Diagnosis and Management of Fibroadenomas in the Adolescent Breast

Cerrato, Felecia; Labow, Brian I.

doi:10.1055/s-0033-1343992

Cited by 65 publications

(79 citation statements)

References 12 publications

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“…[1,2] Patients with FAD present with a palpable lump, detected during self-examination or incidentally during screening mammography or other imaging of the chest area. [2,3] Ultrasound (US) is the main diagnostic method used, but confirmation can only be obtained by core needle biopsy (CNB).…”

Section: Introductionmentioning

confidence: 99%

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High intensity focused ultrasound in the treatment of breast fibroadenomata: results of the HIFU-F trial

Peek

Ahmed

Scudder

et al. 2016

International Journal of Hyperthermia

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High intensity focused ultrasound in the treatment of breast fibroadenomata: Results of the HIFU-F feasibility trialObjectives: Breast fibroadenomata (FAD) are the most common breast lumps in women. High intensity focused ultrasound (HIFU) is a non-invasive ablative technique that can be used to treat FAD but is associated with prolonged treatment times. In the HIFU-F trial, we evaluated the change in volume over time with circumferential HIFU treatment of FAD and compare this to no treatment.Methods: Patients ≥18 years, diagnosed with symptomatic, palpable FAD, visible on ultrasound (US) were recruited. Twenty patients were treated using the US-guided-HIFU under local anaesthesia. Another 20 participants underwent an US six months after diagnosis. Outcome measures included: reduction in treatment time compared to whole lesion ablation; feasibility to achieve a 50% reduction in volume after six months; decrease in volume compared to a control group and reduction in symptoms.Results: Circumferential ablation reduced the mean treatment time by 37.5% (SD 20.1%) compared to whole lesion ablation. US demonstrated a significant mean reduction in FAD volume of 43.5% (SD 38.8%; p=0.016, paired t-test) in the HIFU group compared to 4.6% (SD 46.0%; p=0.530) in the control group after six months. This mean reduction in FAD volume between the two groups was significant in favour of the HIFU group (p=0.002, grouped t-test). Pre-treatment pain completely resolved in six out of eight patients six months post-treatment.Conclusion: Circumferential HIFU ablation of FAD is feasible, with a significant reduction in pain and volume compared to control participants. It provides a simple, non-invasive, outpatient -based alternative to surgical excision for FAD.ISRCTN registration: 76622747

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Section: Introductionmentioning

confidence: 99%

“…[2,3] Ultrasound (US) is the main diagnostic method used, but confirmation can only be obtained by core needle biopsy (CNB). [1][2][3] The management of FAD is generally limited to patient reassurance. Excision, either surgically or radiologically (e.g.…”

Section: Introductionmentioning

confidence: 99%

High intensity focused ultrasound in the treatment of breast fibroadenomata: results of the HIFU-F trial

Peek

Ahmed

Scudder

et al. 2016

International Journal of Hyperthermia

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“…Juvenile fibroadenomas account for 7 to 8% of all fibroadenomas, which occur most often in African American adolescents, and present as rapidly growing masses with associated skin ulcerations and prominent veins (6,7,10). Clinically, their presentation is variable, ranging from small mobile painless masses to rapidly growing tumors.…”

Section: Discussionmentioning

confidence: 99%

“…Patients should undergo a medical evaluation, which includes taking detailed medical and family histories, recording the occurrence of any previous breast-related issues, the history of any malignancy or mantle radiation, and constitutional symptoms. Providers should inquire about mass location, duration, change in size, whether it may be dependent on menses, associated pain or discharge, and the occurrence of any additional masses (6). The physical exam should also assess the size, the mobility, and the consistency of the mass.…”

Section: Introductionmentioning

confidence: 99%

Breast Masses In Children

Yeşil¹,

Karaman²,

Bozkurt³

et al. 2014

GMJ

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Objective: The overwhelming majority of breast masses in children are benign. In this paper we aimed to evaluate the breast masses in children. Methods: All children younger than 18, who were diagnosed with breast mass and were admitted to our center between March 2012 and March 2014 were analyzed for age, gender, complaint, the history of malignancy, the localization of breast mass, sonographic and pathological findings, and the diagnosis, retrospectively. Results: Twenty-nine girls and 8 boys (age ranges from 5 to 18) were admitted to our center with breast mass within the last two years. Except for mass, 5 patients had pain, and 8 patients had nipple discharge. Two patients had family history of breast cancer. Three patients had an operation of mass excision. Histopathological diagnosis of two patients were juvenile fibroadenoma, and pseudoangiomatous stromal hyperplasia.Other diagnoses according to clinical and sonographic features were: Fibroadenoma 11, gynecomastia 8, breast abscess 6, premature thelarche 3, mammary duct ectasia 2, accessory breast 1, fibrocystic change 1 and adenosis 1. Patients were followed up with ultrasound and none of them developed malignacy. Conclusion: The prevalence of breast cancer in the pediatric age group is extremely low, so a conservative approach of clinical and sonographic followup is more commonly adopted in children.

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“…Fibroadenomas are the most common tumours of the female breast [1]. They originate from epithelial mesenchyme and mostly occur as solitary nodules.…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Breast Fibroadenoma Excision Using an Ultrasound-Guided Vacuum-Assisted Biopsy Device

Papathemelis

Heim

Lux

et al. 2017

Geburtshilfe Frauenheilkd

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ABSTR ACTIntroduction We studied the extent to which an ultrasound-guided vacuum-assisted biopsy device ("hand-held Mammotome") could be used not only as a valuable tool for investigation of suspicious breast lesions, but also therapeutically for the complete removal of breast fibroadenomas.Materials and Methods 132 aspiration biopsies showing fibroadenoma on histology were collected retrospectively. We ascertained whether there were residual findings on breast ultrasound at a median follow-up of approx. 9 months following biopsy. A questionnaire was used to determine the complication rate, patient satisfaction and acceptance of the procedure.Results In this study complete fibroadenomectomy was achieved at aspiration biopsy in 76 % of cases (n = 132). Compared to fibroadenomas larger than 2.51 cm 3 (59 %), those smaller than 2.5 cm 3 were completely removed more often (87.6 %; p < 0.05). The procedure is associated with very little pain during and after biopsy and minimal haematoma development, both factors supporting a high rate of acceptance among patients.Conclusion Ultrasound-guided vacuum-assisted biopsy is safe and associated with very few complications. Its additional therapeutic potential is dependant on the size of the benign lesion as measured at initial ultrasound. ZUSAMMENFASSUNGEinleitung Im Folgenden wurde untersucht, inwiefern die Vakuum-

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Diagnosis and Management of Fibroadenomas in the Adolescent Breast

Cited by 65 publications

References 12 publications

High intensity focused ultrasound in the treatment of breast fibroadenomata: results of the HIFU-F trial

High intensity focused ultrasound in the treatment of breast fibroadenomata: results of the HIFU-F trial

Breast Masses In Children

Minimally Invasive Breast Fibroadenoma Excision Using an Ultrasound-Guided Vacuum-Assisted Biopsy Device

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