Fibroadenoma

Diagnosis

The diagnosis of fibroadenoma often begins with discovering a breast lump.

• Physical examination: The breast lump may have been noticeable and detected while performing a breast self-exam, or while taking a bath or a shower. Depending on the age and the characteristics of the breast lump, testing may be necessary. However, small fibroadenomas can sometimes go undetected. Imaging scans or a biopsy may be required to confirm a diagnosis. Screening mammography or a breast ultrasound can detect fibroadenomas.
• Imaging tests: These tests can provide information about a breast lump’s size, shape, and other characteristics:
  • Breast ultrasound. An ultrasound of the breasts produces images of the insides of the breasts. This test can provide extra information about small areas of interest within the breast that a mammography may not be able to detect in depth. A fibroadenoma’s size and shape are plainly seen on ultrasound. This test can also distinguish between a solid breast mass and a fluid-filled cyst. Ultrasound is frequently recommended to examine a breast lump of women under the age of 30.
  • Mammography. This is often utilized to check for any abnormalities especially if one experiences a new symptom such a lump, soreness, nipple discharge, or breast skin changes. X-rays are used in mammography to provide a picture of the breast tissue. It recognizes the boundaries of a fibroadenoma and distinguishes it from surrounding tissues. Mammography is commonly used to detect breast cancer early on before symptoms appear.

Although it uses a low-dose X-ray, it is still not recommended for women under the age of 30 due to the radiation risk. Younger patients with fibroadenomas may not respond well to mammography because of their dense tissue. Dense tissue makes it more difficult to distinguish between normal breast tissue and potential fibroadenomas.

• Biopsy: Image-guided core needle breast biopsy is often requested to further examine the lump. Using ultrasound equipment, the doctor inserts a hollow needle to a specific location to get a sample of breast tissue. The sample is sent to the lab for analysis to determine whether it is a fibroadenoma or a phyllodes tumor. It can also show the type or nature of lump present. If the biopsy results are unclear, and if the breast lump is rapidly expanding, causing pain, or causing other difficulties, removal of the lump may be necessary.

Treatment

Whether a fibroadenoma requires treatment depends on its growth rate and whether it is causing any symptoms. Typically, fibroadenomas do not require treatment and may only require regular monitoring. However, in some cases, surgery may be necessary.

In some cases, fibroadenomas may resolve on their own without the need for treatment. If a biopsy confirms that the lump is benign, the doctor may advise clinical evaluation or regular check-ups to monitor the fibroadenoma. It may be necessary to undergo an ultrasound every six months for up to two years to ensure that the fibroadenoma’s shape and size do not change.

• Surgery: The primary treatment for large fibroadenomas and phyllodes tumors is surgery. Several factors must be taken into consideration when deciding on surgery, such as:
  • Breast surgery might alter the appearance of the breast area.
  • Fibroadenomas can diminish or disappear on their own.
  • Fibroadenomas may remain unchanged over time.

Surgery is particularly recommended if the fibroadenoma is growing quickly, causing symptoms, and if the imaging test or biopsy raises concerns. Surgical treatments for fibroadenoma include:

• • Excision: This treatment involves surgically cutting off the entire fibroadenoma using a knife.
  • Freezing: This treatment kills the fibroadenoma by freezing the tissue. A small wand-like instrument is introduced through the skin of the breast to the fibroadenoma. The instrument becomes extremely cold and freezes the tissue.

Even after treatment, women who are prone to developing fibroadenomas may still experience its recurrence. To determine whether a new breast lump is a fibroadenoma or another type of breast condition, ultrasound, mammography, or biopsy may be necessary. Furthermore, it is crucial to regularly self-check and promptly consult a doctor if a new breast lump develops.