Download PDF
Semin Plast Surg 2013; 27(01): 062-066
DOI: 10.1055/s-0033-1343997
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Nonsurgical Management of Fibroadenoma and Virginal Breast Hypertrophy

Sandhya Pruthi
1   Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
,
Katie N. Jones
2   Department of Radiology, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

Publication Date:
23 May 2013 (online)

Also available at
    Permissions and Reprints

Abstract

The management and treatment of an adolescent presenting with a fibroadenoma or virginal breast hypertrophy can be challenging as there is a paucity of original research on these conditions. Although surgical therapies are often discussed as first-line therapy in adolescents presenting with a breast mass, it is prudent that nonsurgical interventions and medical therapies be considered as initial therapy with the goal of maintaining an acceptable cosmetic outcome.

Keywords

juvenile (virginal) hypertrophy - fibroadenoma - cryoablation - tamoxifen - image-guided biopsy
 

  • References

  • 1 Simmons PS, Jayasinghe YL, Wold LE, Melton III LJ. Breast carcinoma in young women. Obstet Gynecol 2011; 118 (3) 529-536
    CrossrefPubMedGoogle Scholar
  • 2 Jayasinghe Y, Simmons PS. Fibroadenomas in adolescence. Curr Opin Obstet Gynecol 2009; 21 (5) 402-406
    CrossrefPubMedGoogle Scholar
  • 3 West KW, Rescorla FJ, Scherer III LR, Grosfeld JL. Diagnosis and treatment of symptomatic breast masses in the pediatric population. J Pediatr Surg 1995; 30 (2) 182-186 , discussion 186–187
    CrossrefPubMedGoogle Scholar
  • 4 Parker SJ, Harries SA. Phyllodes tumours. Postgrad Med J 2001; 77 (909) 428-435
    CrossrefPubMedGoogle Scholar
  • 5 Dixon JM, Dobie V, Lamb J, Walsh JS, Chetty U. Assessment of the acceptability of conservative management of fibroadenoma of the breast. Br J Surg 1996; 83 (2) 264-265
    CrossrefPubMedGoogle Scholar
  • 6 March DE, Coughlin BF, Barham RB , et al. Breast masses: removal of all US evidence during biopsy by using a handheld vacuum-assisted device—initial experience. Radiology 2003; 227 (2) 549-555
    CrossrefPubMedGoogle Scholar
  • 7 Singletary SE. Radiofrequency ablation of breast cancer. Am Surg 2003; 69 (1) 37-40
    PubMedGoogle Scholar
  • 8 Huber PE, Jenne JW, Rastert R , et al. A new noninvasive approach in breast cancer therapy using magnetic resonance imaging-guided focused ultrasound surgery. Cancer Res 2001; 61 (23) 8441-8447
    PubMedGoogle Scholar
  • 9 Fine RE, Whitworth PW, Kim JA, Harness JK, Boyd BA, Burak Jr WE. Low-risk palpable breast masses removed using a vacuum-assisted hand-held device. Am J Surg 2003; 186 (4) 362-367
    CrossrefPubMedGoogle Scholar
  • 10 Wang ZL, Li JL, Su L, Zhang YF, Tang J. An evaluation of a 10-gauge vacuum-assisted system for ultrasound-guided excision of clinically benign breast lesions. Breast 2009; 18 (3) 192-196
    CrossrefPubMedGoogle Scholar
  • 11 Sperber F, Blank A, Metser U, Flusser G, Klausner JM, Lev-Chelouche D. Diagnosis and treatment of breast fibroadenomas by ultrasound-guided vacuum-assisted biopsy. Arch Surg 2003; 138 (7) 796-800
    CrossrefPubMedGoogle Scholar
  • 12 Krainick-Strobel U, Huber B, Majer I , et al. Complete extirpation of benign breast lesions with an ultrasound-guided vacuum biopsy system. Ultrasound Obstet Gynecol 2007; 29 (3) 342-346
    CrossrefPubMedGoogle Scholar
