Introduction
Fibroadenomas are clinically characterized as solid, benign breast lumps that are observed more commonly in women between the age of 15 and 35. This non-cancerous lump may feel smooth, firm, rubbery, or hard and the shape is well-defined. It usually does not cause any pain and feels like a marble present in the breast which is capable of moving freely when the physical examination is done. Fibroadenomas can vary in size, and they can get enlarged or shrink on their own. These types of swellings are one of the most common noncancerous breast lumps in young women.
What Are the Symptoms?
As mentioned earlier, fibroadenomas are solid types of lumps of the breast which may have the following features:
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Round in shape.
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Distinct and smooth borders.
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Painless.
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Can move easily.
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Firm or rubbery inconsistency.
The fibroadenomas can be present in one or both breasts and can be single or multiple.
It is more common to observe lumps in the breasts of healthy women. Anyway, if you notice any of the following, you should consult your physician:
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Any recent changes in the breasts.
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Detection of a new lump in the breast during a self-examination.
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They already resent that the lump has increased in size or has changed the borders.
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Any lump which appears to be separate from the surrounding breast tissues.
How Is It Caused?
The etiology of fibroadenomas is still unknown, but they are thought to be associated with reproductive hormones. These swellings are seen to be more prevalent during the reproductive years and can get enlarged during teenage pregnancy, or in those undergoing hormone therapy. They can shrink after menopause or once the hormones are back to normal levels.
What Are the Types of Fibroadenomas?
Following are the various types of fibroadenomas:
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Simple Fibroadenomas- They are simply the lumpy breast and the swelling is single in number.
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Complex Fibroadenomas- This type can have hyperplastic changes which tend to grow rapidly. The diagnosis is done by a pathologist after examining the biopsy specimen.
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Juvenile Fibroadenomas- This type is the most commonly prevalent breast lump which is found in girls and adolescents ranging between the age of 10 to 18. These fibroadenomas are capable of growing large but most of them shrink with time and may even disappear.
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Giant Fibroadenomas- These are the fibroadenomas that can have a large growth. The size can be larger than 2 inches (5 centimeters). They might require removal as they can compress the surrounding tissues or might replace them.
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Phyllodes Tumor- Fibroadenomas are mostly benign but some of the phyllodes tumors can turn cancerous /malignant with time. The usually recommended management by the doctors for this type is removal.
How Can It Be Diagnosed?
When you visit your physician, you will be asked about the signs and symptoms, when you noticed the swelling, did it grow rapidly or slowly, if it is the same size, etc. Your family and personal history will also be asked.
Following this, a physical examination will be done. During this, both the breasts are evaluated for any lumps or any other problems. Some very smaller lumps may get left out during physical examination and may require imaging methods.
Following are the tests that can be done to evaluate the lump in the breast. The type of test will be decided by your physician depending on the patient’s age and other features.
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Diagnostic Mammography- Mammography is the method in which X-rays are used to produce an image called a mammogram of the examining areas of the breast tissue. A fibroadenoma might be detected on a mammogram and looks like a breast mass having smooth, round edges, which is different from the surrounding breast tissues.
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Breast Ultrasound- This method of imaging utilizes sound waves to produce images of the internal areas of the breast. This type of examination may be required along with a mammogram if the patient has dense breast tissue. It is also more commonly used to examine breast lumps in women less than 30 years of age.
A breast ultrasound can help to assess the type of breast lump like whether it is solid or filled with fluid. If the mass is solid, it is more likely to be a fibroadenoma whereas a fluid-filled mass is more suggestive of a cyst.
Following procedures may also be done to evaluate the breast lump:
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Fine-needle Aspiration- The contents of the breast are removed using a fine needle. If the content is fluid, the lump is more likely to be a cyst.
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Core Needle Biopsy- This procedure is done by a radiologist using guidance from an ultrasound. The physician collects samples from the lump using ultrasound guidance and sends the sample to the laboratory for examination.
How Can It Be Treated?
Most of the cases of fibroadenoma do not require any treatment. Some women prefer surgical removal of the lump. However, some women choose surgical removal for their peace of mind.
Following are the two types of management:
1. Nonsurgical Management
If the diagnosis is certain that the lesion is a fibroadenoma, then surgical removal is not required. Following are the justifications:
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Surgery can lead to a change in shape and texture of the breast.
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Fibroadenomas can sometimes shrink or they can even disappear on their own.
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If no changes in the lump, with time.
If surgical removal is not done for the lump, it is important to have regular follow-ups.
2. Surgery
If the examination reveals that the fibroadenoma is large or is causing complications, surgical removal is preferred.
The below-mentioned procedures can be utilized to remove a fibroadenoma.
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Lumpectomy or Excisional Biopsy- In this, the lump is removed and examined in the laboratory for the presence of any cancer cells.
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Cryoablation- In this, a thin, wand-like device called a cryoprobe is inserted through the skin to reach the fibroadenoma. Then, it is frozen using gas and destroyed. It is necessary to be in regular follow-ups even after surgical removal.
What Are the Complications?
Most fibroadenomas do not lead to breast cancer. Anyway, a complex fibroadenoma or a phyllodes tumor can increase the risk of developing breast cancer.
Conclusion
A fibroadenoma is a solid lump on the breast. There is no malignancy associated with this breast lump. The most common age range for fibroadenoma occurrence is 15 to 35. However, it can be found in anyone of any age. A fibroadenoma is a well-defined, solid, smooth, or rubbery lump in the breast. When touched, it moves gently and without pain. A new lump or breast alteration should be examined by a doctor, even though healthy breast tissue frequently feels lumpy. Treatment includes monitoring for changes in the size, a biopsy to evaluate it, or surgery to remove it. You can consult a specialist online through online medical platforms to know more about this condition.
