Breast Fibroadenoma: What It Is and How It Is Managed
What is a fibroadenoma?
The fibroadenoma is the most common benign breast tumor, especially in women aged 15 to 35 years. It accounts for about 50% of breast biopsies in this age group. It usually appears as a round, mobile and painless formation, and can be single or multiple.
The etiology remains unclear, but is related to hormonal fluctuations of reproductive age. Most fibroadenomas subside or stabilize after menopause.
How is it detected?
Fibroadenomas are identified by:
- With clinical palpation (usually by the woman herself)
- Via Breast ultrasound
- Less commonly, mammography or MRI
Their size varies from 1 to 3 cm but can reach up to 10 cm.
Does it increase breast cancer risk?
Στα simple fibroadenomas, no increased risk is observed cancer development.
The risk only increases when:
- Fibroadenoma is complex (complex)
- There is family history breast cancer
- Other histopathological abnormalities coexist
That's why the pathological identification is important in risk assessment.
What is the appropriate management?
The standard treatment of fibroadenomas is the tracking:
- If the mass has features of fibroadenoma and is <2 cm, it is recommended ultrasound check every 4-6 months for 2 years, and then annually.
- In cases of doubtful image, it can be performed Biopsy with a needle under local anesthesia.
Many fibroadenomas decrease in size over time, while some disappear completely.
When is removal recommended?
The Surgical removal of a fibroadenoma is necessary when:
- It is larger than 2–3 cm
- It is symptomatic (e.g. causes pain or discomfort)
- It is increasing in size
- Shows suspicious imaging features
- There is a strong family history of breast cancer
- The patient prefers not to undergo regular monitoring
Important: Sudden increase in size raises suspicion foliated tumor, which requires a different surgical approach.
Promising Non-invasive Treatments
For patients who do not want surgery, are now being studied modern alternatives, such as:
- Cryoablation: A minimally invasive technique that destroys the lesion by freezing it using a specialized needle under ultrasound guidance.
- High Intensity Focused Ultrasound (HIFU): A non-invasive method using ultrasound energy to ablate the tumor without incisions or anesthesia, with high rates of tumor shrinkage and pain relief.
These options are ideal for women who want good aesthetics and quick recovery.
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Bibliography:
Ramala R, Sinha A, Patel H, et al. A Comprehensive Review of Breast Fibroadenoma: Correlating Clinical Presentation and Histology. Cureus. 2023 Dec 15;15(12):e38179396.
Boeer B, Oberlechner E, Rottscholl R, et al. Five-year follow-up after a single US-guided high intensity focused ultrasound treatment of breast fibroadenoma. Sci Rep. 2024 Aug 7;14(1):18370.
Díaz de Bustamante Durbán T, et al. Ultrasound-guided cryoablation: Our experience in percutaneous treatment as an alternative to surgery for fibroadenomas of the breast lesions. Radiologia (Engl Ed). 2024 May-Jun;66(3):228-235.
Ramala R, Sinha A, Patel H, et al. Understanding Fibroadenoma of the Breast: A Comprehensive Review. Cureus. 2023 Dec 15;15(12):e38288219.
PMID: 38288219
