乳房纖維腺瘤 | Fibroadenoma
乳房纖維腺瘤
1. 什麼是纖維腺瘤？
纖維腺瘤是一種非常常見的良性（非癌症）乳腺疾病。
纖維腺瘤通常發生在青春期，所以多見於年輕女性，但也可發生在任何年齡的女性。男性也可以得纖維腺瘤，但這是非常罕見的。
2. 纖維腺瘤症狀
纖維腺瘤通常被認為是乳房中的一個腫塊，摸上去很光滑，在皮膚下很容易移動。
纖維腺瘤通常是無痛的，但有時他們可能會感到柔軟，甚至疼痛，特別是在月經前。
3. 纖維腺瘤類型
單純性纖維腺瘤
大多數纖維腺瘤大小約1-3釐米，稱為單純性纖維腺瘤。當在顯微鏡下觀察時，單純性纖維腺瘤全身看起來都一樣。
單純性纖維腺瘤不會新增將來患乳腺癌的風險。
複雜纖維腺瘤
一些纖維腺瘤被稱為複合纖維腺瘤。當在顯微鏡下觀察這些細胞時，有些細胞有不同的特徵。
患有複雜的纖維腺瘤會略微新增將來患乳腺癌的風險。
巨大或幼年纖維腺瘤
有時，纖維腺瘤可以長到5釐米以上，可以稱為巨大纖維腺瘤。在少女身上發現的那些可能被稱為青少年纖維腺瘤。
4. 纖維腺瘤的病因
纖維腺瘤的病因尚不清楚。有人認為這可能是因為對雌激素的敏感性新增。
乳房由小葉（產奶腺）和導管（將牛奶輸送到乳頭的導管）組成。周圍有腺體、纖維組織和脂肪組織。這種組織賦予乳房大小和形狀。
纖維腺瘤由小葉發展而來。腺體組織和導管生長在小葉上形成一個實性腫塊。
5. 診斷
如果你發現一個乳房腫塊，看你的家庭醫生。他們可能會把你推薦到乳腺診所，在那裡你會被專業醫生或護士看病。
在乳腺診所你要做一系列的檢查。這些可能包括：
乳房x光片
超聲波掃描（利用聲波產生影像）
覈心活組織檢查（用空心針取乳腺組織樣本在顯微鏡下觀察）
細針抽吸（FNA）（使用細針和注射器採集細胞樣本，在顯微鏡下觀察）
纖維腺瘤在年輕女性中往往更容易識別。如果你在20出頭或更小，你的纖維腺瘤可以通過乳房檢查和超聲波診斷。但是，如果對診斷有任何不確定的地方，可以做活檢或細針穿刺。
如果你不到40歲，你更有可能做超聲波檢查而不是乳房X光檢查。年輕女性的乳腺組織可能很緻密，這會使x光影像不那麼清晰，所以正常變化或良性乳腺疾病可能更難識別。然而，對於一些40歲以下的女性來說，可能仍然需要乳房X光片來完成評估。
6. 治療和隨訪
在大多數情况下，如果你患有纖維腺瘤，你不需要任何治療或隨訪。通常你只會被要求回到你的家庭醫生或乳腺診所，如果它變得更大或你注意到一個變化。
大多數纖維腺瘤大小相同。有些會變小，有些會隨著時間的推移而消失。少數纖維腺瘤變大，尤其是少女。纖維腺瘤在懷孕和哺乳期間或接受激素替代療法（HRT）時也會變大，但通常在之後又會變小。
外科
如果纖維腺瘤是大的、複雜的或幼年的纖維腺瘤，有時需要做手術，稱為切除活檢。你也可以要求切除纖維腺瘤。這通常是在全身麻醉下進行的。
您的外科醫生可能會使用可溶解的縫線放置在皮膚下，這將不需要删除。但是，如果使用不溶性縫線，手術後一周左右需要取出。在你離開醫院之前，你會得到關於照顧傷口的資訊。
真空輔助（VAC/VAB）切除活檢
你可能會被提供一個真空輔助切除活檢切除纖維腺瘤。這是一種在局部麻醉下切除小纖維腺瘤的方法，無需在全身麻醉下進行手術。
注射局部麻醉劑後，皮膚上會有一個小切口。一個連接到真空裝置的空心探針通過這個放置。利用超聲波作為引導，纖維腺瘤被真空通過探頭吸入收集室。活檢裝置是這樣使用的，直到所有纖維腺瘤已被删除。這可能意味著手術可以避免。
這個過程可能會導致一些瘀傷和疼痛後幾天。切除纖維腺瘤通常不會影響乳房的形狀，但在切除的地方可能會有輕微的凹痕。
7. 保持乳房意識
對大多數女性來說，纖維腺瘤不會新增患乳腺癌的風險。
如果你被診斷出患有複雜的纖維腺瘤，你可能會擔心你的風險會略微新增。然而，這並不一定意味著你將來會患乳腺癌。
重要的是要繼續保持對乳房的警惕，如果你注意到你的乳房有任何變化，就回到你的家庭醫生那裡去，不管你被診斷為纖維腺瘤後多久這些變化就會發生。(1)
1. What is a fibroadenoma?
A fibroadenoma is a very common benign (not cancer) breast condition.
