Fibroadenoma

What is Fibroadenoma?

Fibroadenoma is a benign or noncancerous breast tumour that mostly occurs as a small, solid lump in the breast tissue measuring about less than 4centimetres in size. Fibroadenomas are firm, smooth, rubbery, and round in shape that easily move around beneath the skin. They most commonly occur in young and premenopausal women, although women of any age can develop fibroadenoma.

Types of Fibroadenomas

Some of the types of fibroadenomas include:

• Simple Fibroadenoma: When you see this type of fibroadenoma under a microscope, it appears the same all over.
• Complex Fibroadenoma: This type of fibroadenoma mostly affects women of advanced age and has cells that grow at a greater rate.
• Juvenile Fibroadenoma: This is the most common type of breast lump seen in adolescents and girls between the age group of 10 to 18. It can grow large, but the majority shrink over a period of time and some even disappear.
• Giant fibroadenoma: This type of fibroadenoma can grow larger than 5 centimeters and may need to be excised if it replaces or presses on other breast tissue.

Causes of Fibroadenoma

It is unknown what exactly causes fibroadenoma. It is suspected to be linked to reproductive hormones as they occur more often at the time of puberty or pregnancy and go away post-menopause. Use of hormone therapy is also suspected to be a potential cause of developing fibroadenoma.

Symptoms of Fibroadenoma

Fibroadenoma is usually painless, and hence you may not notice it until you feel a lump beneath your breasts while you are doing a self-check. Other times, your doctor may palpate it during your annual breast check-up or mammogram/ultrasound study. In about 10% of patient, Fibroadenomas may present with focal tenderness or even pain which may increase before a period.

Diagnosis of Fibroadenoma

In order to diagnose fibroadenoma, your doctor may perform the following diagnostic tests:

• A review of your medical history to check for any previous history of breast conditions
• A clinical breast examination to check for any lumps and other problems, such as nipple discharge or changes in the appearance of the breasts
• Ultrasound scan– use of high-frequency sound waves to create pictures of breast tissue to differentiate between a fluid-filled cyst and a solid mass
• Breast biopsy– surgical removal of a sample of breast tissue or cells from a suspicious area for microscopic analysis

Treatment for Fibroadenoma

Some of the treatment approaches employed in the treatment of fibroadenoma include:

• Wait and Watch: If the fibroadenoma is small in size, we mostly opt to simply wait and watch to see whether the lump shrinks or grows in size rather than try to excise it completely. This is the same method employed if fibroadenoma is noted during pregnancy or breastfeeding, where we wait for your hormone levels to normalise to observe if the lump disappears by itself.
• Surgery: We may opt for surgical excision of the fibroadenoma if your clinical breast exam, imaging test, or biopsy confirms abnormality or if the fibroadenoma is deemed very large, increasing in size, or causing symptoms. Surgical procedures employed for the excision of fibroadenoma include:

• Simple Excision: In this procedure, the lump is removed and sent for laboratory. This is suitable for smaller lesions.
• Excision combined with Partial Breast Reconstruction: In large fibroadenomas when removal of the lesion can cause breast deformity, Oncoplastic technique will be used for partial breast reconstruction to maintain or enhance breast shape and contour.