Fibroadenoma - breast

Definition
Fibroadenoma of the breast is a benign (noncancerous) tumor.

Causes, incidence, and risk factors

Fibroadenoma is the most common benign tumor of the breast and the most common breast tumor in women less than 30 years of age. Fibroadenomas are usually found as solitary lumps, but about 10-15% of women have multiple lumps that may affect both breasts.

Black women tend to develop fibroadenomas more frequently and at an earlier age than white women. The cause of fibroadenoma is not known.

Symptoms

• May be felt as a moveable, painless, firm, or rubbery lump with well-defined borders
  
• May grow in size, especially during pregnancy
  
• Often gets smaller after menopause (if not taking hormones)

The following may be performed to gain information about a breast lump:

• Physical examination
  
• Mammogram
  
• Ultrasound
  
• Fine needle aspiration
  
• Biopsy (needle or open)

• A biopsy is needed to get a definitive diagnosis. Women in their teens or early 20s may not need a biopsy if the lump appears to be a typical fibroadenoma and does not change.
  
• If a biopsy indicates that the lump is a fibroadenoma, the lump may be left in place or removed, depending on the patient and the lump. If left in place, it may be watched over time with physical examinations, mammograms, and ultrasounds.
  
• The lump may be surgically removed at the time of an open biopsy. (This is called an excisional biopsy.) This depends on the features of the lump and the patient’s preferences.
  
• Alternative treatments include removing the lump with a needle, and destroying the lump without removing it (such as freezing, called cryoablation).

The outlook is excellent, although patients with fibroadenoma have a slightly higher risk of breast cancer later. Lumps that are not removed should be periodically monitored by physical examinations and imaging, following the recommendations of the doctor.

Complications

• If the lump is left in place for observation, removal may be needed at a later time if the lump changes or grows.
  
• Cancer may be found in the lump (very rare) and require further treatment.
  
• Biopsy or removal may result in bleeding or scarring.

Patients should contact their health care provider if they feel a new breast lump, if a known lump changes, or if they note changes in the breast that aren’t affected by the menstrual cycle. Women should perform regular breast self exam and undergo breast screening as recommended by their health care provider.

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