From the Guidelines

Fibroadenoma of the breast is typically managed with observation, as the likelihood of malignancy is low, especially in young women.

For women younger than 30 years of age with a palpable breast mass and US findings probably benign, short-interval follow-up with US is a reasonable alternative to biopsy 1.
Benign US features of a solid mass include oval or round shape, abrupt well-defined margin, homogeneous echogenicity, and orientation parallel to the chest wall with no posterior acoustic shadowing 1.
Biopsy is recommended for palpable solid masses with suspicious features or if the clinical examination suggests a malignant etiology 1.
Excisional biopsy is not typically necessary for fibroadenoma, but may be considered if there is a clinical suspicion of phyllodes tumor, such as rapid growth or large size (> 2 cm) 1.

Ultrasound is the preferred imaging modality for characterizing palpable breast masses, especially in young women 1.
Mammogram may be considered for women aged 30 years and older 1.
Core needle biopsy may be used to confirm the diagnosis, but may not distinguish fibroadenoma from phyllodes tumor in most cases 1.

From the Research

The management of fibroadenoma of the breast can be approached through conservative management or surgical excision 2, 3.
Conservative management is considered safe and acceptable if the result of an adequate triple test (clinical examination, imaging, and non-surgical tissue biopsy) is both negative for cancer and consistent with a fibroadenoma 3.
Surgical excision is often recommended for symptomatic fibroadenomas, and this option should always be offered to patients 3.

Physical examination, sonography, and fine needle aspiration are effective in distinguishing fibroadenomas from breast cancer 2.
The triple test, which includes clinical examination, imaging, and non-surgical tissue biopsy, is the most accurate means of establishing the diagnosis of fibroadenoma 3.
Mammography, combined with ultrasound in older women, and ultrasound alone in younger women, can be used for imaging 3.

Transformation from fibroadenoma to cancer is rare, and regression or resolution is frequent, supporting conservative approaches to follow-up and management 2.
Conservative management of fibroadenomas over 5 years may not be practical in some settings due to high patient attrition rates 4.
Patients who undergo surgical excision of fibroadenomas may experience recurrence or development of additional fibroadenomas, and this should be addressed during counseling for treatment options and postoperative follow-up 5.

Minimally invasive techniques and ongoing research into genomics and molecular aspects hold promise for the future of fibroadenoma management 6.
Multidisciplinary collaboration among healthcare providers is paramount, ensuring accurate diagnosis, personalized treatment decisions, and holistic patient care 6.