Fibroadenoma (Breast lump)

What is fibroadenoma?

 Fibroadenomas are benign breast tumours commonly found in young women. Fibroadenoma means a tumour composed of glandular (related to gland) and fibrous (containing fibres) tissues. Breast fibroadenomas, abnormal growths of glandular and fibrous tissues, are most common between the ages of 15 and 30. They are found rarely in postmenopausal women. Described as feeling like marbles, these firm, round, movable, and rubbery lumps range from 1 cm-5 cm in size. Giant fibroadenomas are larger, lemon-sized lumps. Usually single, nearly 10-15% of women have more than one. While some types of breast lumps come and go during the menstrual cycle, fibroadenomas typically do not disappear after a woman's period, and should be checked by a doctor.

What are the causes?

The cause of breast fibroadenomas is unknown. They may be dependent upon oestrogen, because they are common in premenopausal women, can be found in postmenopausal women taking oestrogen, and because they grow larger in pregnant women.

How is the diagnosis made?

When the doctor takes a complete medical history, they will ask when the lump was first noticed, if there were any symptoms or changes in lump size, and if there is any personal or family history of breast disease. The doctor thoroughly feels the breasts. Tests are done, usually including mammography or ultrasound scans, or surgical removal of cells or tissue for examination under the microscope (biopsy).

Diagnostic tests include:

• Mammogram - an x-ray examination of the breast
• Ultrasound scan - a technique that uses sound waves to display a two-dimensional image of the breast, showing whether a lump is solid or fluid-filled (cystic)
• Fine-needle aspiration biopsy - a minor procedure wherein fluid or cells are drawn out of the lump through a small needle
• Core biopsy - a procedure wherein a larger piece of tissue is withdrawn from the lump through a larger needle
• Incisional biopsy - a surgical procedure wherein a piece of the lump is removed through an cut or incision
• Excisional biopsy - a surgical procedure wherein the entire lump is removed through an cut or incision

What are the symptoms?

Fibroadenomas usually cause no symptoms and may be discovered during breast self-examination, or during a routine check-up.

What is the treatment?

Breast fibroadenomas are removed by lumpectomy, or surgical excision under local or general anaesthesia. Sometimes lumps in younger women are not removed but are monitored by self-examination, yearly doctor check-ups, and mammograms. Surgery is generally recommended for women over 30, and for lumps that are painful or enlarging.

It is recommended to include a low-fat, high-fibre, vegetarian-type diet, a reduction in caffeine intake, supplementation with fish oil and vitamins E and C and the application of hot compresses to the breast.

What is the prognosis?

Breast fibroadenomas are not cancerous. The lumps recur in up to 20% of women.

What is the prevention?

Breast fibroadenomas cannot be prevented. They can be discovered early by regular breast self-examination.