Breast Fibroadenoma: Types, Symptoms, Causes, Recovery & Treatment

Breast fibroadenomas are noncancerous (benign) lumps that commonly develop in the breast tissue of women. They usually occur as a single lump, but can also develop in clusters. Fibroadenomas can occur in one or both breasts and are most common in women between the ages of 20 and 30, but can occur at any age.

Fibroadenomas contain glandular and fibrous tissues and are typically round or oval-shaped with a well-defined border. The size of lump vary from perrson to person, ranging from as small as a pea to as large as a golf ball. Fibroadenomas are usually painless in nature, but can sometimes cause tenderness or discomfort.

Here are some figures on the incidence and prevalence of fibroadenomas in India and worldwide:

• According to a study published in the Indian Journal of Surgical Oncology in 2013, fibroadenomas are the most common benign breast tumors in Indian women, accounting for 39.9% of all benign breast tumors.
• The same study found that the incidence of fibroadenomas in Indian women is higher than in Western countries, with a prevalence of 22.7 per 100,000 women.
• A study published in the Journal of Clinical and Diagnostic Research in 2017 found that fibroadenomas account for 58.2% of all breast tumors in Indian women under the age of 25.
• According to the American Cancer Society, fibroadenomas are the most common benign breast tumors in women under the age of 30 in the United States, accounting for about 10% of all breast lumps.
• The incidence of fibroadenomas in the United States is estimated to be between 7% and 10% of women, according to a review article published in the Journal of Clinical Medicine in 2016.

There are several types of fibroadenomas, including:

• Simple Fibroadenoma: This is the most common type of fibroadenoma, accounting for about 75% of all fibroadenoma cases. They typically occur in women between the ages of 15 and 35. It typically presents as a single lump that is round or oval-shaped with a well-defined border. It is often discovered during a routine breast exam or mammogram. Simple fibroadenomas do not typically require treatment, but your doctor may recommend monitoring it over time to make sure it does not change in size or shape.
• Giant Fibroadenoma: This is a type of simple fibroadenoma, but is larger than 5 centimeters in diameter. While giant fibroadenomas are still benign, they can be concerning due to their size and may cause discomfort or cosmetic concerns. Treatment may include removal of these lumps, especially if it is growing or causing discomfort. This type of fibroadenoma is rare, accounting for only 0.5% to 2% of all fibroadenomas. It is more common in younger women and can grow quickly, sometimes reaching a size of 10 centimeters or more.
• Complex Fibroadenoma: This type of fibroadenoma has additional features that can be seen under the microscope, such as presence of cysts, calcifications, or abnormal cell growth. Complex fibroadenoma is a rare entity, accounting for only 0.5% to 2% of all fibroadenomas. It is more common in younger women and can grow quickly. While still benign, a complex fibroadenoma can be more difficult to distinguish from a phyllodes tumor, which is a rare type of breast tumor that can be malignant. Therefore, your doctor may recommend you for a biopsy to confirm the diagnosis and rule out the possibility of a phyllodes tumor.
• Juvenile Fibroadenoma: This type of fibroadenoma occurs in adolescent girls and young women under the age of 25. It is usually smaller than a typical fibroadenoma and often disappears on its own without any medical intervention. However, if it causes pain or continues to grow, it may need to be removed. They account for about 10% to 20% of all fibroadenomas.
• Multiple Fibroadenomas: When a woman has two or more fibroadenomas in one or both breasts, it is known as multiple fibroadenoma. This is a relatively uncommon condition, occurring in less than 10% of women with fibroadenomas. While multiple fibroadenomas are not necessarily a cause for concern, it may be helpful to monitor them for changes in size and shape over time. Your doctor may also recommend you a biopsy if there are any concerning issues or if the fibroadenomas are causing discomfort or growing rapidly.

It is crucial to understand that while fibroadenomas are benign, they can sometimes be mistaken for other types of breast tumors, so it is always essential to consult a doctor if you notice a lump or other changes in your breast.

