From the Guidelines

Fibroadenoma of the breast is typically diagnosed with ultrasound and treated with observation or excisional biopsy if necessary.

The diagnosis of fibroadenoma is often made with ultrasound, which can identify benign features such as oval or round shape, abrupt well-defined margin, homogeneous echogenicity, and orientation parallel to the chest wall with no posterior acoustic shadowing 1.
Mammography may also be used in women aged 30 and older to further characterize the finding 1.

Observation is a reasonable alternative to biopsy for palpable solid masses with benign features identified by US, especially in young women 1.
Excisional biopsy may be recommended for palpable solid masses, especially if there are mitigating reasons to establish a definitive diagnosis more immediately, such as high-risk patients or patients with known synchronous cancers 1.
Image-guided core biopsy is the preferred method of tissue sampling, but fine-needle aspiration biopsy (FNAB) may be performed after complete imaging assessment if necessary 1.
Wide excision without axillary staging may be performed if the diagnosis is confirmed as fibroadenoma 1.
It's worth noting that fibroadenoma and phyllodes tumor can have similar clinical and imaging features, and excisional biopsy is recommended if there is a clinical suspicion of phyllodes tumor, such as rapid growth, large size, or imaging suggestive of fibroadenoma except for size and/or history of growth 1.

From the Research

Fibroadenomas are typically diagnosed through a combination of clinical examination, breast imaging, and pathological confirmation 2, 3, 4
The triple test, which includes clinical examination, imaging, and non-surgical tissue biopsy, is the most reliable method for diagnosing fibroadenomas 4
Imaging techniques such as ultrasonography and mammography can help identify fibroadenomas, which typically appear as solid, round, well-circumscribed masses 3, 4
Fine-needle aspiration biopsy (FNAB) or core biopsy can be used to establish a definitive diagnosis, but may sometimes lead to under- or overdiagnosis due to cellular discohesion and atypia 5

Surgical interventions, including excisional biopsy and lumpectomy, are commonly used to treat fibroadenomas, offering symptom relief and favorable long-term outcomes 2, 3
Conservative management may be suitable for some patients, particularly those with small, asymptomatic fibroadenomas, but requires regular follow-up and monitoring for changes in symptoms or clinical findings 3, 4
High intensity focused ultrasound (HIFU) is a non-invasive treatment option that has shown promise in reducing the volume of fibroadenomas, alleviating symptoms, and improving quality of life 6
The choice of treatment depends on various factors, including the size and location of the fibroadenoma, patient age, and presence of symptoms or anxiety 3, 4

Multidisciplinary collaboration among healthcare providers is essential for ensuring accurate diagnosis, personalized treatment decisions, and holistic patient care 2
Patients should be informed of the limitations of diagnostic tests and the potential risks and benefits of different treatment options 4
Regular follow-up and monitoring are crucial for detecting any changes in symptoms or clinical findings, and for adjusting treatment plans as needed 3, 4