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Difference between Cancer and Fibro adenoma

A lump in the breast need not be a cause of panic in all cases. Lumps in the breast can be benign or malignant. A benign lump is known as fibro adenoma and a malignant lump can take the form of breast cancer.

What is fibro adenoma?

During a routine home examination of breast, a nodule like formation may be felt under the skin. It can be felt as small, round marble like with lot of mobility. Such a painless highly mobile mass is known as fibro adenoma. These are solid non-cancerous masses seen in girls and women of child bearing age usually below the age of 30 years. Such a mass is usually not a cause for concern as its presence is linked to increase in the reproductive hormone levels. It increases with an increase in oestrogen hormone levels which occurs in growth years and during pregnancy. The masses are seen to shrink and go away during menopause at which time the hormone levels are at their lowest. The fibro adenomas have a well-defined shape when seen with naked eye. It is firm and hard to touch with a rubbery feel. Their sizes can vary from less than 3 cm to as big as 5 cm.

Wait and watch policy is applied for the diagnosis and treatment of fibro adenoma. There can be two types of fibro adenoma – simple and complex. The simple fibro adenoma is just a mass of glandular tissue in the breast which grows very slowly. They do not increase the risk of breast cancer. On the other hand complex fibro adenoma contains fluid filled structures and calcium deposits within the lump. They can increase the risk of breast cancer and need to be monitored regularly for any change in behaviour.

If you feel presence of lump in your breast, you need to visit a physician to rule out any malignancy. In mammogram, an X-ray of the breast is taken to locate the size and shape of the lump and also to look for any calcifications. Breast ultrasound is done after mammography to understand the consistency of the lump. This is followed by fine needle aspiration cytology, in which a thin needle is inserted into the mass and tissue material is extracted. If only fluid comes out, then the lump is just a cyst. This may be followed by core needle biopsy which requires insertion of a thicker needle to remove small amount of tissue for biopsy.

Once all the diagnostic tests point towards fibro adenoma, no treatment other than regular breast examination is required. Excision of lump is not done usually as it distorts the breast shape and also increases the chance of recurrence. Still if patients insist, lumpectomy or excision of the mass is done in some cases. Cryo-ablation is another way to destroy the lump. A thin stick like device is inserted into the lump area. Gas is released into the tissue which freezes the tissue permanently. This is recommended only for smaller lumps.

Breast cancer

This is a cancerous growth in the breast that is usually malignant and can spread to surrounding areas through lymph nodes. The patient may present with lump, dimpling or puckering of overlying skin, discharge through the nipples, ulceration, rarely painful breasts, retracted nipples etc. Presence of these symptoms doesn’t necessarily indicate cancer. The lumps are hard and less mobile as compared to fibro adenoma and grow slowly in size.

Females with these symptoms must visit the physician for further check-up. Mammogram and Breast ultrasound help to locate the size of the mass and also provide its dimensions and consistency. Fine needle aspiration cytology and core needle biopsy help in procuring samples of tissue mass for pathological use. If the mass shows rapidly multiplying cells with altered shape and type, it indicates cancer. Excisional biopsy of the lump gives a better picture of the malignancy potential of the lump.

Once diagnosed as cancer, the patient needs to undergo surgery to remove the tumour mass. If it has spread, then radical mastectomy is advised. This includes removal of entire breast tissue along with its lymph nodes. This is followed by intensive chemo and radio therapy regimes.

To summarise fibro adenoma or breast mice as they are known are benign lumps requiring no treatment. Cancer on the other hand requires aggressive treatment plan.

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