Fibroadenoma

Fibroadenoma is a benign breast growth that most commonly presents in teenage girls and women under the age of thirty. The presence of a fibroadenoma mass in a breast often causes women anxiety and concern, partly because people equate any type of breast lump with cancer. Fibroadenoma carries a very slight risk for future breast cancer, but the majority of fibroadenoma are benign breast growths.

Fibroadenomas are the most commonly diagnosed benign breast tumor in young women. A fibroadenoma tends to be sphere shaped, with a smoother surface than most malignant breast cancers. While malignant tumors tend to be immobile, fibroadenoma growths move easily within the breast.

Estrogen sensitivity is thought to play a role in fibroadenoma growth: some tumors may increase in size towards the end of the menstruation or during pregnancy. After menopause, many fibroadenomas spontaneously shrink due to lower estrogen levels. Hormone therapy for postmenopausal women may prevent fibroadenomas from shrinking.

Fibroadenoma growths are usually painless, but size and location of the growth can cause breast tenderness or pain. A fibroadenoma feels slightly malleable or rubbery to the touch when examined. While younger women tend to have clearly defined fibroadenoma growths, older women may present with breast calcification rather than masses.

Fibroadenoma are usually isolated breast masses. In ten to fifteen percent of cases multiple fibroadenomas may occur, and may be present in both breasts.

All fibroadenoma are composed of glandular cells and fibroconnective, or stromal, cells. The majority of fibroadenoma grow no larger than one to three centimeters, but some may grow to over five centimeters, or two inches, in length. These unusually large growths are referred to as giant fibroadenoma. Fibroadenomas found in teenagers are often referred to as juvenile fibroadenomas.

Fibroadenoma diagnosis begins with a physical examination, after which a mammogram (breast x-ray) or breast ultrasound may be ordered. Ultimately, a biopsy sample is the only definitive diagnostic method for fibroadenoma. Biopsy samples may be gathered by incisional surgery, or though fine needle aspiration. During a fine needle aspiration a long thin needle is inserted into the fibroadenoma mass to retrieve cell samples.

While biopsy is the only sure way to confirm fibroadenoma, young women in their teens to mid twenties may not require a biopsy if the lump meets all the requirements for a characteristic fibroadenoma mass.

As benign growths, fibroadenomas are not always removed from the breast. Instead, the mass is left and carefully monitored for changes in shape and size. Whether fibroadenomas are removed depends on a number of physical and psychological factors. If tumor size or location causes pain or discomfort, then the fibroadenoma will be removed.

Patient concerns and anxieties are also factors. If a woman is uneasy with the idea of a breast mass remaining untreated, the fibroadenoma may be removed to alleviate her anxiety.

A fibroadenoma may be removed under local anesthetic, either through surgery or through the use of a fine needle. If a biopsy is required to rule out malignancy, the entire fibroadenoma may be removed during the procedure.

Women with fibroadenoma have a slightly higher risk of breast cancer than other women, but not by a significant amount. Very rarely, cancerous cells are found in fibroadenoma biopsy samples, but almost all fibroadenoma are benign.

Complications from fibroadenomas are not uncommon. Biopsies and fibroadenoma removal, like all surgical procedures, carry the risk of bleeding, scarring, and post-operative infection. After a fibroadenoma is removed, it is not unusual for a new fibroadenoma to grow in the same location.

Resources

American Cancer Society. (updated 2003). Benign breast conditions.

Breast Cancer Care. (2003, August). Fibroadenoma. Breast Cancer Care leaflet.

National Library of Medicine. (updated 2003). Fibroadenoma: Breast. MedlinePlus Medical Encyclopedia.

Roubidoux, M. (updated 2004). Breast, fibroadenoma. eMedicine.