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What is a Fibroadenoma?
Causes of Fibroadenoma
Fibroadenoma Symptoms
Types of Fibroadenoma
Fibroadenoma Diagnosis
What Happens if Fibroadenoma is Left Untreated?
Fibroadenoma Treatment Options

What is a Fibroadenoma?

A breast fibroadenoma is a type of benign breast lump that appears as a solid lump. It commonly occurs in women between the ages of 14 and 35. They usually appear unilaterally as a solid lump in the breast comprising epithelial and stromal tissues. 

Typically, a fibroadenoma doesn’t cause any pain or discomfort and often appears as a pea-sized lump in the breast. They can remain the same size or grow up to 1 or 2 cm. In rare cases, the fibroadenoma can become larger than 5 cm. In some women, these lumps persist till menopause and start to shrink afterward. Not all women are lucky enough to get rid of these lumps on their own, some need proper treatment and even surgery for fibroadenoma removal. 

To understand the condition better and make an informed decision about the best treatment plan, it’s crucial to get the breast lump diagnosed immediately and consult an expert surgeon. 

Causes of Fibroadenoma

The exact cause of a fibroadenoma is still unclear, but it is known to be related to the female hormone estrogen. The breast comprises lobules (milk-producing glands), ducts (that carry milk to the nipple), glandular tissues, fatty tissues, and fibrous tissues. The fibroadenoma develops in the lobules where milk is produced, and then the glandular tissues and ducts grow over it, solidifying the lump. 

The causes of the lump can be any of the following: 

  • Hormonal fluctuations, i.e., fluctuations in estrogen and progesterone, are considered the primary cause of the lump formation. Fibroadenomas are known to have heightened sensitivity to hormones, which can lead to growth. 
  • Reproductive factors, such as early onset of menstruation or late menopause, can also increase the risk of fibroadenoma formation. Many women who haven’t started breastfeeding even after the age of 30 years also have a high risk of developing fibroadenoma. 
  • Genetic factors also play a major role in the development of fibroadenomas. Some patients have a genetic predisposition that makes them prone to developing this lump. 
  • Hormone replacement therapy that is often prescribed to women during menopause years can also cause severe fluctuations and contribute to the development of breast fibroadenomas. 
  • Birth control pills also have a major impact on hormone levels, which can again lead to the formation of fibroadenomas in the breast. 

As the exact cause of fibroadenomas is unclear, doctors always recommend taking caution and regularly examining the breast region to look for signs of breast lumps. 

Fibroadenoma Symptoms

When minute in size, fibroadenomas don’t have clear and noticeable symptoms. But as they grow, clear symptoms start to appear, which include the following: 

  • The lump is palpable and has a firm and rubbery texture. 
  • The lump is usually painless and has clear and defined borders. 
  • The size of the lump changes with menstrual cycles, i.e., the lump is larger before the periods and then shrinks afterward. 
  • The breasts seem tender, and there is occasional pain and discomfort in the affected area. 
  • The lump is movable when touched. 
  • The skin above the lump changes color or texture, such as dimpling or puckering. 

The symptoms of breast lumps are usually the same. Due to this, even though patients notice the symptoms, they cannot differentiate between the types, i.e., identify a fibroadenoma. 

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Types of Fibroadenoma

Based on the composition and structure, fibroadenomas are divided into the following types: 

  • Simple Fibroadenoma: This type of fibroadenoma has a uniform composition when they are examined under a microscope. They are the most common type of fibroadenomas, which tend to be smaller and are more likely to disappear on their own. 
  • Complex Fibroadenoma: A complex fibroadenoma has a non-uniform composition and can grow in size comparatively larger than a simple fibroadenoma. Around 15% of cases of fibroadenomas are complex, and they may also increase the risk of breast cancer. 
  • Juvenile Fibroadenoma: This type of fibroadenoma develops in people during the pubertal age, i.e., between 10 and 18, when the hormones are imbalanced. 

There is a specific type of fibroadenoma, called giant fibroadenoma, which is larger than 5 cm in size. When the lump grows this much in size, it tends to press on nearby tissues and can also disrupt the function. 

Fibroadenoma Diagnosis

When the individual finds a lump in the breast, he/she should contact a healthcare professional to get the lump accurately diagnosed and determine what would be the next step in the treatment/management plan. For a thorough diagnosis, the following tests will be recommended. 

  • Physical Exam: First, the doctor will examine the breast tissue by palpating it and assess the size, shape, and consistency of the fibroadenoma lump. 
  • Ultrasound: This test is performed for women below the age of 30 years to create a detailed image of the abnormal lump and identify its composition, size, and shape, along with the margins. 
  • Mammogram: If the woman is above 30 years old, the doctor will recommend a mammogram to get clear images of the breast tissues and identify the composition of the lump. This test also helps to determine the boundaries and margins of the lump, which further allows the surgeon to plan the treatment. 
  • Tissue Biopsy: If the result of the imaging studies is suspicious, the surgeon will recommend a tissue biopsy that involves extracting a small sample of the fibroadenoma and evaluating it under a microscope. The biopsy test confirms the diagnosis and also rules out the possibility of cancerous breast lumps. 

The above tests help to plan the most suitable method to treat fibroadenomas, which can include monitoring or removal depending on the severity of the condition. Once the fibroadenoma diagnosis is confirmed, the doctor will advise the patient to get regular follow-ups and timely screenings to monitor the changes in the breast tissues.

What Happens if Fibroadenoma is Left Untreated?

