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Fibroadenoma: Causes, Symptoms, Diagnosis And Treatment

A fibroadenoma is a highly common non-cancerous breast condition [1] . The most common symptom is the presence of a lump in your breast that would move when touched. Other than this, you are unlikely to experience any other symptoms. This condition is benign and mostly found in the young woman. Studies have linked its occurrence to the time during puberty [2] . Nevertheless, it can occur in any women, irrespective of the age. In some rare cases, men can also get fibroadenoma.

Read on to know more about its causes, symptoms, diagnosis and treatment.

What Is A Fibroadenoma?

This condition involves the development of a benign tumour in the breast [1] . Doctors are yet to find out the real reason why some people develop them while others do not. These benign tumours are made up of glandular and connective tissue [3] . They can vary in size. In some cases, the lump is so small that the person cannot even feel it. However, in most of the cases, these lumps are average in size and can be easily located during a self-examination.

A person can have just one or numerous fibroadenoma. These fibroadenomas may grow or shrink in size with time. Doctors classify this condition as either simple or complex [4] . In case of simple fibroadenoma, they all appear the same when examined under a microscope, whereas complex fibroadenoma is usually large and have different features.

Symptoms Of A Fibroadenoma

Fibroadenomas are accompanied with the following symptoms [5] :

  • Painless breast lumps
  • Lumps that move when touched
  • Firm or rubbery kind of breast lump
  • Solid breast lumps that appear round with distinct, smooth borders
  • Lumps that might feel tender just before your periods (when they swell due to hormonal changes)

Causes Of Fibroadenoma

The exact cause of this condition is unknown. Studies have predicted that this condition is influenced by estrogen. This is because they appear most often in premenopausal or pregnant women [2] . In some cases, it can also occur in postmenopausal women who take hormone replacement therapy [6] .

The size of the breast lump most likely changes during your menstrual cycle (when the hormone levels change)

Risk factors: This condition is most common in women between the age of 15 and 30 years [7] . It is also common in pregnant women.

Diagnosis Of Fibroadenoma

It is important to see your healthcare provider the moment you notice a lump in your breast. You might be referred to a breast clinic where specialist doctors could check you. To reach a definite diagnosis, you might need to undergo various investigations, known as 'triple assessment'. This assessment includes the following [5] :

  • Ultrasound scan/mammogram
  • A breast examination
  • A core biopsy/fine needle aspiration

For women who are in their early 20s, diagnosis of fibroadenoma is simple and can be easily diagnosed with a breast examination or ultrasound. A core biopsy is opted only when there's any uncertainty about the diagnosis [8] .

For women under 40 years of age, an ultrasound is preferred over a mammogram. This is because younger women tend to have dense breast tissues that can make the x-ray image blur making benign breast conditions hard to identify. Nevertheless, for some women under 40, mammograms might still be necessary to reach a proper diagnosis [2] .

Treatment For Fibroadenoma

Confirmed fibroadenoma diagnosis does not necessarily mean that it would need to be removed. Depending on your family history, physical symptoms and personal concerns, a decision can be reached whether it would need to be removed or not. Fibroadenoma that does not grow in size and has been confirmed to be non-cancerous would only need close monitoring with regular clinical breast examination and imaging tests, in some cases [9] .

The decision as to whether removal of the fibroadenoma is necessary depends on the following [10] :

  • If there is an impact on the natural shape of the breast
  • If it is painful
  • If you are worried about developing cancer
  • If your biopsy results are doubtful
  • If you have a family history of cancer

Note that even after a fibroadenoma is removed, one or more can grow in its place. Procedure to remove a fibroadenoma include the following:

  • Lumpectomy (excisional biopsy): The surgeon removes the breast tissue and sends it to a lab to check for cancer [11] .
  • Cryoablation: A thin wand-like device is inserted through your skin to the fibroadenoma. A gas is then used to freeze and destroy the tissue [12] .

Complications Of Fibroadenoma

Usually, fibroadenoma does not cause any complications as such. The possibility of developing breast cancer out of a fibroadenoma is highly unlikely. Based on research studies, only around 0.002 per cent of fibroadenomas become cancerous [13] .

View Article References
  1. [1] Lee, M., & Soltanian, H. T. (2015). Breast fibroadenomas in adolescents: current perspectives.Adolescent health, medicine and therapeutics,6, 159–163.
  2. [2] Ng, W. K., Mrad, M. A., & Brown, M. H. (2011). Juvenile fibroadenoma of the breast: Treatment and literature review.The Canadian journal of plastic surgery = Journal canadien de chirurgie plastique,19(3), 105–107.
  3. [3] Greenberg, R., Skornick, Y., & Kaplan, O. (1998). Management of breast fibroadenomas.Journal of general internal medicine,13(9), 640–645.
  4. [4] Nassar, A., Visscher, D. W., Degnim, A. C., Frank, R. D., Vierkant, R. A., Frost, M., … Ghosh, K. (2015). Complex fibroadenoma and breast cancer risk: a Mayo Clinic Benign Breast Disease Cohort Study.Breast cancer research and treatment,153(2), 397–405.
  5. [5] Cerrato, F., & Labow, B. I. (2013). Diagnosis and management of fibroadenomas in the adolescent breast.Seminars in plastic surgery,27(1), 23–25.
  6. [6] Dixon J. M. (2001). Hormone replacement therapy and the breast.BMJ (Clinical research ed.),323(7326), 1381–1382.
  7. [7] Sanders, L. M., & Sara, R. (2015). The growing fibroadenoma.Acta radiologica open,4(4), 2047981615572273.
  8. [8] Taylor, K., Britton, P., Sonoda, L., Wallis, M., & Sinnatamby, R. (2009). Is it safe practice not to biopsy fibroadenomas in women under 30?.Breast Cancer Research : BCR,11(Suppl 2), P1.
  9. [9] Ajao O. G. (1979). Benign breast lesions.Journal of the National Medical Association,71(9), 867–868.
  10. [10] Pruthi, S., & Jones, K. N. (2013). Nonsurgical management of fibroadenoma and virginal breast hypertrophy.Seminars in plastic surgery,27(1), 62–66.
  11. [11] Wu, Y. T., Chen, S. T., Chen, C. J., Kuo, Y. L., Tseng, L. M., Chen, D. R., … Lai, H. W. (2014). Breast cancer arising within fibroadenoma: collective analysis of case reports in the literature and hints on treatment policy.World journal of surgical oncology,12, 335.
  12. [12] Baust, J. G., Gage, A. A., Bjerklund Johansen, T. E., & Baust, J. M. (2014). Mechanisms of cryoablation: clinical consequences on malignant tumors.Cryobiology,68(1), 1–11.
  13. [13] Greenberg, R., Skornick, Y., & Kaplan, O. (1998). Management of breast fibroadenomas.Journal of general internal medicine,13(9), 640–645.

Read more about: breast puberty
Story first published: Saturday, June 22, 2019, 9:00 [IST]
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