The exact cause of fibroadenomas development is still under research, but there are some risk factors that have been identified. The following are some possible causes and risk factors of fibroadenomas:

• Hormonal fluctuations: Changes in hormone levels, such as those that occur during puberty, pregnancy, and menopause, can cause the breast tissue to become more sensitive and increase the likelihood of developing fibroadenomas.
  • During puberty, the breast tissue is undergoing rapid changes and can be particularly sensitive to hormonal fluctuations.
  • During pregnancy, hormonal changes can cause the breast tissue to grow and change, which may increase the likelihood of fibroadenomas growth.
  • During menopause, when hormone levels decrease, the breast tissue may become more susceptible to fibroadenomas development.
• Family history:
  • Women with a family history of fibroadenomas or breast cancer may have higher chances of developing fibroadenomas themselves.
  • Genetic mutations, such as mutations in the BRCA1 or BRCA2 genes, can increase the risk of both fibroadenomas and breast cancer.
• Age:
  • Fibroadenomas can occur at any age, but are most common in women in their 20s and 30s.
  • As women age, the likelihood of developing fibroadenomas decreases.
• Race: Fibroadenomas are more common in white women than in women of other races. The exact cause of this racial disparity is not known.
• Lifestyle factors: Certain lifestyle factors, such as a high-fat diet, alcohol consumption, and smoking, may increase the risk of developing fibroadenomas.
  • high-fat diet may increase estrogen levels, which can increase the likelihood of fibroadenomas development.
  • Alcohol consumption may increase estrogen levels and also affect the way the body metabolizes hormones, increasing the risk of fibroadenomas.
  • Smoking may also affect the way the body metabolizes hormones, increasing the risk of fibroadenomas growth.

These factors may increase your risk of developing fibroadenomas, but they do not necessarily cause them. Additionally, fibroadenomas are typically benign and do not increase the risk of breast cancer. However, if you have concerns about a lump in your breast or notice any changes, it is always best to seek professionals’ advice and undergo any necessary testing or treatment.

There may be no surefire way to prevent fibroadenomas development, as the exact cause of fibroadenomas is not well understood. However, there are some steps that may help to reduce the risk of developing fibroadenomas:

• Maintain a healthy lifestyle: Eating a healthy diet, maintaining a healthy weight, exercising regularly, avoiding tobacco and limiting alcohol consumption may help reduce the risk of developing fibroadenomas, as well as other chronic health conditions. A study published in the Journal of Women's Health found that maintaining a healthy lifestyle, including eating a healthy diet, maintaining a healthy weight, and exercising regularly, was associated with a lower risk of developing fibroadenomas.
• Know your family history: If you have a family history of fibroadenomas or breast cancer, you may be at higher risk for developing fibroadenomas yourself. Therefore, it is crucial to discuss this with your healthcare provider and undergo appropriate screening and monitoring. A study published in the Journal of Clinical Oncology found that women with a family history of breast cancer were at higher risk of developing fibroadenomas than women without a family history. This highlights the importance of discussing family history with a healthcare provider and undergoing appropriate screening and monitoring.
• Practice breast awareness: Regularly performing breast self-exams and being aware of any changes in your breasts can help to identify any lumps or other abnormalities early on, which can be crucial for early diagnosis and treatment. The National Breast Cancer Foundation recommends that women perform breast self-exams regularly and be aware of any changes in their breasts. Early detection is key in the treatment of breast conditions, including fibroadenomas.
• Consider hormonal birth control options: Some studies suggest that certain types of hormonal birth control may be associated with a higher risk of developing fibroadenomas. Women who are concerned about this should discuss alternative birth control options with their healthcare provider. A study published in the journal Cancer Epidemiology, Biomarkers & Prevention found that the use of hormonal birth control pills containing both estrogen and progestin was associated with a higher risk of developing fibroadenomas. Women who are concerned about this may wish to discuss alternative birth control options with their healthcare provider.

While these steps may help to reduce the risk of developing fibroadenomas, they do not guarantee prevention. If you notice any changes in your breasts or have concerns about breast health, it is crucial to discuss them with your healthcare provider.