  • 13 Plantade R, Hammou JC, Gerard F , et al. Ultrasound-guided vacuum-assisted biopsy: review of 382 cases. [in French]. J Radiol 2005; 86 (9 Pt 1) 1003-1015
    CrossrefPubMedGoogle Scholar
  • 14 Fine RE, Boyd BA, Whitworth PW, Kim JA, Harness JK, Burak WE. Percutaneous removal of benign breast masses using a vacuum-assisted hand-held device with ultrasound guidance. Am J Surg 2002; 184 (4) 332-336
    CrossrefPubMedGoogle Scholar
  • 15 Baez E, Huber A, Vetter M, Hackelöer BJ. Minimal invasive complete excision of benign breast tumors using a three-dimensional ultrasound-guided mammotome vacuum device. Ultrasound Obstet Gynecol 2003; 21 (3) 267-272
    CrossrefPubMedGoogle Scholar
  • 16 Johnson AT, Henry-Tillman RS, Smith LF , et al. Percutaneous excisional breast biopsy. Am J Surg 2002; 184 (6) 550-554 , discussion 554
    CrossrefPubMedGoogle Scholar
  • 17 Thurley P, Evans A, Hamilton L, James J, Wilson R. Patient satisfaction and efficacy of vacuum-assisted excision biopsy of fibroadenomas. Clin Radiol 2009; 64 (4) 381-385
    CrossrefPubMedGoogle Scholar
  • 18 Yom CK, Moon BI, Choe KJ, Choi HY, Park YL. Long-term results after excision of breast mass using a vacuum-assisted biopsy device. ANZ J Surg 2009; 79 (11) 794-798
    CrossrefPubMedGoogle Scholar
  • 19 Parker SH, Klaus AJ, McWey PJ , et al. Sonographically guided directional vacuum-assisted breast biopsy using a handheld device. AJR Am J Roentgenol 2001; 177 (2) 405-408
    CrossrefPubMedGoogle Scholar
  • 20 Perez-Fuentes JA, Longobardi IR, Acosta VF, Marin CE, Liberman L. Sonographically guided directional vacuum-assisted breast biopsy: preliminary experience in Venezuela. AJR Am J Roentgenol 2001; 177 (6) 1459-1463
    CrossrefPubMedGoogle Scholar
  • 21 Simon JR, Kalbhen CL, Cooper RA, Flisak ME. Accuracy and complication rates of US-guided vacuum-assisted core breast biopsy: initial results. Radiology 2000; 215 (3) 694-697
    CrossrefPubMedGoogle Scholar
  • 22 Ko EY, Bae YA, Kim MJ, Lee KS, Lee Y, Kim LS. Factors affecting the efficacy of ultrasound-guided vacuum-assisted percutaneous excision for removal of benign breast lesions. J Ultrasound Med 2008; 27 (1) 65-73
    PubMedGoogle Scholar
  • 23 Luo HJ, Chen X, Tu G, Wang J, Wu CY, Yang GL. Therapeutic application of ultrasound-guided 8-gauge Mammotome system in presumed benign breast lesions. Breast J 2011; 17 (5) 490-497
    CrossrefPubMedGoogle Scholar
  • 24 Tagaya N, Nakagawa A, Ishikawa Y, Oyama T, Kubota K. Experience with ultrasonographically guided vacuum-assisted resection of benign breast tumors. Clin Radiol 2008; 63 (4) 396-400
    CrossrefPubMedGoogle Scholar
  • 25 Littrup PJ, Freeman-Gibb L, Andea A , et al. Cryotherapy for breast fibroadenomas. Radiology 2005; 234 (1) 63-72
    CrossrefPubMedGoogle Scholar
  • 26 Kaufman CS, Littrup PJ, Freeman-Gibb LA , et al. Office-based cryoablation of breast fibroadenomas with long-term follow-up. Breast J 2005; 11 (5) 344-350
    CrossrefPubMedGoogle Scholar
  • 27 Kaufman CS, Bachman B, Littrup PJ , et al. Office-based ultrasound-guided cryoablation of breast fibroadenomas. Am J Surg 2002; 184 (5) 394-400
    CrossrefPubMedGoogle Scholar
  • 28 Edwards MJ, Broadwater R, Tafra L , et al. Progressive adoption of cryoablative therapy for breast fibroadenoma in community practice. Am J Surg 2004; 188 (3) 221-224
    CrossrefPubMedGoogle Scholar
