Should a fibroadenoma be removed or watched?
Size, growth rate and imaging findings decide. Which fibroadenomas can be followed with ultrasound.
What a fibroadenoma is
A fibroadenoma is a benign lump made up of the normal building blocks of breast tissue. It is most common in the twenties and thirties. It feels round, smooth-edged, slippery and painless; the way it slides away when pushed with a finger is typical.
It responds to hormones: it may grow and become tender before a period, may enlarge in pregnancy, and tends to shrink after the menopause. It does not turn into cancer.
Watch or remove
Fibroadenomas with a typical appearance on ultrasound, smaller than two centimetres, not growing and causing no symptoms can be followed without surgery. Ultrasound every six months in the first year and annually thereafter is usually enough.
Fibroadenomas that grow quickly, exceed three centimetres, distort the shape of the breast, cause pain or show atypical features on imaging are removed. A lump that first appears over the age of forty is also assessed more carefully.
If the ultrasound findings are not fully typical, the diagnosis must be confirmed with a needle biopsy before any period of watching begins. A decision to watch is only made once the diagnosis is certain.
The decision is not the surgeon’s alone. Being troubled by the presence of the lump, or feeling anxious at every check-up, is a valid reason too, and we discuss it together.
How it is removed
A fibroadenoma is mostly removed through a small incision hidden in the natural creases of the breast. The procedure usually takes under an hour, you go home the same day and return to daily life within a few days. The removed tissue is always sent to pathology.
A recurrence in the same place is not expected, but a new fibroadenoma can develop elsewhere in the breast. That does not mean the operation failed.
A standard fibroadenoma operation preserves the milk ducts and does not prevent breastfeeding. For lumps sitting very close to the nipple we discuss this specifically before surgery.
The content on this site is for general information and does not replace an examination by a physician. If you have symptoms, please book an appointment.
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