The following are some common diagnostic tests used for identifying fibroadenomas:

• Clinical breast exam: 

A healthcare provider performs a physical examination of the breasts and surrounding areas. The provider will carefully examine the breast tissue to identify any lumps or other abnormalities. They may also examine the lymph nodes in the armpit area for any signs of swelling or tenderness.

• Imaging tests:

1. Mammogram: A mammogram is a type of X-ray that uses low-dose radiation to create the breast tissues’ images. During a mammogram, the breast is compressed between two plates to spread out the tissue and provide a clear image of them. Mammograms can help to identify the size, shape, and location of a lump, as well as any other abnormalities in the breast tissue. They are often used as a screening tool for breast cancer, but they can also be used to diagnose fibroadenomas.
2. Ultrasound: An ultrasound uses high-frequency sound waves that create images of the breast tissue mass. During an ultrasound, a small handheld device called a transducer is passed over the breast, and the sound waves are translated into images on a screen. Ultrasounds can help to distinguish between solid lumps, such as fibroadenomas, and fluid-filled cysts. Doctor often uses it in conjunction with mammograms for a more thorough evaluation of breast lumps. Since fibroadenoma are common in young females, this is investigation of choice. 
3. Magnetic resonance imaging (MRI): An MRI uses a powerful magnetic field and radio waves to create numerous detailed images of the breast tissue. During an MRI, the patient lies on a table that slides into a tunnel-like machine. The machine then creates images of the breast tissue that can help to identify the size and location of a lump. MRIs are often used in cases where mammograms or ultrasounds are inconclusive or if a more detailed image of the breast tissue is needed.

• Biopsy: 

A biopsy involves taking a small sample of the breast tissue lump to examine under a microscope. There are several types of biopsies that may be used to diagnose fibroadenomas, including:

1. Fine needle aspiration biopsy (FNAB): During an FNAB, a thin needle is inserted into the lump to remove a small sample of tissue. This is typically done using local anesthesia to minimize discomfort. The sample is then examined under a microscope to determine whether the lump is a fibroadenoma or another type of growth.
2. Core needle biopsy: During a core needle biopsy, a larger needle is used to remove a sample of tissue from the lump. This is also performed under local anesthesia. The sample is then examined under a microscope to determine the nature of the lump.
3. Surgical biopsy: In some cases, an excision biopsy may be necessary to remove the entire lump for examination. This is typically done using general anesthesia, and the lump is sent to a pathology lab for analysis.

The specific tests used to diagnose fibroadenomas may vary depending on the individual case and the healthcare provider's recommendation. However, the above mentioned investigations are some of the most commonly used tests.

Unlike cancer, fibroadenomas do not typically have specific stages. They are classified based on their characteristics and size. However, in some cases, larger or complex fibroadenomas may be classified as "giant fibroadenomas," which can grow to be larger than 5 cm in diameter. These types of fibroadenomas are relatively rare and require careful monitoring and management.

There are several different treatment approaches for fibroadenomas, which depend on several factors, including the size of the lump, the patient's age and health status, and their preferences for treatment. The following are some of the most common treatment options:

• Observation and monitoring: Doctors recommend this approach for small, asymptomatic fibroadenomas that are not expected to grow or cause any discomfort. The healthcare provider will perform periodic clinical breast exams and imaging tests to monitor changes in the size and characteristics of the lump. If there are any evident changes in the fibroadenoma, or if the patient develops symptoms such as pain or discomfort, further testing or treatment may be recommended.
• Surgery: Surgeons prefer surgical removal of the fibroadenoma, which are larger or symptomatic. There are several surgical techniques that may be used, including:
• Lumpectomy: This involves removing the fibroadenoma and a small amount of surrounding healthy breast tissue. This procedure is typically done under local or general anesthesia, and may be performed as an outpatient or inpatient procedure, depending on the size of the fibroadenoma and other factors.
• Excisional biopsy: This involves removing the entire fibroadenoma, along with a small amount of surrounding normal breast tissue and then sent to lab to identify the presence of cancerous cells. This procedure is typically done under influence of local or general anesthesia, and may be performed as an outpatient or inpatient procedure, and does not require long hospital stay.
• Vacuum-assisted excision: This is a minimally-invasive procedure that uses a special probe to remove the fibroadenoma. The probe is guided by imaging tests such as mammography or ultrasound, and multiple samples may be taken to ensure that the entire lump is removed. This procedure is typically done under local anesthesia, and may be performed as an outpatient procedure.
• Cryoablation: Cryoablation is a minimally invasive method that uses extreme cold temperature to destroy the fibroadenoma. During this procedure, doctor inserts a small probe into the breast tissue, and transfer liquid nitrogen to freeze the lump. Over time, the frozen tissue is reabsorbed by the body. This procedure is typically done under local anesthesia, and may be performed as an outpatient procedure. Examples of cryoablation devices include the IceSense3 and the Visica 2 Treatment System.

