Leaf-shaped breast tumor
A leaf—shaped breast tumor is the formation of a fibroepithelial plan on the mammary gland. It belongs to a number of potentially malignant tumors. The manifestation of a leaf-shaped tumor consists in the densification of the gland tissues, in some cases, reaching large sizes. Sometimes it manifests itself with pain, as well as discharge from the nipple. Diagnostics contains such medical aspects as mammography, ultrasound, puncture biopsy and examination of the material at the cytological level. The treatment of this ailment is exclusively operative, sometimes including a sectoral, radical resection or mastectomy.
The content of the article:
Characteristics of leaf-shaped tumors that have appeared on the mammary gland
Causes of leaf-type tumors on the mammary gland
Symptoms of the formation of a leaf-shaped tumor on the mammary glands
Diagnosis of a leaf-shaped tumor on the mammary gland
Treatment of a leaf-shaped breast tumor
Prognosis for a leaf-shaped tumor
Leaf-shaped breast tumor
Among other things, leaf-like breast disease in the mammology section can be found with names such as intracanalicular, giant, phylloid and other fibroadenomas. By the way, like other component manifestations on the mammary gland, this tumor is distinguished by the proliferation of connective tissue, as well as epithelial components, and with the active advantage of the first. Among all known formations of a fibroepithelial nature on the mammary gland, such a disease as a leaf-shaped tumor occurs in 1.2-2% of cases.
A leaf-shaped tumor that has manifested on the mammary gland is also a hard-to-diagnose formation, prone to active growth, the possibility of relapse, and the degeneration of a malignant nature into sarcoma. The transition of a leaf-shaped tumor to a malignant “level” is possible in 3-5% of three to five percent of cases.
Characteristics of leaf-shaped tumors that have appeared on the mammary gland
The histological international classifier inclines a leaf-shaped tumor into the ranks of fibroepithelial formations, distinguishing three probable forms — benign, malignant, and also the so-called borderline, which is an intermediate form.
The macroscopic appearance of a leaf-shaped tumor comes from the size of the formation. For example, a five-centimeter tumor in diameter is shown as a serious pinkish or white-grayish formation separated from the rest of the tissues with a lobular or coarse-grained structure. At the junction, you can notice small cysts and slit-like cavities, which include a viscous mass of a mucus-like type. The macrostructure of leaf-shaped tumors on the mammary gland, which exceeds the five-centimeter mark, is shown in the form of cystic slits and cavities that are filled with polypoid growths in the area of cystic cavities, as well as a gelatin-like secret.
If we microscopically consider a leaf-shaped breast tumor, then we can notice the predominance of the stromal (connective tissue) element. The difference between a leaf-shaped tumor and a fibroma appears in the form of a more pronounced stroma with serious manifestations of proliferation and polymorphism of stromal cells.
Also, a leaf-shaped tumor can be represented by single or multiple nodes, the location of which is concentrated in one or all of the mammary glands. Phylloid tumors are characterized by sudden, dynamic growth. The sizes of fibroadenomas of a leaf—like nature can be very different – from small nodules, ending with tumors twenty or more centimeters in diameter.
Causes of leaf-type tumors on the mammary gland
The etiological component of the leaf-shaped tumor is not fully known. Its developing process is associated with the failure of the hormonal balance, primarily with hyperestrogenism, as well as an insufficient amount of progesterone. Based on this, the phases of detection of phylloid fibroadenomas fall on the periods of hormonal transitional activity of women: from eleven to twenty years, and much more often — from forty to fifty. Very rarely, but still you can find leaf-shaped tumors on the male mammary glands.
The provoking factors of the appearance of leaf-shaped tumors on the mammary glands are as follows: abortions, pregnancy, cystic fibrotic mastopathy, lactation, extragenital endocrinopathies, as well as metabolic disorders such as diabetes mellitus, tumors of the pituitary gland and adrenal glands, thyroid gland, obesity, liver diseases and others.
