Fibroadenoma

Diagnosis

You may first notice a fibroadenoma while bathing, showering, or performing a breast self-exam. Sometimes, fibroadenomas are discovered during a routine medical exam, a screening mammogram, or a breast ultrasound.

If you have a breast lump that can be felt, your healthcare provider may recommend specific tests or procedures. The type of test depends on your age and the characteristics of the lump.

Imaging tests
Imaging tests help determine the size, shape, and structure of the lump:

• Breast ultrasound:
  This test uses sound waves to create images of the inside of the breast. It’s often the first choice for people under 30 because it clearly shows the size and shape of a fibroadenoma and can distinguish between a solid lump and a fluid-filled cyst. Ultrasound is painless and noninvasive.

• Mammography:
  This imaging method uses X-rays to capture pictures of breast tissue, known as mammograms. It can help define the borders of a fibroadenoma and differentiate it from surrounding tissue. However, it may be less effective for younger individuals with dense breast tissue. Due to radiation exposure, mammograms are generally not recommended for people under 30.

Biopsy
If imaging results are unclear or if there’s any doubt about the type of lump, a biopsy may be done to examine a sample of the tissue.

A core needle biopsy is the most common procedure for fibroadenomas. During this test, a radiologist uses ultrasound guidance to insert a hollow needle into the lump and collect a tissue sample. A pathologist then examines the sample under a microscope to confirm whether it’s a fibroadenoma or a different type of tumor, such as a phyllodes tumor.

If the lump is painful, growing quickly, or causing other issues, your healthcare provider may recommend removing it entirely. Surgery may also be needed if biopsy results are unclear.

Treatment

Many fibroadenomas do not require treatment. However, in some cases—such as when the lump grows quickly or causes discomfort—surgical removal may be recommended.

When no treatment is needed
If imaging and biopsy results confirm that the lump is a fibroadenoma, you may not need surgery. Consider the following before deciding:

• Surgery can alter the appearance of your breast.

• Fibroadenomas sometimes shrink or disappear naturally.

• They may remain stable without changes over time.

If you choose not to have surgery, your healthcare provider may schedule follow-up visits to monitor the fibroadenoma with ultrasound imaging. Report any changes in the lump between visits.

When surgery may be needed
Surgery might be recommended if:

• Imaging or biopsy results raise concern

• The fibroadenoma is large, growing rapidly, or causing symptoms

• The lump is identified as a giant fibroadenoma or phyllodes tumor

Surgical options include:

• Surgical excision: The surgeon removes the fibroadenoma using a small incision.

• Cryoablation (freezing): A thin probe is inserted into the breast and cooled to freeze and destroy the fibroadenoma. This option may not be available at all medical centers.

After treatment, new fibroadenomas may form. If you discover another lump, contact your healthcare provider for evaluation. Tests such as ultrasound, mammography, or biopsy may be needed to determine whether it’s a new fibroadenoma or another breast condition.