Fibroadenoma is a common non-cancerous, painless, unilateral breast tumour which is solid, not fluid filled lump. Mostly common in young women ranging from age 14 until 35. This tumour is made up of glandular tissue and stromal tissue. Fibroadenomas tend to shrink after menopause, therefore less likely to be seen with post-menopausal women. It is also often referred to as a breast mouse because of their high mobility. Mens also can be diagnosed with fibroadenomas but rare. These fibroadenomas feel like a rubbery firm with regular borders and are often in various sizes. It is mostly located at the upper outer quadrant of the breast.
What causes fibroadenomas?
The exact cause is unknown. Females who are on oral contraceptive pills within the age of 20 will have a higher rate of getting a fibroadenoma. The professionals believe that the estrogen hormone has a tendency to increase the sensitivity of breast tissue.
Types:
- Simple fibroadenoma
Looked the same as all over under a microscope. - Complex fibroadenoma
Is a hyperplastic cell which rapidly grows. - Juvenile fibroadenoma
Commonly found with paediatrics patients in age of 10 till 18 years old. - Giant fibroadenoma
This tissue is slightly larger in size which may require resections because it compresses the normal function of breast tissue.
History and physical examination:
History taking which starts from age. Age is the most important to identify the incidence of fibroadenoma. Family history of breast cancer can be significant. Womens with a history of first degree relatives with breast cancer should be carefully monitored. A manual breast examination will be performed to identify the size, numerous features and association of lymph node enlargement.
Most commonly fibroadenoma will be found at the upper and outer quadrant of the breast. It has the features of painless/non-tender, mobile, single lump, rapidly growing solid.
Diagnosis:
A thorough history taking and manual breast examination followed by imaging modalities such as breast ultrasound or diagnostic mammogram.
Ultrasound of breast
Usually a breast ultrasound will be performed in women younger than the age of 35 years. On ultrasound, the fibroadenoma usually appears like a well-circumscribed, round to oval, or macro-lobulated mass with uniform hypoechogenicity.
Diagnostic mammogram
A mammogram usually performs in women aged more than 35 years. A fibroadenoma appears like a smooth round edge as a distinct area from breast muscle on mammography. It shows variable sizes from a well-circumscribed discrete oval mass hypodense of breast glandular tissue to a mass with macro-lobulated or partially obscured margins.
Image guided core needle biopsy
Minimally invasive procedures will be performed by taking a small tissue sample and sending it to the laboratory if necessary.
Treatment:
Most fibroadenoma need no treatment. It will shrink and disappear over time. If the size is large and compresses the breast tissue, it should be removed. A surgeon will be referred for a surgical intervention.
The decision of surgical removal of lump will be depending on the size whether increasing rapidly or upon patient request. 2 method of surgical removal of fibroadenoma: Lumpectomy or excisional biopsy and Cryoablation.
Breast self examination is advised for all women
- Best to examine after 4-10 days of menses.
- Look to the mirror with your arms on hips (look for size, shape and color). Observe for abnormalities such as dimpling skin, abnormal shape, nipple inverted and inflammation).
- Raise up your both arms and look for the same as mentioned in step 2. Additionally look for any nipple discharge.
- Lying down on bed with raised arms. Use the pad of the fingers with massage oil for a smooth touch on each breast. Pattern follows up and down, circular and wedges from armpit to breast and rib cage. Feel for any abnormalities such as lump or swelling of lymph nodes.
- Sitting or standing position with similar step number 4.
Any abnormalities should consult a doctor.
DTAP clinic offers breast cancer awareness screening which includes manual breast examination, breast ultrasound, pap smear and medical review.
