Management Of Fibroadenoma Research Articles

Metformin as a new option in the medical management of breast fibroadenoma; a randomized clinical trial

BackgroundFibroadenoma (FA) is the most common benign solid breast mass in women, with no definite method of management. Because fibroadenoma is dependent on female sex hormones and comprises hypertrophic changes at cellular levels, we investigated the effects of metformin (MF), a safe hypoglycemic agent with anti-estrogenic and anti-proliferative properties, in the management of fibroadenoma.MethodsIn this randomized clinical trial study, eligible women with fibroadenomas were assigned randomly to the metformin (1000 mg daily for six months) or the placebo group. Breast physical and ultrasound exam was performed before and after the intervention, and the changes in the size of fibroadenomas were compared in the two groups.ResultsOverall, 83 patients in the treatment, and 92 in the placebo group completed the study. A statistically significant difference in changing size between the two groups was observed only in the smallest mass. In the largest FAs, the rate of size reduction was higher in the treatment group (60.2 % vs. 43.5 %); while a higher rate of enlargement was observed in the placebo group (38 % vs. 20.5 %). In the smallest FAs, the rate of the masses that got smaller or remained stable was about 90 % in the treatment group and 50 % in the placebo group. We categorized size changes of FAs into < 20 % enlargement and ≥ 20 % enlargement. The odds ratio (OR) for an elargemnt less than 20% was 1.48 (95 % CI = 1.10–1.99) in the treatment group in comparison with the placebo group; the odds for an enlargement less than 20% was higher in women with multiples fibroadenomas (OR = 4.67, 95 % CI: 1.34–16.28). In our study, no serious adverse effect was recorded, and the medicine was well-tolerated by all users.ConclusionsThis is the first study that evaluates the effect of MF on the management of fibroadenoma, and the results suggest a favorable effect. Larger studies using higher doses of MF and including a separate design for patients with single or multiple FAs are suggested in order to confirm this effect.Trial registrationThis trial (IRCT20100706004329N7) was retrospectively registered on 2018-10-07.

Homoeopathic Management of Breast Fibroadenoma—An Open Label, Single Arm, Observational Trial

Abstract Background Fibroadenoma of breast is the commonest ailment of women with significant morbidity. Available literature revealed that breast tumour recedes by homoeopathic treatment.The present study evaluated the role of homoeopathic treatment on breast fibroadenoma by using ‘Triple assessment criteria’ and to explore the mechanism, whether homoeopathic medicines bring their therapeutic effect by altering the oestrogen and progesterone receptor (ER/PR) status on tumour tissue. Materials and Methods An open label, prospective, single arm, observational study was conducted on 64 female patients having fibroadenoma of breast. Triple assessment criteria were used to explore the effectiveness of homoeopathic treatment on breast fibroadenoma. Individualised homoeopathic medicines were prescribed. The outcome measures were changes in clinical picture, number and size of lump by ultrasonomammography. ER/PR study was performed by immunohistochemistry using quick score analysis. Results Post-treatment response of 23 cases (35.93%) of fibroadenoma revealed disappearance of lump. Partial improvement was noticed in 22 cases (34.37%) with significant reduction in mean size (p &lt; 0.001). Similarly significant reduction in number of lesions was seen in fibroadenoma (p &lt;0.05). Conium maculatum and Phytolacca decandra were found to be the most useful remedies. Quick score value of ER after treatment showed significant reduction (Z = 4.910). Conclusion The study revealed that the therapeutic effects of individualised homoeopathic medicines play significant role in management of fibroadenoma of breast. The results of ER/PR show significant reduction in ER suggesting that homoeopathic medicines have some inhibitory effect on ER.

Diagnosis and management of fibroadenomas in the adolescent breast.

Fibroadenomas are benign breast masses that can present a management challenge in adolescent populations. Most fibroadenomas may be managed conservatively without surgery, but those masses that are symptomatic or increasing in size may require surgical excision. In adolescents, the implications of surgical intervention in the breast are unclear, and there is little outcomes data. In this article, the authors discuss the presentation, diagnosis, and management of fibroadenoma in adolescents. Key considerations for physicians in treating these masses in this population are reviewed.

Fibroadenomas in adolescence

Fibroadenomas are the most common breast masses in adolescent women, therefore it is important that health providers understand their assessment and management. This review discusses an approach to investigation and management of fibroadenomas in adolescents. Fibroadenomas are benign tumors which commonly present in late adolescence. They are classified according to their histology and size. Simple fibroadenomas are the most common type and usually present as smooth mobile masses up to 3 cm in diameter. Giant fibroadenomas are more uncommon but typically present in adolescence. Fibroadenomas associated with other soft-tissue masses should raise the possibility of an inherited syndrome. Assessment of breast masses in this age group generally involves clinical assessment through history and physical examination and, when imaging is needed, ultrasonography. As the incidence of primary breast malignancy is very low in this age group, core biopsy is not routinely recommended. Large or rapidly growing tumors, or those associated with suspicious features, warrant surgical excision. New minimally invasive excision techniques are being introduced which are associated with high initial success rates. Whereas the vast majority of fibroadenomas in teenagers may be monitored with surveillance alone, new minimally invasive techniques may play an important role in the management of selected patients.

An audit reviewing the management of fibroadenomas with the advent of Mammotome in the breast unit in Bradford

Fibroadenomas are the commonest benign breast tumours. Prior to vacuum-assisted large-volume biopsy, surgical excision was the only therapeutic option available. Our unit introduced Mammotome (Ethicon Endo-Surgery, Cincinnati, OH, USA) in January 2006, with Mammotome excision offered from September 2006 (for lesions 25 mm or less). We reviewed the change in practice with the advent of Mammotome. Patients with histological diagnosis of fibroadenoma throughout 2006 and 2007 were identified. The radiology and histology were reviewed. A total of 355 fibroadenomas were diagnosed in 333 patients: 252 presented symptomatically, 81 were screen-detected. Thirty-five diagnostic Mammotomes were performed (33 had been nondiagnostic on needle-core biopsy, two had radiology/pathology discordance). Definitive diagnosis was consequently made in 34 cases. One patient with nondiagnostic Mammotome had subsequent surgical biopsy of benign fibroadenoma. Seventy patients underwent excision. Fifteen were ultrasound Mammotome excisions; 13 confirmed fibroadenoma and two were phylloides (having surgical cavity excision subsequently). Fifty-five were surgical excisions; 33 were either unsuitable for Mammotome excision or the patient chose surgery; 11 were B2/B3 lesions and pathology recommended surgical excision; and the remaining 11 were before the introduction of Mammotome excision. Mammotome offers patient choice regarding excision of fibroadenomas, and reduces the number of surgical biopsies.

Fine needle aspiration biopsy in the diagnosis and management of fibroadenoma of the breast

Cytological and histological biopsies were obtained on 75 breast lumps clinically diagnosed as fibroadenomas. Of these, 95 per cent of lesions were benign. In 51 (68 per cent) confirmed as fibroadenomas histologically, cytology was benign in 78 per cent, but inadequate for diagnosis in 16 per cent. The remaining 24 lesions included three breast cancers and one lymph node with Hodgkin's disease. In this group cytology was inadequate for diagnosis in 54 per cent, including one breast cancer. No lesion with benign cytology was subsequently shown to be malignant. The study supports the view that clinical diagnosis and cytology are accurate in the diagnosis of benign breast disease of this type. Breast cancer may rarely present with the clinical features of a fibroadenoma and too few lesions have been studied to assess fully the performance of cytological biopsy in detecting these small mobile lesions. A non-excisional policy should therefore include prolonged follow-up and repeat biopsy.