What Is Surgery – Benign Tumor in Breast

What Is Surgery – Benign Tumor in Breast 

DEFINITION 
Physiopathological lesions of the epithelial, stromal, fat, or vascular components of the breast, also known  as non-malignant diseases of the breast. 

Fibroadenoma: A fibroadenoma is a benign tumour that develops from the hyperplasia of a breast lobule and contains both epithelial and connective tissue features. Irregular and necrotic adipocytes, amorphous debris, and inflammatory cells, including foreign body giant cells, can all be mistaken for cancer in fat necrosis. 

Sclerosing adenosis is a type of involution that is abnormal. When central ducts become dilated with duct secretions, duct ectasia occurs. 
If leakage occurs into periductal tissue, an inflammatory reaction occurs (periductal mastitis). 

AETIOLOGY 
Under endocrine regulation, breast tissue undergoes a variety of alterations. Fat necrosis is a complication of trauma. The ANDI classification (aberrations of normal development and involution) organises benign disorders by aetiology and degree of abnormality. 
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RISK FACTORS/ASSOCIATIONS It's possible that those who take the contraceptive pill have a lower risk. Periductal mastitis can be caused by smoking. 

EPIDEMIOLOGY Only 10–20 percent of cases are histologically diagnosed,Diffuse fibrocystic alterations are highly frequent, affecting up to 60% of women, and 70% of them suffer from mastalgia. 

Fibroadenomas are more prevalent in women between the ages of 15 and 25, whereas breast cysts are more common in women between the ages of 40 and 50, and both vanish after menopause unless they are treated with hormone replacement therapy (HRT). 

HISTORY
Breast discomfort or pain (cyclical or non-cyclical mastalgia), edoema, or lump are all possible symptoms. Nipple discharge (malignancy should be detected if blood is seen). Family history, menstruation history, pregnancies, and use of OCP or hormone replacement treatment are all risk factors for breast cancer that should be ascertained. 

EXAMINATION 
Breast nodularity, either focal or widespread. Smooth, well-circumscribed, movable lumps (1–2 cm in diameter, 'breast mouse') are typical of fibroadenomas. Nipple discharge (yellow/green) (duct ectasia). Dimpling, peau d'orange skin alterations, and enlarged axillary lymph nodes are not present, indicating no malignancy. 

INVESTIGATIONS
Usually used in conjunction with a triple assessment: 1. A clinical examination is performed. 2. Mammography (craniocaudal and oblique mediolateral views with spot compression and magnification) or USS in younger patients (under 35 years). Calcification is less common in benign tumours (microcalcifications are highly indicative of malignancy). MRI scanning is also a viable option. 3. Cytology/histochemistry: FNA (fine-needle aspiration) cytology, trucut or excision biopsy 

MANAGEMENT
 Conservative: Mastalgia is treated with symptomatic treatments such as analgesics and evening primrose oil (a rich source of gammalinoleic acid). Wearing a supportive bra and eating a healthy diet are two suggestions (reduced dietary fat). Danazol is a therapy that is used as a last resort. (17-a-ethinyl testosterone inhibits ovarian steroid synthesis, reduces gonadotropin production, and stops LH surge). 
Fibroadenomas can be handled conservatively or surgically removed if they are large or if the patient requests it. Simple cysts do not require aspiration unless clinically indicated, and should dissolve fully after aspiration. If it's not a breast lump, it should be handled as such. 

Surgery: Removal or excision biopsy of a breast mass; if there is any suspicion that it is not benign, a wide local excision should be performed. 
Intraductal papillomas are treated with microdochectomy. In duct ectasia, Hadfield's (or Adair's) procedure excises central ducts. 

COMPLICATIONS 
Recurrence of pain. 

PROGNOSIS 
Although recurrence is common, this is a good result. Fibroadenomas: In women with simple FA, there is no increased risk of cancer, and there is no increased family history of breast cancer.