Don’t be alarmed if you’re told you have a “fibroadenoma” in your breast, it’s not cancer. This is the most common breast lump in young women. In many cases, fibroadenomas can shrink and disappear without treatment. In other cases, it is removed by your doctor through quick surgery.
It may not be felt
Fibroadenoma is a benign, non-cancerous breast tumor. Unlike breast cancer, which grows in size and metastasizes to other organs over time, fibroadenomas will remain in the breast tissue.
Fibroadenomas are relatively small, most are only 1 cm or 2 cm in size, and fibroadenomas larger than 5 cm in diameter are very rare.
Usually, fibroadenomas are not painful and feel like pebbles sliding under the skin, and their texture may be described as hard, smooth, or flexible. Sometimes, however, the patient may not feel the mass at all and may not feel its presence.
What is the cause?
Doctors are not sure what causes fibroadenomas, which may be related to changes in hormone levels, as they usually appear during puberty or pregnancy and disappear after menopause.
What are the symptoms?
Because fibroadenomas are usually painless, patients may not notice them themselves until they are discovered in the shower or during a breast self-examination.
In addition, your doctor may first find a fibroadenoma through a routine physical exam, a mammogram, or other tests.
Unlike breast cancer, fibroadenoma does not cause nipple discharge, swelling, redness, or skin irritation around the breast.
Who may have fibroadenoma of the breast?
Fibroadenoma of the breast is common, occurring in about 10% of women, but many patients do not even know the lump is there.
Fibroadenomas are most often seen in women who are 15 to 35 years old or who are pregnant or breastfeeding. Some researchers have found that women with a family history of breast cancer are most likely to develop fibroadenoma of the breast.
Most patients have only 1 fibroadenoma, but about 10% to 15% of patients have more than 1 fibroadenoma, and these masses appear either simultaneously or sequentially.
How is it diagnosed?
If you find a breast lump, you should seek medical attention. The patient cannot tell for sure what the lump is just by touching it.
The doctor may touch the lump in order to make a judgment about the texture and size of the lump. Even if the doctor thinks the lump may be a fibroadenoma, he or she may still recommend additional testing to verify.
Depending on age and whether or not the patient is pregnant, the patient may receive an ultrasound or a mammogram. The radiologist will look at the patient’s breast images to determine whether it may be a fibroadenoma or another breast tumor.
A biopsy is the only way your doctor can clarify if the lump is a fibroadenoma. A biopsy means that a sample of the mass needs to be obtained and examined in the laboratory. Based on the results of the physical examination and imaging, the doctor will decide whether to perform a biopsy to further define the nature of the lesion. To perform a biopsy, the doctor will insert a fine puncture needle into the patient’s breast to obtain a small lump as a sample.
How is it treated?
Patients may not need any treatment. If the fibroadenoma is small, the doctor may recommend waiting to see if the lump grows or shrinks, rather than having it removed right away.
Likewise, if a fibroadenoma is found during pregnancy or breastfeeding, the doctor may recommend waiting until the patient’s hormone levels return to normal to see if the lump goes away on its own.
If the patient has had multiple fibroadenomas removed and they are confirmed to be fibroadenomas on examination, the doctor may also recommend delaying removal of the new mass that has appeared.
If a fibroadenoma gets larger, or if the doctor suspects it will get larger or is unsure if the mass is a fibroadenoma, the doctor will usually recommend removing the mass, which will clarify whether it is cancerous and will stop the mass from growing and distorting the surrounding breast tissue.
Depending on the size, location, and number of fibroadenomas, they can be removed using the following methods:
- Lump excision or excisional biopsy is a minor procedure to remove a fibroadenoma of the breast.
- Cryoablation. The doctor locates the fibroadenoma with ultrasound and places a freezing probe on the skin. This probe freezes the nearby tissue and destroys the fibroadenoma without surgery.
How do I follow up?
For most women, no action is needed beyond routine screening, and the doctor continues to check and watch for changes in the breast.
If a fibroadenoma is “simple,” a lump with no cysts, hardness, or abnormal changes, the patient is not at increased risk for breast cancer; but if it is “complex,” it may mean that the patient is at slightly increased risk for breast cancer later in life. However, if it is “complicated,” it may mean that the patient has a slightly increased risk of developing breast cancer later in life. Unless the patient has other risk factors (such as a close family member with breast cancer), the risk of breast cancer remains very low.
Whether the fibroadenoma is “simple” or “complex,” patients should continue to be routinely screened and ask their doctor what screening methods they need and when they need to be screened