Fibroadenomas can be felt during your monthly breast self-exam, and will show up on mammograms and ultrasounds. Women in their 20s or 30s are most likely to develop a breast fibroadenoma, which may grow larger during pregnancy or lactation.
Inside a Breast FibroadenomaMost fibroadenomas are the simple type -- there's usually just one of them in your breast, with a definite border and very uniform cells. A simple fibroadenoma does not raise your risk for breast cancer.
Complex fibroadenomas are less common, and while they may have a definite border, it's what is inside this kind of fibroadenoma that makes it different. A complex fibroadenoma will not look organized and uniform like a simple fibroadenoma. Even though complex fibroadenomas don't become cancer, they may contain a collection of small cysts, calcifications, enlarged breast lobules, papillomas and different kinds of hyperplasia. When atypical hyperplasia occurs, it raises your risk of developing breast cancer.
Diagnosing a Breast FibroadenomaA breast fibroadenoma will feel smooth, firm and rubbery. It may move within your breast tissue when you're doing your breast self-exam, and it is not likely to feel painful or tender. Most of these benign lumps are between one and three centimeters, but some may grow as large as five centimeters.
Your radiologist will be able to see a fibroadenoma on your screening mammogram, and an ultrasound will help distinguish it from a fluid-filled cyst. But the most definite way to get a diagnosis of fibroadenoma is with a breast biopsy.
Treatments for a Breast FibroadenomaIf you have a clear diagnosis of a fibroadenoma, you'll have some options for dealing with it.
Watch and wait is one approach. Since fibroadenomas are not always troublesome and sometimes shrink on their own, just keeping an eye on their progress is the least invasive way to handle them.
Lumpectomy, or surgical removal of a fibroadenoma, can be done if you're worried about keeping it in your breast. Depending on the relative size of this lump and your breast, a lumpectomy may cause a change your breast's size or shape. New fibroadenomas may grow in the neighborhood of the first lump, so you should know that surgery is not a guarantee that you'll never have another fibroadenoma. On the other hand, your fibroadenoma can be carefully examined by the pathology lab to make sure the diagnosis was correct and breast cancer can be ruled out.
Laser ablation is a non-surgical way to get rid of a fibroadenoma. In your surgeon's office, an ultrasound-guided laser device is used to destroy the fibroadenoma, leaving behind only a tiny scar, no sutures, and no change in breast shape. There's no general anesthesia and no hospital visit.
Cryoablation is a fast, efficient way to freeze a fibroadenoma to death. In one office visit, cryoablation simply freezes the lump so that healthy tissue can take over. This procedure takes less than 30 minutes and results in a tiny scar.
Radiofrequency-assisted (RFA) removal of fibroadenomas is another way to take an unwanted lump out of your breast without resorting to a lumpectomy. Using local anesthesia and ultrasound guidance, a 6- to 8-millimeter cut is made above the fibroadenoma. Through this cut, a surgical wand is inserted and then tipped by a knife that is heated by radiofrequency current. This helps cut through the breast tissue without causing much bleeding. Once it reaches the target, small wires and robotic arms capture the fibroadenoma and extract it.
Mammotome breast biopsy systems can now be used as a fairly non-invasive way to remove fibroadenomas. In less than an hour, and under local anesthesia, a 6-millimeter (1/4 inch) cut is made over the fibroadenoma. Then with ultrasound guidance, a Mammotome probe is threaded into the lump, which vacuums out sections of the tissue. Recovery is quick and your scar will be quite small.
Homeopathic treatments are also used to prevent or treat breast fibroadenomas. Herbal tonics, teas, ointments, or homeopathic pills have been used in traditional cultures for fibroadenomas. Hot compresses of water, castor oil, or ginger tea have been tried as well, for relief of breast tenderness which may or may not be due to a fibroadenoma.
Bottom Line on Breast FibroadenomasThe only way to get a conclusive diagnosis of a fibroadenoma is a breast biopsy. While this can cause some anxiety, just understand that it takes a pathologist looking at the cells of a breast lump to really tell what the true nature of a breast lump may be. If you've got a fibroadenoma, you have choices about how to deal with it. And if you're ever in doubt about any breast lump, get it checked out.
Histopathology of Fibroadenoma of the Breast. Arno Kuijper, MSc, Ellen C.M. Mommers, MSc, Elsken van der Wall, PhD, and Paul J. van Diest, PhD. Am J Clin Pathol 2001;115:736-742.
Percutaneous radiofrequency-assisted excision of fibroadenomas. Fine R.E., Staren E.D. (2006) American Journal of Surgery, 192 (4), pp. 545-547.
Therapeutic Mammotome excision of fibroadenomas. A. J. Maxwell. Breast Cancer Online (2006), 9:3:e10 Cambridge University Press.