cm in size, the blood flow in it can be determined in 75% of cases. Scientists have proven that the presence of blood flow in the node does not distinguish between fibroadenoma and breast cancer. In small nodules, the blood supply is almost never determined.

Fibroadenoma can also be detected using. This x-ray examination is carried out annually for all women over 40 years of age as part of the medical examination of the population.

A puncture of the node is mandatory, that is, it is punctured with a special needle and biopsy material is taken. The resulting tissue sample is examined under a microscope, excluding malignant degeneration. A more modern and accurate diagnostic method is trephine biopsy. It allows you to get several small "cylinders" from different parts of the tumor and make a more reliable diagnosis. Histological examination fully confirms the disease.

Treatment

Breast fibroadenoma is almost always treated with surgery. Only with very small nodes (up to 5 mm in diameter) can observation be continued. The question of whether or not to remove breast fibroadenoma is decided by the doctor after examination, hormone testing, ultrasound and tissue biopsy.

Is it necessary to remove fibroadenoma before a planned pregnancy or during it? The combination of conditions such as fibroadenoma and pregnancy can lead to malignant degeneration of the tumor. If this does not happen, there may be difficulties in breastfeeding, especially with large sizes of the node or multiple nodes: milk will not flow well through the milk ducts, mastitis will also occur.

Therefore, it is desirable to remove the formation as early as possible, mainly at the planning stage. At rapid growth tumors during childbearing, less traumatic interventions are preferable. However, the question of the scope of the operation, especially during pregnancy, is decided immediately, but only after observation and examination by several specialists. With a small node size, no suspicion of cancer surgical treatment postpone and spend it after the birth of the child and the completion of breastfeeding.

Contraindications for removal:

fever and infectious diseases;
oncological and other serious illnesses;
unwillingness of a woman to undergo surgical treatment;
blood clotting disorders, high arterial hypertension, poorly compensated diabetes mellitus and other conditions, after the correction of which, the operation becomes possible.

Operation and rehabilitation

The operation to remove breast fibroadenoma can be carried out in two fundamentally different ways:

enucleation (husking) - removal of only the nodule itself through a small incision near the nipple;
sectoral resection - removal of a tumor with surrounding tissues in the form of a sector of the gland, more often performed if a malignant transformation is suspected.

Depending on the volume, the surgical intervention is performed using local or intravenous anesthesia. It lasts about an hour. After removal of the tumor, cosmetic sutures are applied to the skin, which allow achieving a good external result.

With a superficial location of the node, confidence in its good quality, it is possible to remove breast fibroadenoma with a laser . This is a low-traumatic operation, accompanied by rapid tissue healing and a good cosmetic effect. In addition to laser therapy, radio wave therapy can be used.

The postoperative period proceeds without complications, the woman does not experience pain. The patient usually leaves the hospital on the same day or the next day after the intervention, the sutures are removed after a week. Mandatory histological examination removed material under a microscope to exclude a cancerous process.

Rehabilitation after removal of fibroadenoma includes a mandatory consultation with a gynecologist. It is desirable to increase the content of animal protein, vegetables in the diet, to refuse fatty foods and allergens (chocolate, citrus fruits, eggs). It is necessary to normalize weight, increase physical activity. Sometimes a consultation with a psychotherapist is required to help a woman realize her illness and cope with its consequences, especially with a large amount of surgery.

If a seal remains after removal, it is necessary to consult a doctor again. This may be a sign of suppuration of the mammary gland, growth malignant tumor or occur with scarring of the suture. In any case, a thorough examination by a specialist is necessary, preferably the doctor who performed the operation.

Small scar after fibroadenoma removal:
1. after surgery
2. a month later

Forecast

At surgical removal the tumor practically does not recur. Can fibroadenoma turn into cancer? Such a possibility exists, although the probability of malignant degeneration is low. Some doctors generally deny such a possibility, others talk about a 20-50% probability. The risk is especially high in the leaf-shaped form of fibroadenoma. The answer to the question of whether education can resolve without treatment depends on many conditions. More often, immature fibroadenomas in girls resolve on their own after the final establishment. menstrual cycle. In mature women, such a tumor will not go away without treatment, but will slowly increase in size.

Prevention

Since the true causes of the development of the disease are unknown, there are no specific preventive measures. To prevent the development of tumor processes, it is recommended to eat well, avoid strong emotional upheavals and chronic nervous strain, protect your mammary glands from bruises. It is recommended to limit visits to the solarium and natural tanning during the daytime.

It is important to periodically conduct self-examination of the mammary glands. It is performed by a woman in front of a mirror 7-10 days after the onset of menstruation, when the mammary gland is painless. Pay attention to the symmetry of the glands, the surface of the skin, supraclavicular and axillary areas, areola and nipple. Then the entire gland is superficially probed in a spiral or from the center along the radii outward. After that, a deeper probing of the entire tissue of the gland is carried out. It is convenient to do this by lubricating your hands with cream or lotion. You can conduct a self-examination of the glands and in the shower, lathering the skin. The main thing is to do it regularly. Such a measure will help to recognize both fibroadenoma and malignant processes in time.