Generally, fibroadenomas can be left untreated if they are small in size and the composition after analysis is found to be uniform and not alarming. In such cases, the lump may go away on its own. 

As fibroadenomas aren’t cancerous, they aren’t considered life-threatening. But over time, they can grow in size, change their appearance (in case of complex lump), and also become painful if they compress the surrounding muscles, nerves, and blood vessels. 

In some cases, delaying seeing a doctor can increase the risk of misdiagnosis, which can, in turn, increase the risk of misdiagnosis of a cancerous breast lump. That’s why it’s always advised not to leave fibroadenomas untreated. 

Fibroadenoma Treatment Options

The most suitable treatment approach for fibroadenomas depends on their size, symptoms, and the patient’s preference. Some common options include the following: 

  • Observation: If the fibroadenoma is small and asymptomatic, it may not require immediate attention. In such cases, the doctor will recommend monitoring the lump over regular intervals through breast exams and imaging tests. 
  • Medical Treatment: As fibroadenomas develop due to hormonal fluctuations, the patient’s overall health is evaluated, and is recommended medicines accordingly. Some common medicines that are used include selective estrogen receptor modulators (SERMs) and oral contraceptives. However, the effectiveness of these methods may not be the same for all patients. Due to their usage, the size of the lump may increase or decrease, and the patient may require further intervention. 
  • Cryoablation: This is a minimally invasive approach used for the removal of fibroadenomas. It involves freezing the fibroadenoma using a cryoprobe that emits liquid nitrogen. The tissues die due to extremely cold temperatures and are expelled by the body on its own. Cryoablation is usually done for small-size fibroadenomas to ensure the scarring is minimal. 
  • Surgery: If the lump is large and symptomatic or the results of imaging tests are inconclusive, the doctor may recommend surgical removal of the fibroadenoma through lumpectomy or excision surgery. 

The best choice of treatment for fibroadenomas is made based on the severity of the condition and considering the patient’s age and other factors. The doctor openly discusses the options and creates a treatment plan that is best suited for the patient.

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FAQs related to Fibroadenoma

How can I get in touch with a Pristyn Care doctor for fibroadenoma treatment?

To get in touch with Pristyn Care’s expert breast surgeons, you can give us a call or fill out the appointment form. Our coordinators will discuss the date, time, and location of the clinic/hospital to schedule the appointment. 

How much does fibroadenoma treatment cost in India?

The cost of fibroadenoma treatment ranges from Rs. 30,000 to Rs. 60,000 or even more in case of multiple lumps. The overall cost of the treatment may be less than this if the doctor prescribes medicines for the treatment and management of the condition. 

Does health insurance cover the cost of fibroadenoma treatment?

Yes, fibroadenoma treatment costs can be covered by health insurance if the surgeon recommends surgical removal. However, the amount of coverage that can be claimed for the procedure might vary depending on your policy. To clearly understand the terms and conditions associated with the policy. 

How fast do fibroadenomas grow?

The growth rate of fibroadenomas is not clear. Normally, the lump grows at a different pace for each patient. In some patients, the growth is fast, while in others, the lump grows to a specific extent and then stops growing entirely. There is no definitive way to determine the growing speed of the breast fibroadenoma. 

Can fibroadenomas cause nipple discharge?

No, a fibroadenoma doesn’t cause nipple discharge as it forms in the lobule. If discharge occurs, there is a higher possibility that the lump is not a fibroadenoma, and further evaluation is required for an accurate diagnosis. 

Can I get breast fibroadenomas on both sides?

Yes, though it is uncommon, there is a possibility that fibroadenomas develop on both sides of the breast simultaneously. 

Can fibroadenomas become cancerous?

Generally, fibroadenomas don’t become cancerous. However, there is a small risk that a complex fibroadenoma increases the risk of cancer. If the patient has a complex fibroadenoma, regular monitoring and screening are required to detect if any cancerous breast lump develops. 

What are the different types of biopsies done for fibroadenomas?

The doctor may recommend a fine needle aspiration, core needle biopsy, or a surgical biopsy for fibroadenomas. A fine needle aspiration is done for lumps that are easily accessible, whereas a core needle biopsy is done for lumps that are difficult to reach. A surgical biopsy involves taking out the entire lump through a procedure and then sending it to the lab for an accurate diagnosis. 

Can lifestyle changes prevent fibroadenomas?

Unfortunately, there is not enough evidence to support that by making certain lifestyle changes, it is possible to prevent fibroadenomas. The only habit that you can include in your life is getting regular screenings and doing breast self-exams to detect any changes in the breasts. 

Will fibroadenoma affect my ability to breastfeed?

Typically, having a fibroadenoma is less likely to cause issues with the breastfeeding abilities of a woman. Most women breastfeed without any difficulty. However, if the patient undergoes surgery, the woman’s ability to breastfeed might be affected depending on the extent of the surgery. 

Can a fibroadenoma recur after treatment?

If only medicines are used for the treatment of fibroadenoma, there is a possibility that the lump will shrink for some time and may grow in size if the patient stops using the medicines. However, if surgical removal is done for the fibroadenoma, the chances of recurrence will be almost negligible. Still, new fibroadenomas can still develop. 

Is surgical removal always necessary for fibroadenomas?

No, surgery is not always necessary for the treatment of fibroadenomas. In many cases, this type of breast lump can disappear on its own. If not, they can also be managed with medications that maintain a balance between estrogen and progesterone hormones throughout the menstrual cycle. Surgical removal of fibroadenomas is recommended when the lump’s size is large, and it is problematic.