Fibroadenoma

What is Fibroadenoma?

Fibroadenoma is a benign (non-cancerous) breast tumour that commonly affects women. It is composed of glandular and stromal (connective) tissue. Fibroadenomas are usually round or oval in shape, have smooth boundaries, and can feel like marbles within the breast. They may move slightly under the skin when touched and are generally painless.


How Does Fibroadenoma Impact Your Anatomy and Health?

Fibroadenomas are usually small, typically 1 to 5 centimetres in diameter, though some can grow larger. They don't normally affect the overall structure of the breast unless they grow exceptionally large, a condition known as giant fibroadenoma, which can distort the shape and size of the breast. Generally, fibroadenomas are not linked to an increased risk of breast cancer. However, a subtype known as complex fibroadenomas, which contain cysts or other changes, may slightly increase the risk of developing breast cancer later in life.


From a health perspective, while fibroadenomas are not dangerous, they can cause emotional or psychological distress due to uncertainty or fear about the presence of a breast lump. It's important for individuals with fibroadenomas to monitor any changes in the size or feel of the lump and to maintain regular check-ups to ensure they remain benign.


Risk Factors for Fibroadenoma

Fibroadenomas are most common in young women in their reproductive years, especially those between 15 and 30. Factors that might increase the risk of developing fibroadenomas include early menstruation, a family history of fibroadenomas or breast cancer, and the use of hormone therapy, particularly during adolescence. There is no specific geographical, racial, or ethnic predominance, as these tumours can occur in women of any background. However, some studies suggest they may be slightly more common in African-American women.


Causes of Fibroadenoma

The exact cause of fibroadenoma is not fully understood, but it is believed to be related to reproductive hormones. Fibroadenomas are thought to result from an abnormal response to hormonal changes, primarily involving oestrogen, as these lumps often increase in size during pregnancy or when using hormone therapy and decrease in size after menopause. Genetic factors might also play a role, though specific genes associated with fibroadenomas have not been conclusively identified.


Symptoms of Fibroadenoma

Fibroadenomas are usually asymptomatic, meaning they typically do not cause any symptoms. When symptoms are present, they generally include:

  • A smooth, firm breast lump that can be moved slightly under the skin when touched.
  • The lump is usually painless.
  • It has a well-defined shape, often described as round or oval.
  • The size can vary, but most are between 1 to 5 centimetres.


Types of Fibroadenoma

Fibroadenomas can be categorised into several types based on their histological features:

  • Simple Fibroadenomas: These are the most common type and consist of stromal and glandular tissue without any cellular atypia. They do not increase the risk of breast cancer.
  • Complex Fibroadenomas contain other elements such as cysts, sclerosing adenosis, or epithelial calcifications. Compared to simple fibroadenomas, complex fibroadenomas are associated with a slightly higher risk of developing breast cancer later in life.
  • Juvenile Fibroadenomas: This type is more common in adolescent girls and can grow larger than typical fibroadenomas. They are usually benign and may sometimes resolve on their own.
  • Giant Fibroadenomas: These can grow to more than 5 centimetres in diameter and may distort the breast's shape or cause discomfort due to size.


Diagnosis of Fibroadenoma

  • Clinical Breast Exam: The doctor will examine the breasts for lumps and other abnormalities.
  • Imaging Tests: Mammography and ultrasound are commonly used to help distinguish fibroadenomas from other types of breast lumps.
  • Biopsy: A definitive diagnosis is made through a biopsy, where a sample of the lump tissue is removed and examined microscopically. Types of biopsies include fine needle aspiration, core needle biopsy, and sometimes an excisional biopsy if the entire lump is removed for analysis.


Treatment of Fibroadenoma

  • Observation: Many fibroadenomas, especially small and asymptomatic ones, do not require immediate treatment and are simply monitored over time for changes in size or feel.
  • Surgical Removal: If a fibroadenoma is large, painful, or growing, it may be surgically removed through a procedure known as a lumpectomy or excisional biopsy.
  • Cryoablation: This is a less invasive option where the fibroadenoma is frozen using a probe inserted into the lump, effectively destroying the abnormal tissue.


What if Fibroadenoma is Untreated?

Leaving a fibroadenoma untreated is often a viable option, especially if it remains stable in size and causes no discomfort. Most fibroadenomas do not increase the risk of breast cancer, particularly the simple type. However, regular monitoring is important to detect any changes requiring intervention. In cases where the fibroadenoma is complex, there is a slightly elevated risk of developing breast cancer, which necessitates careful follow-up with doctors.