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      The Role of High Intensity Focused Ultrasound in the Treatment of Fibroadenomas: A Systematic Review

      systematic-review

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          Abstract

          Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30–75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging, and mammography, as well as core needle biopsies. Current management includes observation for 6–12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple areolar distortion, scarring, and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases Embase, MEDLINE/PubMed, Google Scholar, and Ovid for English language papers published between January 1, 2000, and March 17, 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were “HIFU”, “High Intensity Focused Ultrasound,” “Fibroadenoma,” “Breast,” “Lesion.” This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, high intensity focused ultrasound (HIFU), was found to be a safe, noninvasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated, with low risk of complications, that can potentially include erythema, skin discoloration, and bruising with the majority of these self-resolving shortly after the procedure.

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          Author and article information

          Journal
          BRC
          BRC
          10.1159/issn.1661-3791
          Breast Care
          Breast Care
          S. Karger AG
          1661-3791
          1661-3805
          2023
          August 2023
          02 May 2022
          : 18
          : 4
          : 278-287
          Affiliations
          [_b] bFaculty of Life Sciences and Medicine, King’s College London, London, UK
          [_c] cCollege of Arts and Sciences, Boston University, Boston, Massachusetts, USA
          [_d] dFaculty of Medicine, Cairo University, Cairo, Egypt
          [_e] eSchool of Medicine, University of Manchester, Manchester, UK
          Author information
          https://orcid.org/0000-0001-6570-7873
          https://orcid.org/0000-0002-4505-9247
          Article
          524738 Breast Care 2023;18:279–288
          10.1159/000524738
          37900548
          65a5c27f-3d2c-4584-b772-ba9fbab52acd
          © 2023 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

          History
          : 25 November 2021
          : 21 April 2022
          Page count
          Figures: 1, Tables: 5, Pages: 10
          Funding
          This work did not receive any grant from funding agencies in the public, commercial, or not-for-profit sectors.
          Categories
          Systematic Review

          Medicine
          Side effects,Fibroadenoma,High intensity focused ultrasound,Ultrasound,Breast,Efficacy
          Medicine
          Side effects, Fibroadenoma, High intensity focused ultrasound, Ultrasound, Breast, Efficacy

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