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EPITHELIAL TUMORS OF THE BREAST: UNDERSTANDING FIBROADENOMAS AND ADENOMAS

 

INTRODUCTION:

Epithelial tumors of the breast are common, non-cancerous growths that arise from the epithelial tissue of the breast. Two prevalent types of epithelial tumors are fibroadenomas and adenomas. While these tumors are typically benign, it is important to understand their characteristics, symptoms, diagnostic methods, and appropriate management to ensure optimal breast health. This article aims to provide an overview of fibroadenomas and adenomas, their features, and clinical implications.

 

FIBROADENOMAS:

Fibroadenomas are the most common benign tumors found in the breast, predominantly affecting young women. They arise from a combination of glandular tissue and fibrous connective tissue. Fibroadenomas are typically well-defined, solid masses that can vary in size. They are not associated with an increased risk of developing breast cancer.

 

Characteristics:

1. SIZE AND CONSISTENCY: Fibroadenomas can range in size from a few millimeters to several centimeters. They are usually smooth, firm, and movable upon palpation.

 

2. AGE DISTRIBUTION: Fibroadenomas most commonly occur in women between the ages of 15 and 35, although they can be seen in older individuals as well.

 

3. HORMONAL INFLUENCE: These tumors are known to be influenced by hormones, and their growth may be affected by hormonal fluctuations during the menstrual cycle or pregnancy.

 

Symptoms and Diagnosis:

1. Palpable Mass: The most common symptom of a fibroadenoma is the presence of a painless, mobile lump in the breast.

 

2. Imaging Techniques: Mammography, ultrasound, and occasionally magnetic resonance imaging (MRI) are used to evaluate the characteristics and location of the fibroadenoma. Imaging can help differentiate it from other breast abnormalities.

 

3. Fine-needle aspiration cytology (FNAC): If needed, a small needle may be used to extract a sample of cells from the fibroadenoma for microscopic examination. This procedure helps to confirm the diagnosis and rule out any potential malignancy.

 

Management:

1. Observation: Small, asymptomatic fibroadenomas may be left under observation without intervention, especially in younger women, as they often regress over time.

 

2. Surgical Excision: Larger or symptomatic fibroadenomas may be surgically removed for diagnostic purposes or if the patient desires it for cosmetic reasons or anxiety reduction.

 

                                            

ADENOMAS:

Breast adenomas are less common benign tumors that arise from the glandular epithelial cells of the breast. They are typically small and well-circumscribed.

 

Characteristics:

1. Size and Consistency: Adenomas are usually small, measuring less than 2 cm in diameter. They are firm and well-defined, similar to fibroadenomas.

 

2. Hormonal Influence: Similar to fibroadenomas, hormonal influences may play a role in the development and growth of adenomas.

 

Symptoms and Diagnosis:

1. Palpable Mass: The presence of a painless, movable lump is the primary symptom of breast adenomas.

 

2. Imaging and Biopsy: Similar to fibroadenomas, imaging techniques such as mammography, ultrasound, and FNAB may be utilized to evaluate and confirm the diagnosis.

 

Management:

1. Surgical Excision: Adenomas are often surgically removed, primarily for diagnostic purposes to rule out any malignancy and to alleviate symptoms or concerns.

 

Knowledge Note:

Understanding the characteristics, symptoms, and diagnostic methods of fibroadenomas and adenomas is crucial for appropriate management and ensuring breast health. While both tumors are typically benign, medical evaluation and consultation are necessary to confirm the diagnosis and determine the most suitable course of action. Regular breast self-examinations,

 

EPITHELIAL TUMOURS OF THE BREAST

 

Fibro-adenomas are rare before puberty, but are the commonest mammary (a) Age and sex incidence tumours between then and the twenty-hith or thirtieth year. Most of them are discovered during this period, but some, especially those with predominant intra-canalicular structure, do not appear until later. The large intra-canalicular tumours are seen usually in middle-aged or elderly people, though there has often been a long history of an enlarging lump.

Fibro-adenomas are very rare in the male breast; Cheatle and Cutler cite recorded cases: Scarff and Smith record 4 examples in a series of 65 mammary lesions in males.

 

Fibro-adenomas in animals (Knowledge Note)

 

These growths have rarely been observed in any species of mammals other than dogs and rats, in both of which however they occur frequently. (i) Dogs.-Mammary fibro-adenomas are common in bitches of most breeds

(Feldman, Schlotthauer,). They are usually found in middle-aged or old animals, but are often known to have been present for some years or are large tumours clearly of long duration when first noticed. They are often multiple in several of the mammae, are often associated with cystic hyperplastic changes, and sometimes carcinomatous changes supervene in them. In the 17 dogs with fibro-adenomas studied by Rudduck and me, the animals ranged in age from 6 to 12 years; the tumours ranged from 1 to 11 centimetres in diameter, were multiple in 5 cases, and showed supervening carci- noma in 2 cases. The microscopical appearances of cartilage may be simulated by epithelial cells scattered in mucinous secretion, as in the pleomorphic tumours of salivary glands; but true cartilage or bone often develops by metaplasia in the fibromatous tissue of the tumours. Cartilage or bone was present in 6 of our 17 cases, and in one case haemopoietic marrow had developed in a mass of bone. Apart from the frequent presence of these metaplastic tissues, the canine tumours are in most respects similar in structure to the human ones.

(ii) Rats.-Fibro-adenomas are the most frequent mammary tumours in rats. Different tumours contain the glandular and fibromatous components in all possible relative propor- tions, from nearly pure adenoma to pure fibroma. The tumours are transplant- able, and by successive transplantation the epithelial component suffers elimina- tion from some tumours, leaving pure fibroma, and in some instances this becomes sarcomatous .

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