What is Breast Fibroadenoma?
A fibroadenoma is a harmless lump in the breast that doesn’t lead to cancer. This smooth and solid lump is typically not painful and is usually found only on one side. It’s most common in women between the ages of 14 and 35, but it can occur at any age. After a woman goes through menopause, a stage in life when her menstrual periods stop, fibroadenomas tend to shrink and become less common.
People often call fibroadenoma a “breast mouse” because it can easily move around under the skin. It’s a firm, rubbery lump that feels like a marble under the skin of the breast. The size can vary, and it’s made of both epithelial (skin) and stromal (connective) tissues.
What Causes Breast Fibroadenoma?
The causes of fibroadenoma, a benign breast tumor, are not completely understood, but it‘s thought that hormones, particularly estrogen, play a role. This belief is supported by the fact that fibroadenoma often grows during pregnancy, when estrogen levels are high, and tends to shrink during menopause, when estrogen levels drop. In addition, it is observed that women who start taking oral birth control pills before the age of 20 tend to have fibroadenoma more often than average.
Risk Factors and Frequency for Breast Fibroadenoma
Fibroadenoma is a condition that usually starts early in life. It’s most commonly detected in teenagers and is less often seen in women after menopause. The chance of getting fibroadenoma reduces as age increases and it’s typically found in women under 30. It’s estimated that about 10% of women worldwide will experience fibroadenoma at some point in their lives.
Signs and Symptoms of Breast Fibroadenoma
Fibroadenoma, which is a common type of benign breast lump, is strongly linked with a person’s age. Therefore, when discussing a person’s medical history, their age should be taken seriously. Another important factor to consider is whether or not there is a history of breast cancer in the family. Women who have close relatives with breast cancer need more cautious monitoring to check for any signs of malignant changes as compared to those without this family history. Fibroadenoma usually appears in the upper outer part of the breast. It can be identified during a physical examination through the following characteristics:
- It does not cause pain or tenderness.
- It is movable under the skin.
- Usually, there is only a single lump.
- The lump grows rapidly and feels rubbery. It also has smooth, even edges.
Testing for Breast Fibroadenoma
After running all necessary tests and conducting a physical examination, your doctor might use several imaging techniques to diagnose fibroadenomas, which is a type of non-cancerous or benign breast lump.
Mammogram Examination
A mammogram is a type of x-ray specifically designed to examine breast tissue. This technique is commonly used for women who are over 35 years. In the case of a fibroadenoma, the mammogram will show a distinct area that looks different from the surrounding breast tissue. This area will appear smooth and round at the edges. Sometimes, the characteristics of a fibroadenoma on a mammogram can vary, ranging from a clear, circular mass to a mass with irregular ‘macro lobulation’ (large bubble-like structures) or partially hidden edges. If fibroadenomas start to shrink or ‘involute’, particularly in older, postmenopausal women, they may contain calcifications. These appear as coarse, popcorn-like spots on the mammogram.
Breast Ultrasound
For women under the age of 35, an ultrasound can often be more helpful. This technology uses sound waves to distinguish between solid lumps like fibroadenomas and fluid-filled lumps (cysts). When a fibroadenoma is viewed through an ultrasound, it generally appears as a well-defined, round, or oval mass with a uniform dark appearance (hypoechogenicity).
If there’s still doubt about the diagnosis after these imaging techniques, your doctor might do a minimally invasive biopsy using a core needle. This involves taking a small sample of the lump tissue to be examined under a microscope. This further helps in confirming the diagnosis of a fibroadenoma.
Treatment Options for Breast Fibroadenoma
In most cases, fibroadenomas, which are non-cancerous lumps in the breast, don’t need treatment. Over time, these lumps tend to reduce in size or disappear completely. However, if a fibroadenoma is large enough that it’s pressing on other breast tissue, it may need to be removed. Still, many women choose not to have this surgery because these lumps are not harmful and don’t increase their risk of developing cancer. Surgery also has the potential to alter the shape of the breast.
When it comes to surgery, doctors might recommend removing the fibroadenoma if it’s very large and continues to grow. Reasons why a surgical procedure may be suggested include rapid growth of the lump, a size greater than 2 cm (around 0.8 inches), or if the patient requests it. There are two surgical procedures that can be used to remove a fibroadenoma:
1. Lumpectomy or excisional biopsy: In this procedure, the doctor removes the lump and sends it to a lab for further examination.
2. Cryoablation: This approach involves using a device called a cryoprobe to freeze and destroy the lump. Before cryoablation, a core needle biopsy has to be performed to make sure that the lump is indeed a fibroadenoma. This involves taking a small sample of the lump tissue with a needle for testing in a lab.
What else can Breast Fibroadenoma be?
When a doctor is trying to figure out whether a patient has a breast fibroadenoma, there are other conditions they need to consider that could show similar symptoms. These include:
- A cyst in the breast
- Breast cancer
- Phyllodes tumor, which is a rare breast tumor
- Breast lymphoma, a type of cancer that starts in cells that fight infection
- Metastasis to the breast from cancer in a different part of the body
What to expect with Breast Fibroadenoma
The outlook for fibroadenoma is positive since it’s a harmless lump that generally becomes smaller over time.
Possible Complications When Diagnosed with Breast Fibroadenoma
The risk of developing breast cancer can be a bit higher in people who have a certain type of lump in their breast known as a complex fibroadenoma. This lump might contain a hard substance, similar to bone, inside the breast tissue.