  • 29 Nurko J, Mabry CD, Whitworth P , et al. Interim results from the FibroAdenoma Cryoablation Treatment Registry. Am J Surg 2005; 190 (4) 647-651 , discussion 651–652
    CrossrefPubMedGoogle Scholar
  • 30 Bland KL, Gass J, Klimberg VS. Radiofrequency, cryoablation, and other modalities for breast cancer ablation. Surg Clin North Am 2007; 87 (2) 539-550, xii xii
    CrossrefPubMedGoogle Scholar
  • 31 Hynynen K, Pomeroy O, Smith DN , et al. MR imaging-guided focused ultrasound surgery of fibroadenomas in the breast: a feasibility study. Radiology 2001; 219 (1) 176-185
    CrossrefPubMedGoogle Scholar
  • 32 van den Bosch MA, Daniel BL. MR-guided interventions of the breast. Magn Reson Imaging Clin N Am 2005; 13 (3) 505-517
    CrossrefPubMedGoogle Scholar
  • 33 Templeman C, Hertweck SP. Breast disorders in the pediatric and adolescent patient. Obstet Gynecol Clin North Am 2000; 27 (1) 19-34
    CrossrefPubMedGoogle Scholar
  • 34 Chang DS, McGrath MH. Management of benign tumors of the adolescent breast. Plast Reconstr Surg 2007; 120 (1) 13e-19e
    CrossrefPubMedGoogle Scholar
  • 35 Latham K, Fernandez S, Iteld L, Panthaki Z, Armstrong MB, Thaller S. Pediatric breast deformity. J Craniofac Surg 2006; 17 (3) 454-467
    CrossrefPubMedGoogle Scholar
  • 36 Griffith JR. Virginal breast hypertrophy. J Adolesc Health Care 1989; 10 (5) 423-432
    CrossrefPubMedGoogle Scholar
  • 37 Li G, Robinson GW, Lesche R , et al. Conditional loss of PTEN leads to precocious development and neoplasia in the mammary gland. Development 2002; 129 (17) 4159-4170
    PubMedGoogle Scholar
  • 38 O'Hare PM, Frieden IJ. Virginal breast hypertrophy. Pediatr Dermatol 2000; 17 (4) 277-281
    CrossrefPubMedGoogle Scholar
  • 39 Jabs AD, Frantz AG, Smith-Vaniz A, Hugo NE. Mammary hypertrophy is not associated with increased estrogen receptors. Plast Reconstr Surg 1990; 86 (1) 64-66
    PubMedGoogle Scholar
  • 40 Gliosci A, Presutti F. Virginal gigantomastia: validity of combined surgical and hormonal treatments. Aesthetic Plast Surg 1993; 17 (1) 61-65
    CrossrefPubMedGoogle Scholar
  • 41 Taylor PJ, Cumming DC, Corenblum B. Successful treatment of D-penicillamine-induced breast gigantism with danazol. Br Med J (Clin Res Ed) 1981; 282 (6261) 362-363
    PubMedGoogle Scholar
  • 42 Hoppe IC, Patel PP, Singer-Granick CJ, Granick MS. Virginal mammary hypertrophy: a meta-analysis and treatment algorithm. Plast Reconstr Surg 2011; 127 (6) 2224-2231
    CrossrefPubMedGoogle Scholar
  • 43 Fisher B, Costantino JP, Wickerham DL , et al. Tamoxifen for the prevention of breast cancer: current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study. J Natl Cancer Inst 2005; 97 (22) 1652-1662
    CrossrefPubMedGoogle Scholar
  • 44 Waters EA, McNeel TS, Stevens WM, Freedman AN. Use of tamoxifen and raloxifene for breast cancer chemoprevention in 2010. Breast Cancer Res Treat 2012; 134 (2) 875-880
    CrossrefPubMedGoogle Scholar
  • 45 Baker SB, Burkey BA, Thornton P, LaRossa D. Juvenile gigantomastia: presentation of four cases and review of the literature. Ann Plast Surg 2001; 46 (5) 517-525 , discussion 525–526
    CrossrefPubMedGoogle Scholar
  • 46 Mayl N, Vasconez LO, Jurkiewicz MJ. Treatment of macromastia in the actively enlarging breast. Plast Reconstr Surg 1974; 54 (1) 6-12
    PubMedGoogle Scholar
  • 47 Ryan RF, Pernoll ML. Virginal hypertrophy. Plast Reconstr Surg 1985; 75 (5) 737-742
    PubMedGoogle Scholar