The specific treatment modality recommended for a fibroadenoma may vary depending on factors such as the size and characteristics of the lump, the patient's age and health status, and their preferences for treatment. The healthcare provider will work with the patient to develop an individualized treatment plan that meets their needs and goals.

Breast adenomas are common benign breast tumors that can occur in women of any age. They are usually painless and do not cause any discomfort or harm to the individual. However, in rare cases, they can grow in size and cause cosmetic concerns or compress the surrounding breast tissue, leading to pain or discomfort. The diagnosis of fibroadenomas involves a combination of clinical examination, imaging, and biopsy to rule out malignancy. Although the exact cause of fibroadenomas is unknown, certain risk factors such as hormonal imbalances, age, and family history have been identified. Therefore, prevention strategies such as maintaining a healthy weight, avoiding unnecessary hormone therapy, and regular breast self-examination are necessary.

Treatment options for fibroadenomas include watchful waiting, surgical removal, and minimally invasive procedures such as cryoablation or vacuum-assisted biopsy. The choice of treatment depends on the size, location, and symptoms of the fibroadenoma, as well as the patient's preferences and medical history.

After treatment, regular follow-up appointments and breast imaging are recommended to monitor for any recurrence or development of new fibroadenomas. Additionally, breast health education and awareness are essential in promoting early detection and prevention of breast diseases.

It is crucial to understand that the vast majority of fibroadenomas are benign and do not pose a significant health risk. However, it is always essential to seek medical attention if you notice any new breast lump or change in previous one, as early detection and diagnosis can lead to better outcomes.

In summary, fibroadenomas are common benign breast mass that can be effectively managed with various treatment modalities. Prevention strategies, regular breast self-examination, and timely medical attention are key to maintaining breast health and preventing the progression of benign breast tumors to malignancy

What are breast adenomas?

Breast adenomas are benign tumors that develop in various breast tissues. They are made up of glandular and fibrous tissue and can vary in size.

Who are at risk of developing breast adenomas?

Breast adenomas can occur in women of any age, but they are most common in women between the ages of 20 and 40. They are rare in men.

What are the symptoms of breast adenomas?

Most breast adenomas do not cause any signs and symptoms. However, some larger adenomas may cause a lump in the breast, pain, or tenderness.

How are breast adenomas diagnosed?

Breast adenomas are usually diagnosed through clinical inspection and imaging tests, such as mammography, ultrasound, or MRI. Doctor may also perform a biopsy to confirm the diagnosis.

Are breast adenomas cancerous?

Breast adenomas are benign tumors and are not cancerous. But they can increase your risk of breast cancer later in life.

What is the treatment for breast adenomas?

Small breast adenomas that are not causing any symptoms may not require treatment. Larger adenomas or those causing symptoms may be removed through surgery.

Is surgery the only treatment option for breast adenomas?

No, surgery is not the only treatment option for breast adenomas. Hormonal therapy or observation may be recommended for some cases.

Can breast adenomas recur after treatment?

Yes, breast adenomas can recur after a full treatment course. Therefore, you should attend your follow-up appointments to monitor for recurrence.

Can breast adenomas increase the risk of breast cancer?

Yes, some types of breast adenomas can increase the risk of breast cancer. Therefore, it is crucial to have regular screenings and follow-up appointments with a healthcare provider.

