From the Research
No specific follow-up is required for a 39-year-old female after resection of a fibroadenoma that extends to the resection margins. Fibroadenomas are benign breast lesions with no malignant potential, so positive margins are not concerning and do not require re-excision 1. The patient should continue with routine breast cancer screening appropriate for her age and risk factors, which typically includes clinical breast exams and screening mammography starting at age 40. If the patient develops new symptoms such as a palpable mass, pain, or nipple discharge, she should seek medical attention promptly. Fibroadenomas are hormone-responsive benign tumors composed of stromal and epithelial elements, and even with positive margins, recurrence rates are low (approximately 10-15%) 2. Any recurrence can be managed with observation or repeat excision if the lesion becomes symptomatic or shows concerning changes. The patient should be reassured about the benign nature of this finding to alleviate any anxiety.
Some key points to consider in the management of fibroadenomas include:
- The size of the fibroadenoma does not necessarily dictate the need for excision, as even large fibroadenomas can be managed conservatively if they are asymptomatic and show no concerning features on imaging 3.
- Surgical excision is typically recommended for cellular fibroepithelial lesions or those lesions with clinical, radiologic, or pathologic features concerning for phyllodes tumor (PT) 3.
- Minimally invasive treatment options, such as ultrasound-guided percutaneous excision, are available for fibroadenomas and can be effective in managing these lesions with minimal scarring and excellent cosmetic outcomes 2.
- Patient satisfaction and aesthetic outcomes are important considerations in the management of fibroadenomas, and patients should be counseled about the potential for recurrence and the need for ongoing surveillance 1.
Overall, the management of fibroadenomas should be individualized based on the patient's symptoms, imaging findings, and personal preferences, with a focus on minimizing morbidity and optimizing quality of life.