What is a fibroadenoma of the breast?

From the Guidelines

A fibroadenoma is a common benign breast tumor that typically affects women, presenting as a firm, smooth, rubbery lump, and is often characterized by oval or round shape, abrupt well-defined margin, homogeneous echogenicity, and orientation parallel to the chest wall with no posterior acoustic shadowing on ultrasound, as described in the study by 1.

Key Characteristics of Fibroadenoma

• Typically affects women between the ages of 15 and 35
• Presents as a firm, smooth, rubbery lump that moves easily when touched
• Usually measures between 1-5 centimeters in size
• Composed of both glandular and fibrous tissue
• Hormone-sensitive, may grow during pregnancy or shrink after menopause

Diagnosis and Management

• Diagnosis is often made through clinical examination and imaging, with ultrasound being a key diagnostic tool, as noted in the study by 1
• Most fibroadenomas do not require treatment unless they cause discomfort or anxiety
• Surgical removal (lumpectomy) may be recommended in some cases
• Regular monitoring through clinical exams and imaging is advised to rule out other conditions, as suggested by 1

Importance of Evaluation

• If a breast lump is discovered, it is essential to have it evaluated by a healthcare provider to confirm the diagnosis and rule out other conditions, such as phyllodes tumors, which can be distinguished from fibroadenomas through excisional biopsy, as discussed in the study by 1

From the Research

Definition and Characteristics of Fibroadenoma

• Fibroadenomas of the breast are common benign lesions that predominantly affect young women 2.
• They typically present as palpable breast lumps, often with no associated nipple discharge 2, 3.
• Fibroadenomas are benign breast tumors that usually affect women in the second and third decade of life 3.

Diagnosis and Diagnostic Tools

• The diagnosis of fibroadenoma relies on a combination of clinical examination, breast imaging, and pathological confirmation 2.
• Breast ultrasound represents the most commonly used imaging modality for the study of pediatric female breast masses and fibroadenomas 3.
• The choice of imaging is mammography, combined with ultrasound in older women, and ultrasound alone in younger women 4.
• Tissue biopsy, by either fine-needle aspiration or core biopsy, is the most accurate means of establishing the diagnosis 4.

Treatment and Management

• Surgical interventions, including excisional biopsy and lumpectomy, offer symptom relief and favorable long-term outcomes 2.
• Local excision of small lesions through a circumareolar or inframammary incision rather than radical surgery is appropriate 3.
• There is increasing evidence that a conservative approach is safe and acceptable, provided the result of an adequate triple test is both negative for cancer and consistent with a fibroadenoma 4.
• Patients who choose conservative management need to be informed of the limitation of the tests, and must be assessed promptly if there is symptomatic or clinical change 4.

Rare Associations and Complications

• Breast cancer arising within a fibroadenoma is a rare phenomenon, but detecting these neoplasms is of utmost importance for complete treatment and follow-up 5.
• Non-fibroadenoma pathology, including benign phylloides, malignant phylloides, atypical ductal hyperplasia, and intraductal papilloma, may be associated with fibroadenomas 6.
• Patients with age >35 years, immobile or poorly circumscribed mass, size >2.5 cm, or biopsy not definitive for fibroadenoma should undergo surgical excision 6.