Fibroadenoma - breast

• Causes, incidence, and risk factors

  Fibroadenoma is the most common benign tumor of the breast and the most common breast tumor in women under age 30. Fibroadenomas are usually found as single lumps, but about 10 - 15% of women have several lumps that may affect both breasts.

  Black women tend to develop fibroadenomas more often and at an earlier age than white women. The cause of fibroadenoma is not known.

• Symptoms

  Lumps may be:

  • Firm
  • Moveable
  • Painless
  • Rubbery

  They should have smooth, well-defined borders. They may grow in size, especially during pregnancy. Fibroadenomas often get smaller after menopause (if a woman is not taking hormone replacement therapy).

• Signs and tests

  After a careful physical examination, one or both of the following tests are usually done to determine further information:

  • Breast ultrasound
  • Mammogram

  A biopsy is needed to get a definite diagnosis. Core needle biopsy is most often performed. For more information on the different types of breast biopsies see:

  • Breast biopsy - sterotactic
  • Breast biopsy - ultrasound (core needle)
  • Breast biopsy - open

  Note: Women in their teens or early 20s may not need a biopsy if the lump goes away on its own.

• Treatment

  A biopsy is needed to get a definite diagnosis. Women in their teens or early 20s may not need a biopsy if the lump goes away on its own.

  If a biopsy indicates that the lump is a fibroadenoma, the lump may be left in place or removed, depending on the patient and the lump. If left in place, it may be watched over time with:

  • Mammograms
  • Physical examinations
  • Ultrasounds

  The lump may be surgically removed. The decision depends on the features of the lump and the patient's preferences.

  Alternative treatments include removing the lump with a needle and destroying the lump without removing it (such as by freezing, in a process called cryoablation).

• Expectations (prognosis)

  The outlook is excellent, although patients with fibroadenoma have a slightly higher risk of breast cancer later in life. Lumps that are not removed should be checked regularly by physical exams and imaging tests, following the doctor's recommendations.

• Complications

  If the lump is left in place and carefully watched, it may need to be removed at a later time if it changes, grows, or doesn't go away.

  In very rare cases, the lump may be cancerous and you may need further treatment.

• Calling your health care provider

  Call your health care provider if:

  • You have a lump and it changes
  • You feel a new breast lump
  • You have changes in the breast that are not affected by the menstrual cycle

  Perform regular breast self-exams and undergo breast screening as recommended by your health care provider.

• References

  Iglehart JK, Smith BL. Diseases of the Breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 34.

  Valea FA, Katz VL. Breast diseases: diagnosis and treatment of benign and malignant disease. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 15.

Review Date: 12/17/2009

Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Debra G. Wechter, MD, FACS, General Surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, Washington.