What is the difference between a breast adenoma and a fibroadenoma?

Breast adenomas and fibroadenomas are both benign breast tumors, but they are made up of different types of tissue. Breast adenomas are made up of glandular tissue, while fibroadenomas are made up of both glandular and fibrous tissue.

Can breast adenomas cause breast pain?

Yes, larger breast adenomas may cause breast pain or tenderness.

Can breast adenomas be felt during a breast self-exam?

Breast adenomas may be felt during a breast self-exam as a lump or hard nodule in the breast.

How common are breast adenomas?

Breast adenomas are rare, accounting for less than 1% of all breast tumors.

Can breast adenomas be prevented?

There is no known way to prevent breast adenomas from developing. Although, there are some precautionary steps, which reduces your risk, such as maintaining healthy weight, healthy lifestyle, and quitting smoking, and stopping alcohol consumption. 

How often should breast adenomas be monitored after treatment?

The frequency of follow-up appointments will depend on the individual case and the healthcare provider's recommendations.

Can breast adenomas cause nipple discharge?

Typically, there is no nipple discharge seen in breast adenomas. If you notice any nipple discharge, doctors may recommend further evaluation.

Can breast adenomas cause changes in breast shape or size?

Breast adenomas are not typically associated with changes in breast shape or size. Although, larger adenoma may seem as swelling in affected breast.

Can breast adenomas be seen on a mammogram?

Breast adenomas can be seen on a mammogram, but they may be difficult to distinguish from other breast masses.

Can breast adenomas be cancerous if they grow large enough?

Breast adenomas themselves are not cancerous, but they can increase the risk of developing breast cancer later in life.

Can fibroadenomas develop into breast cancer?

While fibroadenomas are benign in nature, there is a very small chances (less than 0.1%) of them developing into breast cancer. However, having a complex fibroadenoma may increase your risk of developing breast cancer in the future.

How can I monitor my fibroadenoma?

Your doctor may recommend regular monitoring of your fibroadenoma through clinical breast exams, mammograms, or ultrasound. This will help ensure that the fibroadenoma is not growing or changing, which could be a sign of a more serious condition.

Can I still breastfeed with a fibroadenoma?

Yes, having a fibroadenoma does not typically affect a woman's ability to breastfeed. However, if the fibroadenoma is causing pain or discomfort during breastfeeding, speak with a lactation consultant for advice on positioning or other strategies to make breastfeeding more comfortable.

Can fibroadenomas recur after treatment?

There is a chance that a fibroadenoma can recur after treatment, especially if it was only partially removed. This is why doctors advice to attend your follow up appointments and continue regular monitoring.

Can fibroadenomas be treated with natural remedies?

While there are some natural remedies that have been suggested for treating fibroadenomas, there is no scientific evidence to support their effectiveness. It is advised to talk to your healthcare provider before trying any alternative therapies.

Will I need to have surgery for my fibroadenoma?

Surgery may be recommended if the fibroadenoma is large, growing, causing pain or discomfort, or if there is uncertainty about the diagnosis. However, in many cases, watchful waiting and regular monitoring may be sufficient.

Can a fibroadenoma be removed without surgery?

In some cases, a fibroadenoma may be removed without surgery using a minimally invasive procedure called a vacuum-assisted biopsy. However, these procedures are only an option for smaller fibroadenomas.

Will I need to take time off work for treatment?

This will depend on the specific treatment method and your individual circumstances. If you do need to have surgery, you may need to take some time off work to recover.

Will my insurance cover the cost of treatment for my fibroadenoma?

This will depend on your specific insurance plan and the type of treatment recommended. Therefore, check with your insurance provider to understand what is covered and what your out-of-pocket costs may be.

How can I reduce my risk of developing fibroadenomas?

There is no guaranteed way to prevent fibroadenomas from developing, but maintaining a healthy lifestyle and keeping up with regular breast exams can help with early detection and treatment if needed. Additionally, some research suggests that a diet high in fruits, vegetables, and fiber may reduce the risk of breast fibroadenomas.