issue: breast
NOVEMBER, 2018 | THE HEALTH
11
ECHOTHERAPIE.COM
The
benign lump
fibroadenoma
F
IBROADENOMA is a breast lump
that is benign. This kind of lump
is usually presented by 80 to 90
per cent of patients.
UM Specialist Centre Consultant
Oncoplastic Breast Surgeon Dr See
Mee Hoong described this type of
lump as common.
“Fibroadenoma happens in the
younger age group. Inside that lump
is a mixture of our gland, the breast
duct and the fibrosis tissue – so it is in
a clump and well encapsulated.”
See explained that there are two
types of fibroadenoma – a very benign
type that always moves around and
solitary. The other type is the multiple
type with a lot of small lesions over.
This type at times occurs in young girls
as early as 15 years old.
“Again, this can be divided into two
types – one which is the hard type
while the other is the soft type. The
hard type can always be felt and can
be likened to a breast mouse which is
constantly moving.”
“The other is the soft type which
grows faster compared to the hard
type as there are a lot of supporting
tissues and this makes it grow faster.
Sometimes, both can be found together
in a breast as well.”
A fibroadenoma can be irritating
under certain circumstances, but
is just a benign lump in the female
breast.
“Fibroadenoma
happens in the
younger age
group. Inside that
lump is a mixture
of our gland,
the breast duct
and the fibrosis
tissue – so it is in
a clump and well
encapsulated.”
“It is not cancerous, but it is a benign
lesion. However, whether it can cause
cancer or not is something that most
people are unsure of.”
See said that there are studies
that show that fibroadenoma has risk
but it is a very small risk compared to
the normal population.
Cause
The common cause for fibroadenoma
is hormonal changes.
However See remarked that this is a
benign disease.
“Even if you have, there is nothing
to be worried about. Those who have
one that is less than four centimetres,
we don’t encourage to have it removed
as sometimes, it would regress.”
“It is only worrying when it is
beyond four centimetres as it can be
phyllodes tumor. So, we would advise
them to remove it.”
“Meanwhile, if it is a new lesion, we
would follow up with them every six
months for four times. If they don’t
grow further, it would regress, but this
again depends.”
Those less than point five centi-
metres to one centimetre; they have a
chance to regress very fast, but they are
benign so there is no need to worry too
much about when a patient has fibro-
adenoma unless the size is really big.”
Phyllodes tumor in a 52 years woman.
Phyllodes
tumors of
the breast
PHYLLODES tumors is a very special
tumour that have split characteristic.
UM Specialist Centre Consultant
Oncoplastic Breast Surgeon Dr See Mee
Hoong explained that there are three
types of tumor under this name - phyl-
loides tumor and cystosarcoma phyllodes
which is a serocystic disease of brodie or
benign cystosarcoma.
“We would be able to see lots of leaf
like projection in the pathology speci-
men, which is why it comes to a diagnosis
we call phylloides.
“Phylloides – the cell in our breast
contains few types of cell. One is the dark
cell, the other lobule and the supporting
tissue that is around the breast. That is
the one that becomes very active – over
growth of that type of cell which results
in phylloides.
“We would
be able to see
lots of leaf like
projection in
the pathology
specimen, which
is why it comes
to a diagnosis we
call phylloides.”
Symptoms
Subareolar breast
abscess in smokers
Subareolar means underneath the
nipple. Breast abscess means infection
and the cause is a collection of having
plural cell and infected tissues.
UM Specialist Centre Consultant
Oncoplastic Breast Surgeon Dr See
Mee Hoong revealed that while
surgeons find it difficult to point to a
specific cause, there are few precipitat-
ing factors that are related to it.
“Those who smoke and women in
their 40’s.”
“When ladies have an infection,
redness just underneath the nipple and
they excrete out whitish fluid, they are
generally treated for an infection.”
“In this group of disease, we have
three types of things that can correlate
with each other – periductal mastitis
where the infection starts with the milk
duct.”
“Periductal mastitis if not treated
well – becomes abscess. Women
actually get these problem due to the
mixture of hormonal changes, smoking
– we are not sure as to why smoking
can cause this, but it always happens
in smokers and normally involves few
HEALTHLINE
Subareolar breast abscess underneath
the nipple.
ducts on both sides (bilateral).”
“Sometimes, these kind of disease is
presented like a cancer – so we always
have to bear in mind – if we have
abscess or mass or lump underneath
the nipple we would again do the three
steps, to find out if it is purely infection
or cancer.”
See described that they present like
normal – with a breast lump but the size
of the lump is disproportionate from the
normal type of benign breast disease.
“They rapidly increase in size. Some is
slower but when they increase, it can be
more than five centimetres. Those that
are a little aggressive or very aggressive
become very big and would occupy the
whole breast.”
This disease presents in three types:
non-cancerous type (benign), borderline
in-between and malignant.
“The way we differentiate between
these three is through a histopathology
which would show how fast is the mitosis,
stromal cellularity or any abnormal cell
in the stroma and supporting tissue, if
the stroma overgrow too rapidly, tumour
interface in between the tumours
whether the tumour is well contained
or if they have spread to other tissues.
These types of tumour needs surgery
but the type of surgery depends on the
type that is presented as well. Otherwise,
the patient will be given chemotherapy,
radiotherapy if the disease has spread to
other places.”