From the Guidelines
Fibroadenoma management typically involves short-interval follow-up with ultrasound, rather than immediate biopsy, in women under 30 years old with probably benign US findings and a clinical examination suggesting a benign etiology.
Key Considerations
- Benign US features of a solid mass, such as oval or round shape, abrupt well-defined margin, homogeneous echogenicity, and orientation parallel to the chest wall with no posterior acoustic shadowing, are characteristic of fibroadenomas 1.
- The likelihood of a mass with probably benign features representing a cancer is low, particularly in young women, with one study finding only 1 of 357 patients (0.3%) younger than age 25 years with such features was subsequently diagnosed with malignancy 1.
- Short-interval follow-up is a reasonable alternative to biopsy for palpable solid masses with benign features identified by US if the clinical examination also suggests a benign etiology 1.
- Image-guided core biopsy is the preferred method of tissue sampling if biopsy is necessary, rather than fine-needle aspiration or surgical biopsy 1.
Management Approach
- For women under 30 years old with a palpable breast mass and probably benign US findings, short-interval follow-up with ultrasound is a reasonable approach 1.
- Clinical examination and US findings should be used in conjunction to determine the likelihood of malignancy and guide management decisions 1.
From the Research
Management of Fibroadenoma
The management of fibroadenoma, a common benign breast lesion, involves a combination of diagnostic tools and treatment options.
- Diagnosis relies on clinical examination, breast imaging, and pathological confirmation 2, 3.
- Surgical interventions, including excisional biopsy and lumpectomy, offer symptom relief and favorable long-term outcomes 2.
- Minimally invasive techniques, such as ultrasound-guided vacuum-assisted biopsy (UGVAB), can serve as an efficient tool for the diagnosis and excision of breast fibroadenomas 4.
- For small lesions (less than or equal to 1.5 cm), complete excision can be achieved through UGVAB 4.
- For larger lesions, surgical excision may be necessary 4.
- In some cases, conservative management and imaging follow-up may be preferred, especially for patients with a low risk of malignancy 3, 5.
- The risk of cancer in a growing fibroadenoma is rare, and malignancy in or adjacent to a core biopsied fibroadenoma is also rare 5.
- Fibroadenomas with abnormal epithelial abnormalities require excision, while those without epithelial abnormality diagnosed by core biopsy may not require specific follow-up 5, 6.
Treatment Options
Treatment options for fibroadenoma include:
- Surgical excision 2, 3, 6, 4
- Minimally invasive techniques, such as UGVAB 4
- Conservative management and imaging follow-up 3, 5
- Excisional biopsy and lumpectomy 2
Follow-up and Surveillance
Follow-up and surveillance are important aspects of fibroadenoma management.