Houssami N, Cheung M N, Dixon J M
Sydney Square Breast Clinic, NSW, Medical Benefits Fund of Australia.
Med J Aust. 2001 Feb 19;174(4):185-8. doi: 10.5694/j.1326-5377.2001.tb143215.x.
Fibroadenoma of the breast is a common cause of a benign breast lump in premenopausal women. The consensus view is that women with fibroadenomas are not at significant increased risk of developing breast cancer. Diagnosis is based on the combination of clinical examination, imaging and non-surgical tissue biopsy (the triple test). A clinical diagnosis of fibroadenoma alone is unreliable and does not exclude malignancy even in younger women. The choice of imaging is mammography, combined with ultrasound in older women, and ultrasound alone in younger women. Tissue biopsy, by either fine-needle aspiration or core biopsy, is the most accurate means of establishing the diagnosis. Traditionally, symptomatic fibroadenomas were treated by surgical excision, and this option should always be offered. There is increasing evidence that a conservative approach is safe and acceptable, provided the result of an adequate triple test is both negative for cancer and consistent with a fibroadenoma. Patients who choose conservative management need to be informed of the limitation of the tests, and must be assessed promptly if there is symptomatic or clinical change.
乳腺纤维腺瘤是绝经前女性乳房良性肿块的常见原因。共识观点是，患有纤维腺瘤的女性患乳腺癌的风险没有显著增加。诊断基于临床检查、影像学检查和非手术组织活检（三联检查）的结合。仅临床诊断为纤维腺瘤是不可靠的，即使在年轻女性中也不能排除恶性肿瘤。影像学检查的选择是乳房X线摄影，老年女性结合超声检查，年轻女性仅进行超声检查。通过细针穿刺或粗针活检进行组织活检是确诊的最准确方法。传统上，有症状的纤维腺瘤通过手术切除进行治疗，并且应始终提供这种选择。越来越多的证据表明，保守治疗方法是安全且可接受的，前提是充分的三联检查结果对癌症呈阴性且与纤维腺瘤一致。选择保守治疗的患者需要了解检查的局限性，如果出现症状或临床变化，必须及时进行评估。
