From the Guidelines
The incorrect statement regarding fibroadenoma is that it is a premalignant lesion. Fibroadenomas are mostly benign breast lesions, and they are not included in the TNM classification system, which is specifically designed for malignant tumors. The TNM system categorizes cancerous breast tumors based on the size of the primary tumor (T), involvement of regional lymph nodes (N), and presence of distant metastasis (M) 1. Since fibroadenomas are non-cancerous growths composed of breast tissue and stromal components, they do not require cancer staging. They are typically managed through observation or surgical excision depending on their size, symptoms, and patient preference 1. Some key characteristics of fibroadenomas include:
- Mostly benign
- Mostly mobile
- Can be diagnosed by mammogram, although this method may not distinguish them from phyllodes tumors in some cases
- May be huge in size Fibroadenomas are the most common benign breast tumors in women under 30 years of age and are characterized by their firm, rubbery texture and mobility within the breast tissue. While they may require clinical attention, their benign nature excludes them from cancer staging protocols like TNM. It's worth noting that phyllodes tumors, which can be benign, borderline, or malignant, may present similarly to fibroadenomas but require a different management approach, including excisional biopsy to determine their nature 1.
From the Research
Incorrect Statement Regarding Fibroadenoma
The incorrect statement regarding fibroadenoma is:
- Premalignant lesion
This is because fibroadenomas are considered benign breast lesions and are not typically considered premalignant lesions. According to 2, the consensus view is that women with fibroadenomas are not at significant increased risk of developing breast cancer. However, it is worth noting that while rare, malignant transformation of a fibroadenoma can occur, as discussed in 3.
Characteristics of Fibroadenoma
Fibroadenomas are characterized by the following:
- Mostly benign 2
- Mostly mobile 4
- Can be diagnosed by mammogram, but diagnosis is based on the combination of clinical examination, imaging, and non-surgical tissue biopsy (the triple test) 2
- May be huge, as in the case of giant fibroadenomas 5
Diagnosis and Management
Diagnosis of fibroadenoma is typically made using a combination of clinical examination, imaging (such as mammography and ultrasound), and tissue biopsy 2, 4. Management options include surgical excision, observation, and conservative management 2, 4. High intensity focused ultrasound (HIFU) has also been explored as a non-invasive treatment option for fibroadenomas 4.