Comprendre l’adénofibrome du sein : symptômes, diagnostic et traitement

Sein’s adenoma is a lesion that consists of glands, lactation that are enclosed in a pocket, giving it a particular hardness. Breast adenofibroma is extremely common and very frequent, it can occur following an emotional shock or local trauma or even as a result of a hormonal imbalance between the progesterone and the estrogens secreted by all women still menstruating. The predominant age of the adenofibroma varies between 15 and 35 years.

Adenofibroma appears as a small swelling that the patient feels on her breast, quite close to the skin, sometimes deeper.

The diagnosis causes a certain astonishment and sometimes anxiety, but it is a relatively soft, indolent benign tumor that does not contract adhesion with the surroundings, nor does it deform the surface of the breast. Clinical examination, mammography, and ultrasound provide formal evidence, ruling out a cyst that is hollow on additional examinations, and other sometimes calcified tumors that could suggest a more worrying histology. In relatively rare cases, adenofibroma can become large, sometimes reaching the size of a lemon!

Evidently, this form of adenofibroma justifies surgical intervention to remove it. This is quite simple in practice, as the adenofibroma is surrounded by a membrane that allows for cleavage without creating too much damage to the surrounding tissue.

The best examination is a biopsy that allows for removing a small fragment of the lesion to be examined in histology. This examination thus provides evidence of the benign nature of this small tumor, whose volume can reach the size of a cherry – or even an apricot!

In some cases, there may be several adenofibromas in the breast gland parenchyma. Not all are necessarily palpable and it is the ultrasound and radiographic examination that will reveal them.

To give you an idea of how adenofibroma is formed, imagine the foliage of a tree that, instead of growing nobly in all directions, is packed in a plastic tissue where all the leaves and branches condense, you will understand the mechanism of adenofibroma formation.

Can an adenofibroma disappear without surgery?

The answer is yes! This happens very frequently. Adenofibroma can grow at certain times due to unexpected stress or as a result of an unforeseen hormonal surge. Episodically, some patients have described the providential disappearance of the adenofibroma which becomes impalpable, barely visible on X-rays, which of course brings great relief to worried patients.

In some cases, I have observed patients long after a period when the adenofibroma had disappeared, and who presented again the same symptoms, even after several years.

Other patients have small, scattered adenofibromas for which surgical removal is not very convenient. In these cases, hormonal treatment is recommended, which has reasonable chances of success in these particular cases of small lesions.

The attached photographs in this file show the presence of an adenofibroma the size of a half-apricot in contact with the shell of a silicone gel breast prosthesis. It is likely that this adenofibroma has led to a fibrous reaction all around the prosthesis.

In these cases, if there is no indication to wait for the disappearance of the adenofibroma by hormonal treatment, either orally or by application of a hormonal gel applied locally, exploratory surgery is necessary. The problem is then to know where to place the scar so that it is as inconspicuous as possible. In some cases, it is even necessary to make a scar directly above the palpable adenofibroma. Once removed, the adenofibroma must be analyzed to certify its benign nature.

The ideal is repeated clinical examination by your gynecologist, self-palpation by informed patients is also possible, but contains a potential for anxiety because the lesion always evolves too slowly for the patient’s liking. X-rays are also sufficient to evaluate the evolution of these adenofibromas, without the need for a CT scan or MRI, to avoid too much X-ray radiation.

Is it necessary to operate on a benign breast adenofibroma?

Not at all! It is sufficient to monitor them regularly. Many patients have had adenofibromas since adolescence, and their entire reproductive life will be marked by the appearance and disappearance of these strictly benign breast tumors.

Only when there is significant psychological distress, it is advisable to proceed with surgical exploration in patients who may be fearful of a cancerous tumor change because there are breast cancers in their family.

The rule is indeed the benign nature of mammary adenoma.

Are there other possibilities than surgery to treat mammary fibroma adenoma?

Some medical teams have proposed to perform targeted cryotherapy after verifying by a biopsy that it is indeed a benign adenofibroma. Cryotherapy consists of freezing the lesion through a transcutaneous injection that creates a decrease in temperature to minus 180 degrees, which will cause involution of the lesion with practically no visible scar. But some other teams prefer a small operation with a short scar to be able to analyze the entire lesion once removed.