Posted by jayaram in This common benign neoplasm occurs most frequently in young women, usually within 20 years after puberty. It is somewhat more frequent and tends to occur at an earlier age in black than in white women. Multiple tumors in one or both breasts are found in 10-15% of patients.
The typical Fibroadenoma is a round, firm, discrete, relatively movable, nontender mass 1-5cm in diameter. The tumor is usually discovered accidentally. Clinical diagnosis in young patients is generally not difficult. In women over 30, cystic disease of the breast and carcinoma of the breast must be considered. Cysts can be identified by aspiration. Fibroadenoma does not normally occur after the menopause, but postmenopausal women may occasionally develop Fibroadenoma after administration of estrogen.
Treatment is by excision under local anesthesia as an outpatient procedure, with pathologic examination of the specimen.
Cystosarcoma phyllodes is a type of Fibroadenoma with cellular stroma that tends to grow rapidly. This tumor may reach a large size and if inadequately excised will recur locally. The lesion is rarely malignant. Treatment is by local excision of the mass with a margin of surrounding breast tissue. The treatment of malignant cystosarcoma phyllodes is more controversial. In general, complete removal of the tumor and a rim of normal tissue should avoid recurrence. Since these tumors may be large, simple mastectomy is sometimes necessary to achieve complete control.