Fibroadenoma

What Is A Fibroadenoma?

A fibroadenoma is a benign tumor of breast tissue that is often diagnosed in younger women, usually in their twenties. The term ‘benign’ refers to the fact that this type of tumour does not display the characteristics of cancer. It is a firm, rubbery mass that may move slightly when pressed. Usually, there is no pain associated with such lumps. A fibroadenoma may grow or shrink with time and a single patient may have one or more of them.

Since fibroadenoma is benign in nature, patients are often advised to leave them in place and only come in for regular check-ups. Surgical removal may be advised if the lump is abnormally large or if it shows features such as cysts or calcification. On the other hand, it may be removed for cosmetic reasons as well.

This is the most common form of benign breast tumor in young women.

What Is Responsible For The Formation Of Fibroadenoma?

Breast tissue is composed of different kinds of tissue including adipose (fatty), fibrous and glandular tissues. The glandular tissues include milk glands (called lobules) which drain into milk ducts. A fibroadenoma originates in a milk gland or lobule and the surrounding tissue then grows around this section, resulting in the tumor. The exact reason for this is not well understood but the current theory holds that it may have to do with the female hormone estrogen. There may be a genetic component, too. The association with hormonal activity is clear because fibroadenoma evidently undergoes changes in size during periods of spikes or drops in hormones.

Here are some patterns that have been observed:

• Such lumps are most often found in premenopausal women between the ages of 15 and 30.
• African-American women have a greater than average risk of developing fibroadenoma. They tend to develop them at a younger age than Caucasian women.
• Fibroadenoma tends to grow larger during pregnancy.
• Taking oral contraceptives or hormone replacement therapy can also affect the size of the tumor.
• Post menopause, the size of existing tumors tends to reduce.

What Are The Symptoms?

A fibroadenoma is a harmless and painless tumor. It does not generally produce any noticeable symptoms. The patient may not even be aware of its presence unless it is large or close to the surface of the skin, forming a visible lump. Sometimes the tumor is small and located deep within the breast. In such cases, it may only be discovered when carrying out imaging tests during an annual check-up or in connection with other illnesses.

It is normal for a fibroadenoma to grow or shrink as time passes. This process has been linked to hormonal changes in the body. Some women notice that the size of the lump may actually be influenced by their menstrual cycle. In other cases, women may notice that the lump tends to shrink after they have attained menopause. Taking oral contraceptives or hormone replacement therapy can also influence the size of an existing fibroadenoma.

What Are The Different Types Of Fibroadenoma?

There are two main types of fibroadenoma. These are the simple and complex types respectively. A simple fibroadenoma, as the name suggests, is uniform in composition throughout. They are made up of stromal and epithelial tissue. During ultrasound imaging, these show up as uniform masses. On the other hand, complex fibroadenoma tends to reveal additional features such as cysts or calcification when subjected to ultrasound imaging. A cyst is a small fluid-filled sac. Calcification is a feature that develops when small flecks of mineral calcium are found deposited within the breast tissue.

What Are The Potential Complications?

Most women would be shocked to discover a breast lump and the first thought to cross anyone’s mind would be that the lump could be a sign of cancer. However, if the lump turns out to be a fibroadenoma, you can be assured that there is a very little risk of it turning into cancer. However, if the patient notices an unusual discharge or bleeding from the breast or if there is any pain as a result of the lump, then she should immediately bring this to the attention of her doctor because it could be a sign of malignancy. Additionally, if you are aware of a history of breast cancer in your family, your doctor may advise you to have the lump removed as a precautionary measure.

Of course, the lump itself could grow quite large and this might become embarrassing or make it difficult to breastfeed. In such instances, the patient may be advised to undergo a simple surgical procedure to have it removed.

How Is Fibroadenoma Diagnosed?

Initially, the patient will undergo a physical examination. Palpating the breast tissue is usually the first step towards diagnosing fibroadenoma. If the lump is a fibroadenoma, it should feel smooth, firm and rubbery and should be able to move slightly. This mobility explains why it is sometimes referred to as a ‘breast mouse’. However, if a tumor is small or located deeper within the breast tissue, it may be missed during this test. The next stage is to carry out ultrasonography of the breast area in order to identify unusual features in the breast tissue. Smaller lumps, cysts or calcification will be discovered during this test. A mammogram may be carried out as well.

In order to confirm that the tumor is indeed benign, the patient will then undergo a procedure known as fine needle aspiration or core biopsy. A small sample of tissue from the lump is obtained in this way, to be studied under the microscope. Based on its histological features or the characteristics of its cells as observed under the microscope, a histopathologist will make a final diagnosis. Sometimes, a biopsy is done after the lump has been surgically removed.

How Is It Treated?

If your tumor is benign and causes you no discomfort, you may be advised to let it remain. In such instances, you will still be asked to undergo regular ultrasounds or mammograms to keep a tab on the growth and monitor any significant changes. However, under certain circumstances, it may be preferable to remove the lump. There are a few different ways to do this. Cryoablation involves freezing the lump to completely destroy it. Alternatively, it can be removed by a straightforward surgical procedure known as a lumpectomy.

Can it be prevented?

While there are no specific ways to prevent the onset of fibroadenoma, it has been observed that healthy diet and lifestyle can reduce your risk. Consume a diet rich in essential nutrients and maintain a healthy weight to decrease your chances of developing fibroadenoma. 

Fibroadenoma is very common among premenopausal women. It can certainly be quite alarming to discover a breast lump, but if your test results confirm that the lump is a fibroadenoma, then you have very little cause for concern. If you have been advised to leave the lump as it is, you will still need to go in for annual or twice-yearly check-ups to monitor the condition of the lump. It is normal for a fibroadenoma to grow or shrink slightly with time. This has been linked to significant hormonal changes. So if you become pregnant or attain menopause, expect to see changes in your fibroadenoma as well.

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