Fibroadenomas often develop during puberty so are mostly found in young women, but they can occur in women of any age. Men can also get fibroadenomas, but this is very rare.
2. Symptoms of fibroadenoma
A fibroadenoma is usually felt as a lump in the breast which is smooth to the touch and moves easily under the skin.
Fibroadenomas are usually painless, but sometimes they may feel tender or even painful, particularly just before a period.
3. Types of fibroadenoma
Simple fibroadenoma
Most fibroadenomas are about 1–3cm in size and are called simple fibroadenomas. When looked at under a microscope, simple fibroadenomas will look the same all over.
Simple fibroadenomas do not increase the risk of developing breast cancer in the future.
Complex fibroadenoma
Some fibroadenomas are called complex fibroadenomas. When these are looked at under a microscope, some of the cells have different features.
Having a complex fibroadenoma can very slightly increase the risk of developing breast cancer in the future.
Giant or juvenile fibroadenoma
Occasionally, a fibroadenoma can grow to more than 5cm and may be called a giant fibroadenoma. Those found in teenage girls may be called juvenile fibroadenomas.
4. Causes of fibroadenoma
It’s not known what causes a fibroadenoma. It’s thought that it probably occurs because of increased sensitivity to the hormone oestrogen.
Breasts are made up of lobules (milk-producing glands) and ducts (tubes that carry milk to the nipple). These are surrounded by glandular, fibrous and fatty tissue. This tissue gives breasts their size and shape.
Fibroadenomas develop from a lobule. The glandular tissue and ducts grow over the lobule and form a solid lump.
5. Diagnosis
If you find a breast lump, see your GP. They’re likely to refer you to a breast clinic where you’ll be seen by specialist doctors or nurses.
At the breast clinic you’ll have a range of tests. These may include:
- A mammogram (breast x-ray)
- An ultrasound scan (using sound waves to produce an image)
- A core biopsy (using a hollow needle to take a sample of breast tissue to be looked at under a microscope)
- A fine needle aspiration (FNA) (using a fine needle and syringe to take a sample of cells to be looked at under a microscope)
Fibroadenomas are often easier to identify in younger women. If you’re in your early 20s or younger, your fibroadenoma may be diagnosed with a breast examination and ultrasound only. However, if there’s any uncertainty about the diagnosis, a core biopsy or FNA will be done.
If you’re under 40, you’re more likely to have an ultrasound than a mammogram. Younger women’s breast tissue can be dense which can make the x-ray image less clear so normal changes or benign breast conditions can be harder to identify. However, for some women under 40, mammograms may still be needed to complete the assessment.
You can call our free Helpline on 0808 800 6000 if you’d like more information about any tests you may be having.
6. Treatment and follow-up
In most cases you’ll not need any treatment or follow-up if you have a fibroadenoma. Usually you’ll only be asked to go back to your GP or the breast clinic if it gets bigger or you notice a change.
Most fibroadenomas stay the same size. Some get smaller and some eventually disappear over time. A small number of fibroadenomas get bigger, particularly those in teenage girls. Fibroadenomas can also get bigger during pregnancy and breastfeeding or while taking hormone replacement therapy (HRT), but usually reduce in size again afterwards.
Surgery
Sometimes an operation, called an excision biopsy, is needed to remove a fibroadenoma if it’s a large, complex or juvenile fibroadenoma. You can also ask to have a fibroadenoma removed. This is usually performed under general anaesthetic.
Your surgeon may use dissolvable stitches placed under the skin which will not need to be removed. However, if a non-dissolvable stitch is used, they’ll need to be taken out about a week after surgery. You’ll be given information about looking after the wound before you leave hospital.
Vacuum assisted (VAC/VAB) excision biopsy
You may be offered a vacuum assisted excision biopsy to remove the fibroadenoma. This is a way of removing small fibroadenomas under local anaesthetic, without having an operation under general anaesthetic.
After an injection of local anaesthetic, a small cut is made in the skin. A hollow probe connected to a vacuum device is placed through this. Using an ultrasound as a guide, the fibroadenoma is sucked through the probe by the vacuum into a collecting chamber. The biopsy device is used in this way until all of the fibroadenoma has been removed. This may mean that surgery can be avoided.
The removed tissue is sent to a laboratory and examined under a microscope.
This procedure can cause some bruising and pain for a few days afterwards. Removing a fibroadenoma does not usually affect the shape of the breast, but there may be a slight dent in the breast where it has been removed.
7. Staying breast aware
For most women, having a fibroadenoma does not increase the risk of developing breast cancer.
If you were diagnosed with a complex fibroadenoma, you may be worried that your risk is very slightly increased. However, this does not necessarily mean you’ll develop breast cancer in the future.
It’s important to continue to be breast aware and go back to your GP if you notice any changes in your breasts, regardless of how soon these occur after your diagnosis of a fibroadenoma.(1)
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