Breast fibrolipoma is a benign tumor consisting of fatty and fibrous tissue. It usually occurs in women over 40 years of age. It is a dense, mobile, painless node that is not soldered to the skin and underlying tissues. The course is long, asymptomatic. When enlarged, it can cause visible deformation of the breast. Calcification is possible. Malignancy is rarely observed. The basis for the diagnosis is the examination data, the results of mammography, ultrasound of the breast and other studies. The treatment is surgical. With small fibrolipomas that do not cause a cosmetic defect, they are sometimes limited to observation
D24 Benign breast neoplasm
Breast fibrolipoma is a type of lipoma, a benign neoplasm consisting of fatty and connective fibrous tissue. It is more often diagnosed in the preclimacteric or menopausal period. It is less common in young girls. It usually happens alone. Sometimes multiple lipomas located in different parts of the body (lipomatosis) are detected.
Malignancy is rarely observed, characterized by a long course, breast fibrolipoma can exist for years or even decades without increasing or slightly increasing in diameter. The highest risk of malignancy is noted with intensive growth of fibrolipomas in the preclimacteric period. The treatment is carried out by specialists in the field of surgical mammology.
The causes of fibrolipoma are not precisely established. Some researchers believe that the neoplasm occurs as a result of disorders of embryogenesis (intrauterine formation of atypical adipose tissue cells in the breast area). Other scientists believe that the main factor in the development of the disease are systemic metabolic disorders. In addition, experts focus on the possible connection of breast fibrolipoma with changes in the hormonal background – in favor of such a connection is evidenced by the frequent manifestation of the disease during hormonal restructuring of the body (in menopause or preclimax).
Among other factors contributing to the development of fibrolipoma, diseases of the pituitary gland, thyroid gland, liver and pancreas are indicated. There are assumptions that the risk of breast fibrolipoma increases with alcoholism, diabetes mellitus, living in unfavorable environmental conditions and prolonged psycho-emotional stress. In some cases, a hereditary predisposition is revealed.
The disease develops more often in women over 40 years of age. It can be asymptomatic for a long time, it is first detected during the next self-examination or examination by a mammologist. When located deep in the breast, small nodes are sometimes not palpable, the tumor is detected only during routine ultrasound or mammography. Breast fibrolipoma is a dense, elastic, painless mobile neoplasm. The node is not soldered to the surrounding tissues, the skin above the tumor is not changed.
The diameter of the breast fibrolipoma varies from 1-2 to 10 centimeters or more. Large neoplasms cause visible deformation of the breast. With a prolonged course, calcium salts can be deposited in the thickness of the tumor. In such cases, the node acquires cartilaginous density, pain and discomfort may occur when wearing a bra and pressure on the affected area.
The growth rate varies significantly. Some fibrolipomas of the breast have existed for years, practically not increasing in size, others show signs of rapid growth. Rapid tumor enlargement, especially in women of premenopausal and menopausal age, indicates an increased risk of malignancy.
The diagnosis is established on the basis of anamnesis, external examination and additional research data. In favor of the benign nature of the neoplasm is evidenced by the mobility of the node, unchanged skin and the absence of adhesions with surrounding tissues. The presence of fibrous tissue can be assumed based on the dense elastic consistency of the tumor.
Mammography and ultrasound of the breast are used to confirm the diagnosis. In doubtful cases, a breast CT scan, thermomammography and a blood test for cancer markers are prescribed. While maintaining diagnostic difficulties, a breast biopsy is performed.
Treatment of breast fibrolipoma is operative. Absolute indications for surgical intervention are:
- rapid tumor growth;
- the presence of a significant cosmetic defect;
- pain and discomfort caused by calcification of the neoplasm.
In addition, breast fibrolipoma is recommended to be removed during pregnancy planning in order to avoid possible growth of the node against the background of changes in hormonal status and to prevent problems during lactation.
Usually, tumor enucleation is performed. If a malignant degeneration is suspected, a sectoral resection of the breast is possible. For small nodes, the decision on the operation is made individually. In the absence of growth, long-term observation is possible. Patients with breast fibrolipoma are recommended to regularly visit a mammologist and undergo mammography. Conservative therapy using resorption drugs is ineffective.
Prognosis and prevention
The prognosis is favorable. With complete removal, fibrolipoma is not prone to recurrence. In the case of tumor malignancy, the prognosis depends on the time of its detection and the possibility of radical treatment. Specific preventive measures have not been developed. To minimize the risks of developing benign neoplasms of the mammary glands, timely treatment of endocrine pathologies and annual mammological screenings are necessary.