From the Guidelines
Breast fibroids, or fibroadenomas, are typically not painful. These benign breast lumps are usually firm, smooth, and mobile when touched, and most women experience no pain or discomfort from them, as supported by the characteristics of benign US features, including oval or round shape, abrupt well-defined margin, homogeneous echogenicity, and orientation parallel to the chest wall with no posterior acoustic shadowing 1. However, some women may experience tenderness or mild pain, particularly before or during menstruation when hormonal changes can cause temporary swelling of breast tissue. Larger fibroadenomas might cause discomfort due to their size or if they press against surrounding structures.
Key Characteristics of Fibroadenomas
- Firm, smooth, and mobile when touched
- Benign US features, including oval or round shape, abrupt well-defined margin, homogeneous echogenicity, and orientation parallel to the chest wall with no posterior acoustic shadowing 1
- Usually develop during reproductive years and may change in size during pregnancy or menopause
Importance of Medical Evaluation
Pain is more commonly associated with other breast conditions like fibrocystic changes, cysts, or infections rather than fibroadenomas. If a breast lump is causing significant pain, it's essential to seek medical evaluation as this could indicate a different condition. During examination, your healthcare provider may use ultrasound or mammography to confirm the diagnosis, and in some cases, a biopsy might be recommended to rule out other conditions, as the likelihood of a mass with probably benign features representing a cancer is low, particularly in young women 1.
From the Research
Breast Fibroadenomas and Pain
- Breast fibroadenomas are typically described as smooth, rubbery, mobile masses on palpation 2
- They are usually treated conservatively, but surgical intervention may be indicated by the presence of symptoms, including pain 2
- Some studies suggest that fibroadenomas can be associated with discomfort or pain, particularly in cases where they are large or rapidly growing 3, 4
- A case report of an axillary fibroadenoma described the patient as experiencing discomfort associated with the lump 3
- A feasibility study on the treatment of breast fibroadenomas with ultrasound-guided high-intensity focused ultrasound ablation found that half of the patients reported a painful mass before treatment 4
- The same study reported that all adverse events were well tolerated and transient, with mild pain being the most common, but no patients reported pain at the 12-month postprocedure follow-up 4
Characteristics of Painful Fibroadenomas
- Pain associated with fibroadenomas may be related to their size, growth rate, or location 2, 3, 4
- Fibroadenomas that are large or rapidly growing may be more likely to cause discomfort or pain 2, 4
- Accessory breast tissue in the axilla, which can give rise to fibroadenomas, may undergo physiological changes like pain and discomfort during pregnancy, lactation, and menstruation 3