An overview of breast fibroadenomas (2023)

BreastFibroadenomeare the most common type of benign (benign) breast tumors. They are often described as round, mobile, painless lumps in the breast that are smooth and rubbery to the touch. They can be felt throughout your monthBreast self-examinationand will show up on mammograms and ultrasounds.

Fibroadenomas usually appear inpremenopausalWomen. They can grow during pregnancy, breastfeeding, or estrogen therapy.

Although fibroadenomas have a typical sensation on physical examination and look on an ultrasound of the breast, the only way to be sure that a breast lump is a fibroadenoma is by aBiopsy. Detected fibroadenomas may not need treatment unless they are large, fast-growing, or are causing bothersome symptoms.

This article explains what you need to know about breast fibroadenoma, how it's diagnosed, and what you can do about it.

Fibroadenoma Symptoms

Typically, the only symptom of a fibroadenoma is a small lump in the breast, which you can detect during a self-examination. These lumps are firm, round, smooth, rubbery to the touch, and mobile.Fibroadenomas are so mobile that women sometimes refer to them as "breast mice" because they tend to run from your fingers.

The masses can feel tender or painful, especially just before your period when they can swell due to hormonal changes.

Most fibroadenomas range in diameter from 1 to 5 centimeters (0.39 in to almost 2 in), but large fibroadenomas can be the size of a small lemon — about 15 centimeters (5.9 in).

What causes fibroadenomas?

The exact cause of fibroadenomas is unknown. You seem influencedEstrogenbecause they are most common in premenopausal or pregnant women or in women receiving estrogen therapy. Conversely, they may shrink or disappear afterwardsMenopause.

Most fibroadenomas change size during your menstrual cycle as your hormone levels change. Therefore, during this time, the same fibroadenoma may become more noticeable or shrink to a point where it is no longer easily recognized.

risk factors

Fibroadenomas are most common in women between the ages of 15 and 30 and during pregnancy.Fibroadenomas occur in 10% of all women and particularly 20% of black women.

Once you reach menopause, your risk goes down unless you use estrogen therapy.

When to see a healthcare provider

If you notice a lump during your monthly breast exam, it's important that you see your doctor, even if you think it might be a fibroadenoma. Fibroadenomas tend to have features that distinguish them from malignant growths, but the only way to be sure a lump isn't cancerous is to take a biopsy.

Your doctor will also be able to identify the type of fibroadenoma you have. This is important because some fibroadenomas can slightly increase your risk of developing breast cancer. If you have this type of fibroadenoma, a healthcare provider may recommend removing it.

Diagnose

A fibroadenoma may first be discovered during a physical exam or during a routine screening mammogram. On a mammogram, fibroadenomas appear as round or oval masses with smooth borders. The outline is clearly defined, not blurred and does not intrude into the adjacent fields. Sometimes they are accompanied by rough onescalcifications(limescale deposits). Fibroadenomas can appearcystsor a well includedTumor.

If you notice a lump during an exam or if an abnormality is seen on the mammogram: abreast ultrasoundis usually the next step. This is especially true if you have dense breast tissue, which can make a lump difficult to see.

Fibroadenoma is easier to distinguish from other tissue on ultrasound because of its response to sound waves. It appears as a dark area with a distinct outline. It appears homogeneous (looks the same everywhere), round or oval, and may have bumps with smooth edges.

Your doctor may also order digital breast tomosynthesis (DBT), a special form of mammography that creates 3D images of the breast and allows for a more detailed examination than a regular mammogram.

Biopsy

While imaging tests can suggest a fibroadenoma, the final diagnostic test is usually a breast biopsy, a procedure to remove a sample of tissue for examination in a laboratory.

Different types of biopsy procedures includeFeinnadelaspirationor core needle biopsy, both of which use needles to extract tissue, and open biopsy, a surgical procedure in which an incision is made in the skin to extract tissue samples. The type your doctor chooses depends on the characteristics of the lump, its location, and other factors. For women at increased risk of breast cancer, your doctor may strongly recommend surgical removal.

As with any biopsy, breast biopsies carry the risk of a false-negative result, i. H. the test will not detect cancer when cancer is actually present). This is because a breast biopsy may only remove part of a lump and the cancerous part could be missed. For this reason, you should continue routine breast cancer screening even if you have had a benign biopsy in the past.

Fibroadenoma Treatment

Due to differences in breast cancer risk, it is important to differentiate between the two types of fibroadenoma when choosing the best treatment options.