Symptoms of the formation of a leaf-shaped tumor on the mammary glands
Leaf-shaped tumor, in the vast majority of cases, proceeds in two phases. As a rule, at the end of a long period of slow development, which can sometimes drag on for decades, the process goes into a phase of unexpected dynamic growth. On average, the size of fibroadenomas of a phylloid nature reaches five to nine centimeters, although there have been cases of reaching a tumor with a diameter of forty-five centimeters and a weight of about seven kilograms. It is noteworthy that the prognosis of a leaf—shaped tumor does not depend on its size – even a small formation risks becoming malignant, just as a huge fibroadenoma can act as a benign one.
As a rule, a leaf-shaped mammary gland tumor is detected by the patient herself or a mammologist after palpation, it looks like a dense knot. When the huge size of the tumor is reached, the skin above the female breast becomes thinner, acquiring the appropriate color, under which you can even see dilated subcutaneous veins. In addition, pain may begin in the mammary gland, ulcers appear on the skin, the affected gland is released from the nipple.
The presence of a leaf-shaped tumor is mainly noticed from above or in the center of the breast, and if the tumor is large, then it can completely occupy the breast or most of it.
A leaf-shaped tumor of a malignant nature mainly affects the liver, bones and lungs. The lymph nodes, in turn, are not affected.
Diagnosis of a leaf-shaped tumor on the mammary gland
During palpation, a leaf-like tumor on the mammary gland is determined under the guise of a seal, which is clearly delimited from the nearest tissues. The seal has a lobular structure, which includes several nodes connected to each other.
When performing ultrasound of the female mammary glands, specialists identify a hypoechoic formation, which resembles something like a cabbage on its slice. It has a heterogeneous structure, as well as many anechoic (liquid) cracks and cavities. Ultrasound Dopplerography inside the formation of nodes on the mammary gland helps to determine the multiple chain of diverse arteries and veins. Mammography, in turn, helps to identify a tumor conglomerate of oval (regular) or rounded (irregular) shape with a lobular structure and clear outlines. A remarkable fact here is that the tumor shadow is a homogeneous and rather intense body.
The degree of importance of preoperative differentiation in relation to a benign leaf-shaped tumor of the female breast, as well as sarcoma, causes the need for a cytological assessment of education. This goal explains the puncture biopsy of the tumor from its various sites, followed by cytological examination of the biopsy.
Treatment of a leaf-shaped breast tumor
Due to rapid progress, a variety of course options, as well as an increase in the potential transition to a malignant form, in relation to a leaf-shaped tumor, only surgical tactics are prescribed.
In the case of benign, as well as intermediate leaf-type tumors, a quadrantectomy or sectoral resection of the female mammary glands is performed. Radical resection of the mammary glands, subcutaneous or radical mastectomy will be useful in the presence of a huge tumor size or the fact of its malignancy. At the same time, lymphadenectomy is extremely rare. After radical interventions, the patient undergoes reconstructive mammoplasty with personal tissues or endoprostheses.
Radiation and hormone therapy is not used when a leaf-shaped tumor is detected.
Prognosis for a leaf-shaped tumor
A distinctive feature of leaf-like formations on the mammary glands is their intense tendency to relapse: observations show that phylloid fibroadenomas of a benign nature reappear in only 8.1% of cases, while more dangerous, borderline and malignant, can occur in 25 and 20% of cases, respectively.
In the vast majority of cases, the occurrence of relapses is noticed in terms of several months and up to about two to four years. In addition, at this time there is a possibility of the transition of the tumor from benign to sarcomatous or intermediate.
With an increase in the intensity of the intervention (that is, the use of mastectomy), the risk of recurrence of leaf-like formation on the mammary gland is minimized.
In one case or another, with the prevention and treatment of the described ailment, the main thing is not to delay in any case and immediately contact a specialist at the first suspicion.
