By: Sanjana Malkareddy
MCR Texas
Overview
Fibroadenomas, most common in women in their 20s and 30s, can occur at any age but often shrink after menopause. This is the most usual type of a non-cancerous breast lump and up to 10% of women assigned female at birth will have a fibroadenoma during their lifetime.
Fibroadenomas are benign, non-cancerous, tumors of the breast. They develop in the lobule region of the breast tissue, where lobules are located. Lobules are the milk-producing glands during lactation. The tumors are composed of fibrous and glandular tissue. The tumors are smooth, round, solid, painless, and, when touched, move effortlessly within the breast tissue. Breast cancer may be present in a fibroadenoma, however, this is very rare.
If a fibroadenoma is present, a healthcare provider may ask you to monitor it for changes in its size or feel. Usually, fibroadenomas shrink or disappear without treatment. Even so, a biopsy may be performed to analyze the lump or surgery to extract it. Apart from that fibroadenomas typically do not require further treatment.
Types of Fibroadenomas
The two prominent types of fibroadenomas include:
Simple Fibroadenomas are smaller, the most common, and don’t increase your risk of obtaining breast cancer. When observed under the microscope, the biopsied tissue shows consistent cellular structure.
Complex Fibroadenomas are common in women over the age of 35 and transpire approximately 15% of the time. These tumors tend to be larger and under the microscope may show differences in the cells. A mammogram may also show breast cysts, which are non-cancerous fluid-filled sacs, or breast calcifications, which are calcium deposits that form in breast tissue. When compared to women without any breast lumps, this type of fibroadenoma may slightly increase your risk for breast cancer.
Additional types of fibroadenomas are:
Giant Fibroadenomas are fibroadenomas that are larger than 5 centimeters.
Juvenile Fibroadenomas are rare and occur in adolescents aged 10 to 18 years.
Symptoms
A fibroadenoma is a solid breast lump that can occur in one or both breasts. It can consist of a singular fibroadenoma or multiple fibroadenomas.
A fibroadenoma is:
Round or oval with distinct borders
Smooth
Firm or rubbery
Easily movable
Fibroadenomas often grow slowly and can be the size of a pea or a golf ball, with the average size being around 2.5 centimeters. They don’t usually cause pain, but large fibroadenomas are more likely to hurt when touched than smaller ones. It also may become tender a few days before your period starts.
Fibroadenomas may not always grow bigger and sometimes shrink. This is most likely to happen during adolescence or menopause. However, they may get larger during pregnancy.
Causes
The exact cause of fibroadenomas is unknown, nonetheless, some believe it is caused by being sensitive to estrogen, a sex hormone essential for supporting sexual and reproductive health. This is thought because fibroadenomas often grow when estrogen levels are high, for example, during hormone therapy or pregnancy, and after menopause, when estrogen levels are low, fibroadenomas are likely to shrink.
Risk Factors
Although anyone who menstruates can get a fibroadenoma, Black individuals have a slightly higher likelihood of developing one. Fibroadenomas are more likely to appear in women in their 20s and 30s and become less common in women who’ve reached menopause.
Complications
While nearly all fibroadenomas are benign and not life-threatening, they are capable of growing larger, changing appearance, or becoming painful. Even though breast diseases are often inevitable, the risk for complications decreases through early detection through regular breast exams or mammograms.
Diagnosis
Fibroadenomas are diagnosed using imaging studies such as mammograms, breast X-rays, and ultrasounds, which use high-energy sound waves to examine structures inside the body. A breast biopsy, a procedure involving taking a sample of the fibroadenoma and sending it to a lab for examination, may also be performed to ensure the mass is a fibroadenoma.
Treatment
Some fibroadenomas may decrease in size or resolve on their own without requiring treatment. If the diagnosis confirms the lump is benign, your healthcare provider may suggest follow-up appointments to observe the lump for changes which could involve breast examinations such as manual breast exams, mammograms, or ultrasounds.
If the imaging tests or biopsy are concerning or if the fibroadenoma causes pain, a healthcare provider may recommend surgery to remove it. Surgery may also be necessary if the fibroadenoma is very large. A fibroadenoma can be removed through a surgical excision, which is the most common procedure used to remove a fibroadenoma. A less common procedure is a cryoablation, which involves freezing the fibroadenoma.
Prevention
Fibroadenomas aren’t preventable, regardless, these steps can be performed to decrease breast cancer risk:
Don’t drink alcohol or drink in moderation
Eat various fruits and vegetables
Exercise regularly
Maintain a healthy weight
Conduct frequent breast self-exams
Get regular breast exams or mammograms
Outlook/Prognosis
The outlook for a fibroadenoma is generally good as they don’t usually cause significant problems and it’s rare for them to turn cancerous. In many cases, fibroadenomas remain stable or may shrink and disappear over time, particularly after menopause. However, it is important to perform regular breast self-exams to check for new lumps or changes to existing ones. Follow-up imaging, such as ultrasound or mammograms, may be recommended to monitor any changes over time.
Citations
Fibroadenomas of the breast. American Cancer Society. (n.d.). https://www.cancer.org/cancer/types/breast-cancer/non-cancerous-breast-conditions/fibroadenomas-of-the-breast.html
Mayo Foundation for Medical Education and Research. (2022, October 13). Fibroadenoma. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/fibroadenoma/symptoms-causes/syc-20352752
MediLexicon International. (n.d.). Fibroadenoma of the breast: Symptoms, treatment, and complications. Medical News Today. https://www.medicalnewstoday.com/articles/323951#outlook
What are fibroadenomas?. Cleveland Clinic. (2024, May 1). https://my.clevelandclinic.org/health/diseases/15690-fibroadenomas-of-the-breast