Finding a lump in your breast can be frightening, but not all lumps are malignant (cancerous).
One of the most frequent benign breast diseases is fibroadenoma. The name of this condition comes from the union of the words "fibro", which stands for fibrosis, and "adenoma", which stands for glandular tissue. Consequently, fibroadenoma represents fibrosis in glandular tissue. Fibroadenomas may appear as breast lumps. Round, smooth, solid, fibroadenoma of the breast is mild and rarely leads to breast cancer.1
In this article we will clarify the differences between breast cancer and fibroadenoma, when to see a doctor, talk about preventing a fibroadenoma and thetreatments that are available.
Types of fibroadenoma
This form of fibroadenoma is characterized by nodules between 1 and 3 cm. The nodules are homogenous in morphology (similar in characterics throughout). The presence of simple fibroadenoma does not increase the risk of developing breast cancer.
Complex fibroadenomas are less common and their composition throughout the lump is different. They may contain small cysts, calcifications, papilloma and various kinds of hyperplasia. The risk for breast cancer for these lesions is higher than a simple fibroadenoma.
Giant or Juvenile fibroadenoma
It is the most common type of breast fibroadenoma in girls aged 10 to 18 years. Some can grow, but most contracts over time, and others go away.Can reach 5 cm and may squeeze or replace some breast tissue.
Causes of fibroadenoma
Causes of fibroadenoma are unclear, but it is thought that that the lesion is caused by increased responsiveness of the breast tissue to the hormone oestrogen. Fibroadenomas can grow during pregnancy and often decrease aftermenopause. Women who take contraceptive pills before the age of 20 tend to suffer from fibroadenoma at higher rates than the general population.1
Signs and symptoms of fibroadenoma
A fibroadenomacan be easily identified by each woman with a simple breast exam. The most optimum period for breast self-exam is within 5 days of the end of menstrual bleeding.
On physical examination, it hasthe following characteristics:
- Painless Mobile Solitary
- Rubber consistency and regular edges
Any changes in shape, uniformity or appearance should be reported to a doctor.
When to see a doctor:
- A mass stuck to your skin or chest wall
- Rough and irregular in texture
- Decrease in skin near lump
- Thick red skin on the chest
- Bleeding out of the nipple (nipple discharge)
- Mass in the armpitthat isentangled or attached to the skin or chest wall2
Management and treatment for fibroadenoma
Most patients with fibroadenoma do not need special therapy. Monitoring is typically recommended every 6 months - 2 years. If a suspicious fibroadenoma becomes painful and becomes larger, your doctor may recommend surgery.
The decision to remove fibroadenoma is typically dependent on:
- Whether it affects the natural form of the chest
- Causes any pain
- Whether there is a risk or stress associated with the development of cancer
- Unclear biopsy results
If fibroadenoma is removed, unfortunately they often recur later down the line
Family history of breast cancer is also important. Patients with first-degree relatives with breast cancer should be monitored and observed more carefully.
Doctors can detect fibroadenomas by an initial physical exam if the mass in the breast is large enough. If the physician suspects fibroadenoma, it will be confirmed by imaging tests, such as mammography or ultrasound (or both). To ensure that this is a fibroadenoma, your doctor may recommend a breast biopsy. For this, a local anaesthetic will be administered, after which the physician will collect a small sample of tissue to be tested in the laboratory.
Ultrasound can be used for visualization and assessment of breast nodules. During this survey, most of the time, the doctor can determine the location of nodes and their size.
Sometimes additional studies, like a biopsy, are needed.
Mammogram uses X-rays to produce an image of breast tissue. Mammograms for prevention of breast cancer are recommended in women above 50
A biopsy is used to collect tissue from the mammary structure . Afterwards, the tissue is examined histologically, to identify cells with cancerous changes.
Physicians may perform one of several types of biopsies:
- Fine needle suction biopsy: Some cells are removed from the mass by means of a thin needle attached to a syringe
- Needle Core Biopsy: A larger needle with a special tip is used to collect a larger breast tissue specimen
- Open biopsy (surgical): Physicians make a small cut to the skin and breast tissue and remove some or all of a lump. This type of biopsy is performed when needle biopsy is not feasible (for example, because no lump is felt). It can also be done after a needle biopsy that does not detect cancer to be sure that the needle biopsy has not missed the cancer
Common risk factors for the onset of fibroadenoma are:3,4,5
- Young age (<35 years)
- History of non-malignant breast disease
- Familial history of multiple fibroadenoma
- Use oral contraceptives before 20 years old
- Never being pregnancy
Research has shown that the development of fibroadenomas may slightly increase the risk of developing cancer: a recent study showed women diagnosed with complex fibroadenoma are approximately 3 times more likely to develop breast cancer than women without this condition.6
Most cases of fibroadenomas are persistent for 15 years. About half of them have recovered in five years. Also, of those that do not remit over time, half maintain their initial size, and half grow in size. Although a few of the nodules remain present in the breasts, they change morphology.
How can I prevent fibroadenoma
Significant downward trends in fibroadenoma risk have been observed with fruit and vegetable consumption and with live births. Reduced risk has also been associated with natural menopause, oral contraception and moderate exercise (such as walking and gardening).3
How common is fibroadenoma
These lesions occur in approximately one in four women7 and may represent more than two-thirds of all benign lesions in young women.8
When should I see a doctor
Self-examination of the breasts is recommendedseveral times a year. Once abreast lump is identified, consult a doctor to rule out the possibility of a more serious pathology. If the diagnosis of fibroadenoma has been made, any changes in the nodule must be studied.
Fibroadenoma is a very frequent benign (non-cancerous) breast disease. in which the symptoms can be easily identified by each woman with a simple breast exam. It is important to consult a doctor when a breast lump is discovered to rule out the possibility of any serious pathology.In most cases, a comprehensive diagnosis, including ultrasound, mammography and biopsy, will reveal a benign diagnosis like fibroadenoma. Most patients with fibroadenomas do not need special treatment, but depending on the case, the doctor may recommend surgical removal.
- Ajmal M, Khan M, Fossen K Van. Breast Fibroadenoma. Radiopaedia.org [Internet]. 2022 Oct 6 [cited 2023 Jun 9]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK535345/
- Koo MM, Von Wagner C, Abel GA, Mcphail S, Rubin GP, Lyratzopoulos G. Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis. 2017 [cited 2023 Jun 9]; Available from: http://creativecommons.org/licenses/by/4.0/
- Soltanian H, Lee M. Breast fibroadenomas in adolescents: current perspectives. Adolesc Heal Med Ther. 2015 Sep;6:159–63.
- Greenberg R, Skornick Y, Kaplan O. Management of breast fibroadenomas. J Gen Intern Med. 1998;13(9):640–5.
- Sheikh Y, Schubert R. Breast fibroadenoma. Radiopaedia.org. 2011 May 19;
- Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer WD, Rados MS, et al. Long-term risk of breast cancer in women with fibroadenoma. N Engl J Med [Internet]. 1994 Jul 7 [cited 2023 Jun 9];331(1):10–5. Available from: https://pubmed.ncbi.nlm.nih.gov/8202095/
- Berkey CS, Tamimi RM, Rosner B, Frazier AL, Colditz GA. Young women with family history of breast cancer and their risk factors for benign breast disease. Cancer. 2012 Jun 1;118(11):2796–803.
- Guray M, Sahin AA. Benign breast diseases: classification, diagnosis, and management. Oncologist [Internet]. 2006 May 1 [cited 2023 Jun 9];11(5):435–49. Available from: https://pubmed.ncbi.nlm.nih.gov/16720843/