Fibroadenomas are classified as either:

• Easy:Most fibroadenomas are of the simple type; they are more common in younger people. Usually there is only one mass in your breast with a distinct border and very uniform cells. A simple fibroadenoma will doNotincrease your risk forbreast cancer.
• Complex:Complex fibroadenomas are less common but become more common with age. While they may have a certain limit, it's what's in this type of fibroadenoma that makes it different. Under the microscope, a complex fibroadenoma does not look organized and uniform like a simple one. There is often evidence of rapidly dividing cells (hyperplasia) which may have an abnormal appearance (atypia). A complex fibroadenoma can increase your risk of developing breast cancer.

Aside from the type of fibroadenoma, other factors can influence the choice of treatment, such as:

• Symptoms, especially discomfort and pain
• Emotional state such as B. Over-concern that it is cancer

With all of this in mind, your doctor will recommend one of the following treatment options for the fibroadenoma.

Watch and wait

Because fibroadenomas aren't always bothersome and sometimes shrink on their own, the least invasive way to treat them is to keep track of their progress.

Laserablation

At your surgeon's office, an ultrasound-guided laser device is used to destroy the fibroadenoma, leaving only a tiny scar, no stitches, and no change in breast shape. You don't need general anesthesia, and it's usually an outpatient procedure, meaning no hospital stay is required.

Kryoablation

Kryoablationis a fast and efficient method to freeze a fibroadenoma. When visiting a doctor, the healthcare provider will simply freeze the lump for healthy tissue to take over. This procedure takes less than 30 minutes and leaves a tiny scar.

Radiofrequenzablation (RFA)

This is a way to remove fibroadenomas without resorting to a lumpectomy. Uselocal anestheticand ultrasound guidance, a 6- to 8-millimeter (about 1/4 inch to nearly 1/3 inch) incision is made over the fibroadenoma. A surgical rod is inserted through this incision and then sharpened with a knife heated by high-frequency current. This helps cut through the breast tissue without causing a lot of bleeding. Once it reaches the target, small wires and robotic arms capture and extract the fibroadenoma.

Vacuum assisted excision

Breast biopsy systems can now be used as a largely non-invasive method for removing small fibroadenomas. In less than an hour and under local anesthesia, a 6mm incision is made over the fibroadenoma. Then, under ultrasound control, a probe is threaded into the knot, which sucks off tissue sections. Recovery is quick and your scar will be fairly small.

High Frequency Focused Ultrasound (HFU)

This is a relatively new treatment that has been used for fibroadenomas and sometimes even breast cancer.HFU appears to cause the selective destruction of deep tissues without damaging surrounding healthy tissues.

wide excision

Surgical removal can be done if you are concerned about fibroadenoma. Depending on the relative size of the lump and your breast, awide excisionmay cause a change in the size or shape of your breasts. New fibroadenomas can grow in the area of ​​the first node, so know that surgery is no guarantee that you will never have a fibroadenoma again. On the other hand, your fibroadenoma can be carefully examined by a pathologist to ensure your diagnosis is correct.

For pain that may be due to a fibroadenoma, over-the-counter pain relievers and applied heat are commonly used.

Complementary and alternative medicine (CAM) concerns

Certain herbal supplements and diets have been touted as effective treatments for fibroadenomas or their symptoms, but few controlled studies have looked at these agents. Adopting a healthy lifestyle, including regular exercise and eating plenty of fruits and vegetables, is always good advice and can help reduce fibroadenoma symptoms.However, remember that these procedures are not intended to replace appropriate testing and treatment. By self-treatment, you may be risking your health.

summary

Breast fibroadenomas are the most common type of benign (benign) breast tumor. They usually occur in premenopausal women. They can be felt during your monthly breast self-exam and they can be detected on imaging with mammography or ultrasound. The only way to be sure that a breast lump is a fibroadenoma is to take a biopsy.

Most fibroadenomas are considered simple and are not associated with an increased risk of breast cancer. Some fibroadenomas are considered complex because their cells look unusual under a microscope. Women with complex fibroadenomas are at increased risk of developing breast cancer and may need careful monitoring for signs of cancer development.

Proven fibroadenomas may not need treatment unless they are large, growing rapidly, or causing bothersome symptoms. Although alternative and complementary therapies (such as herbs and dietary changes) can help with symptoms, they should not replace standard evaluation and treatment.

A word from Verywell

In the end, while a biopsy can be worrying, it may be the best way to reduce the fear of fibroadenoma. Most breast lumps areNotcancerous, and it's the only way you can definitively determine what your cause is. Remember that there are many types of breast lumps, only one of which is a fibroadenoma. If you spot one, don't hesitate — have it checked out by your doctor.