From the Guidelines
The treatment for fibroadenoma typically involves observation with regular monitoring if the lump is small and not causing symptoms, as recommended by the National Comprehensive Cancer Network guidelines 1. When it comes to managing fibroadenomas, the approach depends on several factors including the size of the tumor, symptoms, and patient preference.
- For small, asymptomatic fibroadenomas, observation is often the preferred approach, with regular follow-up using clinical breast exams and imaging studies such as ultrasound or mammogram, depending on the patient's age 1.
- Larger or symptomatic fibroadenomas may require surgical excision, which is usually performed under local anesthesia as an outpatient procedure, with the goal of removing the tumor completely while minimizing scarring and promoting quick recovery.
- It's worth noting that distinguishing between fibroadenoma and phyllodes tumor can be challenging, and clinical suspicion of phyllodes tumor, based on factors like rapid growth, large size, or suggestive ultrasound findings, may necessitate a more aggressive approach, including excisional biopsy 1.
- The use of medications to treat fibroadenomas directly is not typically recommended, although hormonal therapies might be considered in specific cases to reduce the size of the tumor.
- Regular monitoring every 6-12 months is crucial for fibroadenomas that are not removed, given their benign nature but small risk of potential complications.
- For patients with multiple or recurrent fibroadenomas, consulting a breast specialist to discuss long-term management strategies is advisable, considering the individual's overall health, preferences, and the specific characteristics of their fibroadenomas.
From the Research
Treatment Options for Fibroadenoma
- Surgical excision is a traditional treatment option for fibroadenomas, and it is still widely used today 2
- Conservative management with regular monitoring by ultrasonography is also a safe and acceptable option for patients under the age of 40, as long as the diagnosis is confirmed by a combination of clinical examination, imaging, and non-surgical tissue biopsy 3, 2
- Minimally invasive treatments, such as ultrasound-guided percutaneous excision and radiofrequency-assisted excision, have also been shown to be effective in removing fibroadenomas with minimal complications 4, 5
- For giant fibroadenomas, tumor excision without reconstructive surgery can be an effective treatment option, with good cosmetic results and outcomes on follow-up 6
Considerations for Treatment
- The size of the fibroadenoma is an important consideration in treatment, with larger lesions being more prone to recurrence after percutaneous excision 4
- Patient age and preferences should also be taken into account when deciding on a treatment option, with younger patients potentially being more suitable for conservative management 3, 2
- The use of imaging and tissue biopsy is crucial in establishing a diagnosis and guiding treatment decisions, with a combination of clinical examination, ultrasonography, and fine-needle aspiration cytology being recommended 3, 2