It is necessary to treat everything in time gynecological diseases, including menstrual irregularities and. It is known that with these diseases, the likelihood of developing fibroadenoma increases. Thus, regular visits to the gynecologist and self-examination become the key to a woman's health.

One of the most dangerous neoplasms that can develop in the tissues of the mammary gland is leaf-shaped fibroadenoma, or, as it is also called, phyllodes tumor. It should immediately be noted that this pathology in the vast majority of cases is diagnosed in women. However, men are also not immune from this, although such a neoplasm is very rarely detected in them.

Leaf-shaped fibroadenoma - features, symptoms and treatment

In medicine, there are 3 forms of this pathology:

benign;
intermediate;
malignant.

The size of the tumor is from 1 to 35 centimeters. It should be noted that a benign neoplasm may well progress into a malignant one over time. Therefore, it is very important that treatment is started on time. If the pathology progresses to malignant, then metastases affect the lungs and bone tissue, and also so important for human body organ like the liver.

In medicine, there is currently no consensus on the exact causes of pathology. It is believed that this may be triggered by impaired estrogen performance and decreased progesterone levels. In addition, there are also certain factors that contribute to the development of such a neoplasm. These are, for example, the changes that have occurred in the body during periods of pregnancy and lactation. In addition, favorable conditions for the development of leaf-shaped fibroadenoma are created after repeated abortions.

This should also include pathologies such as ovarian and thyroid tumors, diabetes mellitus, fibrocystic mastopathy, processes that disrupt the hormonal balance of the body. Often, a neoplasm develops in women who have excess weight. contributing factor It could also be uterine fibroadenoma.

At the very initial stage of its development, neoplasms do not manifest themselves in any way. Leaf-shaped fibroadenoma has the ability to be latent for quite a long time. The development of a neoplasm begins when conditions favorable for this appear in the body. If we talk directly about the symptoms that such a neoplasm manifests itself, then here, first of all, it is necessary to highlight the appearance of pain in the chest area. In addition, large tumors are clearly felt on palpation. The neoplasm is elastic to the touch, having a smooth surface.

The veins under the skin can increase in size, and as the pathology develops, this will become more and more noticeable. There is weakness, fatigue, a general deterioration in well-being. Another symptom that you should definitely pay attention to is the appearance of discharge from the nipple of the breast where the tumor develops. Often, a neoplasm makes itself felt by a lack of appetite, anemia, and an increase in body temperature.

An accurate diagnosis requires a comprehensive examination. First of all, the doctor must examine the patient, listen to his complaints. Palpation will be very informative in this case. With its help, you can directly detect the seal, as well as set the number of nodes and the size of the neoplasm. However, it is impossible to make an accurate diagnosis on this basis alone. To confirm the suspicions, the patient is sent for an ultrasound. In addition, you need to undergo a procedure such as a puncture biopsy followed by cytological examination taken material. Dopplerography and mammography are very informative diagnostic methods here.

Each of these procedures has specific goals. In particular, ultrasound is needed to detect the presence of a hypoechoic compound. If an operation is planned, then a cytological assessment of the neoplasm will be required before surgery. With the help of mammography, the doctor gets an accurate idea of the shape and structure of the tumor, as well as the intensity of its development. In order to identify the network of arteries and veins surrounding the fibroadenoma, the patient is sent for dopplerography.

After studying the results of the examination, the doctor must decide on the therapy. It should be noted that in the event that the size of the tumor is insignificant (no more than 1 centimeter), then urgent treatment in such a situation is not required. Regular examinations are quite enough here, which will help to timely identify the beginning of the growth process of the neoplasm - if, of course, one begins. In this case, the patient must strictly follow all the recommendations of the doctor.

If the tumor begins to grow in size, then enucleation is required, during which the surgeon exfoliates the tumor. The variant with the use of quadrantectomy is not excluded. This procedure consists in removing the neoplasm, and this is done together with the fourth part of the mammary gland. If the examination showed that the neoplasm is malignant, then there will be only one possible treatment option - surgery. In this case, the surgeon performs an operation using the resection method, which involves the removal of not only the tumor, but also the soft tissues adjacent to it.

This neoplasm has a tendency to relapse. It is difficult to predict the time when the tumor will reappear after the treatment. Sometimes it happens in a month, in some cases it takes several years. There are situations when, after a relapse, a neoplasm degenerates into a cancerous tumor. In such a situation, the patient is referred for urgent surgery, during which both the malignant neoplasm and the mammary gland are removed. Treatment options such as lymphadenectomy and radiation therapy for fibroadenoma foliaceus are generally not used. However, there may well be exceptions.