Breast fibroadenoma is a common benign breast disease, most often detected by physical examination and breast ultrasonography, and diagnosed on the basis of pathology, with management including follow-up observation and surgical intervention. The peak incidence of breast fibroadenomas is between 15 and 35 years of age, of which about 25% are asymptomatic, about 20% have unilateral or bilateral multiple lesions, and patients with multiple fibroadenomas have a family history. The natural course of fibroadenomas is long, with a few rapidly increasing and most lesions growing slowly or unchanged. Fibroadenomas have a very low rate of malignancy and do not require treatment based on oncologic considerations. Diagnosis Fibroadenomas are mainly characterized by palpation of a firm, well-defined, well-mobile mass, occasionally accompanied by pain. The accuracy of diagnosing fibroadenomas on clinical examination alone is only about 66%. Ultrasonographic manifestation is mostly a hyperechoic area with regular shape, clear boundary and peripheral membrane, and the sensitivity and specificity of diagnosing fibroadenoma based on breast ultrasound alone is about 87%. In young women with dense glands, the diagnostic role of molybdenum-palladium in breast fibroadenoma is limited. Patients with fibroadenomas suspected by breast ultrasound to have malignant potential need to undergo molybdenum-palladium screening. Breast magnetic resonance imaging (MRI) is not recommended as a diagnostic imaging method for fibroadenomas. For fibroadenomas intended for follow-up observation, a pathologic diagnosis should be obtained whenever possible, and a pathologic diagnosis should be obtained for any suspected fibroadenoma with a Breast Imaging Reporting Data System (BI-RADS) grade 3 or higher in the imaging judgment. Hollow needle aspiration histology (CNB) is recommended to obtain sufficient tissue volume for benign-malignant differentiation. Treatment In addition to rapid tumor growth, an increased BI-RADS grading grade is an indication for surgical intervention. In addition, fibroadenomas may lead to changes in breast shape, breast discomfort, and increased patient stress. The patient’s wishes should be respected as much as possible with regard to the surgical intervention and the method of implementation. Surgical approach The main methods of surgical intervention are the traditional incisional lumpectomy and the newer vacuum-assisted hollow needle minimally invasive rotational resection. Follow-up Observation Follow-up observation after pathologic confirmation of the diagnosis by hollow-needle aspiration biopsy is medically least expensive and is indicated for most patients with slow-growing or unchanged fibroadenomas <3 cm. In patients with fibroadenomas, the rate of missed breast cancer diagnosis is very low with follow-up. The recommended frequency of observation is every 6 months, and the recommended screening tool is physical examination combined with breast ultrasound. For patients over 35 years of age, the addition of molybdenum-palladium as a follow-up examination is recommended. When rapid tumor growth is detected during follow-up, it is recommended to end the follow-up observation and undergo surgical intervention. Criteria for rapid growth include an increase in the maximum diameter of the adenoma of more than 20% within 6 months; or an increase in the maximum diameter of the adenoma of more than 16% per month in patients <50 years of age and more than 13% per month in patients ≥50 years of age.