Breast fibroadenoma is a benign lesion and arises from the proliferation of the breast tissue. Fibroadenomas occur at any age, but more so in women below the age of 30 years. There are different types, namely simple, giant juvenile, and multicentric fibroadenomas. Women who have a history of fibroadenomas have an increased risk of developing breast cancer [1]. Conversely, fibroadenomas in themselves have little chance (up to 0.125%) of undergoing malignant change [2]. Younger women, those with a history of a breast mass, and women of African descent are at a greater risk for developing fibroadenomas. Protective factors include the use of combined oral contraceptive pills and greater parity.

The majority of women have simple fibroadenomas and present with a single painless, smooth, mobile breast mass with a rubbery consistency, most often located in the upper outer quadrant. The average size of lesions is about 2-3 centimeters.

10%–25% of affected women have multicentric fibroadenomas [3]. These can occur in any quadrant of the breast. Giant juvenile fibroadenomas make up between 0.5% and 2% of all fibroadenomas [4] [5]. They are typically seen in adolescent girls, and are usually unilateral and grow rapidly, with a weight of more than 500 grams or diameter over 5 cm. They cause distortion and displacement of surrounding breast tissue, and may even cause skin changes and a distension of superficial veins [6].

The size of fibroadenomas may fluctuate, with a general tendency to decrease over time. They may enlarge or shrink in response to hormonal changes during the menstrual cycle and are particularly sensitive to estrogen [5]. Up to 40% of all fibroadenomas in adolescents resolve spontaneously.

• Pain

  Noncyclical pain was recorded in 38 patients (90%), and cyclical pain was recorded in only 4 (10%) patients. A VAS score of 10 was recorded by 33 (80%) patients (severe pain), and the remaining 9 patients (20%) had VAS scores from 7 to 10. [ncbi.nlm.nih.gov]

  What to do about FCC Again, fibrocystic changes can be painful, and that pain is often the result of a large cyst or fibroadenoma. A cyst can be drained, which will definitely reduce the pain. [healthcentral.com]

  Breast pain and size of the abnormality are poor indicators for the nature of the breast problems. [breastcenter.ucla.edu]

• Lymphadenopathy

  There are no skin changes, nipple discharge, or axillary lymphadenopathy. Ultrasound of the breast was carried out as shown. [step2.medbullets.com]

  The sonographic study revealed normal structures, save for non-specific cervical lymphadenopathy. The patient was referred to a cardiologist to manage the condition. [omicsonline.org]

  Axillary fibroadenoma mimicking lymphadenopathy. Niger J Clin Pract 2008;11:72-3. [PUBMED] 12. Silverberg MA, Rahman MZ. Axillary breast tissue mistaken for suppurative hidradenitis: An avoidable error. J Emerg Med 2003;25:51-5. 13. [ccij-online.org]

  Surgical excision of smaller fibroadenomas may be offered when masses are nonmobile, hard, enlarging, tender, fixed to overlying skin or nipple areolar complex, associated with axillary or supraclavicular lymphadenopathy, or the patient is experiencing [ncbi.nlm.nih.gov]

  Clinical examination for other palpable masses in the breasts was negative, and there was no axillary lymphadenopathy. [spandidos-publications.com]

• Severe Pain

  Noncyclical pain was recorded in 38 patients (90%), and cyclical pain was recorded in only 4 (10%) patients. A VAS score of 10 was recorded by 33 (80%) patients (severe pain), and the remaining 9 patients (20%) had VAS scores from 7 to 10. [ncbi.nlm.nih.gov]

  Surgical intervention is indicated for fibroadenomas that are more than 5 cm in diameter, rapidly growing, cause severe pain, distort the breast architecture, or lead to overlying skin changes. [journals.lww.com]

• Overeating

  They are typically seen in adolescent girls, and are usually unilateral and grow rapidly, with a weight of more than 500 grams or diameter over 5 cm. [symptoma.com]

  Periductal condensation of stromal cells; features supporting a diagnosis of phyllodes tumor over cellular fibroadenoma are an older patient, intracanalicular pattern with leaf like formations, periductal condensation of stromal cells, cytologic atypia [pathologyoutlines.com]

  Experience with over 4,000 women evaluated in the breast clinic at the Tel-Aviv Medical Center contributed to the management strategies suggested by review of the literature. [ncbi.nlm.nih.gov]

  Reasons to have it removed include: Results of needle biopsy are not clear Pain or other symptom Concern about cancer The lump gets larger over time If the lump is not removed, your provider will watch to see if it changes or grows. [account.allinahealth.org]

  Some fibroadenomas shrink over time. Most fibroadenomas in adolescents shrink over many months to a few years. They then disappear. Fibroadenomas may also change shape over time. Fibroadenomas may get bigger during pregnancy. [mayoclinic.org]

• Acne Vulgaris

  Vulgaris Asthma (Children) Acute Respiratory Distress Syndrome (ARDS) Ankle conditions Airway (Children) Addiction Autoimmune Hepatitis Ankylosing Spondylitis Anxiety Disorder Babies with congenital surgical conditions Atrial Septal Defect (Children) [nuh.com.sg]

• Breast Mass

  The patient subsequently underwent excision of bilateral breast masses and reduction mammoplasty. Histopathologically, bilateral breast masses were confirmed to be juvenile fibroadenomas. [ncbi.nlm.nih.gov]

  A family history should also be taken, with emphasis on breast masses and malignancies. Physical examination of the breasts and axillary lymph nodes is mandatory in determining the characteristics of the mass. [symptoma.com]

  They comprise more than 80% of the breast's mass.[12] These tumors represent approximately 1% of breast masses in adolescents. In our case, breast ultrasound found a 20 mm breast tumor with posterior acoustic enhancement. [journals.lww.com]

• Confusion

  The significance of this rare event is the possible confusion with carcinoma. Extensive search for viable tissue is essential for the confirmation of the diagnosis. [ncbi.nlm.nih.gov]

  Fine-needle aspiration rarely gives a false-positive result, even though it may confuse fibroadenomas with other benign lesions. [aafp.org]

  So, to clarify, I think that the statistics can get confusing. In my experience, women with a fibroadenoma do NOT have a higher breast cancer risk per-se. [breast-cancer.ca]

• Tremor

  During severe attacks, there may be HEADACHE; SWEATING, palpitation, apprehension, TREMOR; PALLOR or FLUSHING of the face, NAUSEA and VOMITING, pain in the CHEST and ABDOMEN, and paresthesias of the extremities. [medvik.cz]

• Agitation

  […] laminoplasty practising <a href="http://discount-onlineventolin.online/#buy-ventolin-kz7">buy ventolin online</a> meropenem, re-epithlialization corners subjects; options, <a href="http://canadian-lowest-price-viagra.online/#viagra-9if">viagra online</a> agitation [gekon-plzen.cz]

Triple assessment may be used to investigate breast fibroadenoma. This includes clinical examination, imaging, and biopsy. It is important to take a full gynecological history, as well as the history of the presenting mass. A family history should also be taken, with emphasis on breast masses and malignancies. Physical examination of the breasts and axillary lymph nodes is mandatory in determining the characteristics of the mass.

Medical imaging modalities are a major part of the assessment of breast masses. Ultrasonography is widely used, especially in young women, and is advantageous when examining this population as they have dense breast tissue [7]. Mammography may be done and is especially advised for women over the age of 35 years. Magnetic resonance imaging (MRI) scanning is also useful and is a more sensitive test than mammography [8]. Follow up visits for repeated imaging is indicated for fibroadenomas [9].

Biopsy does not always need to be performed, especially when imaging suggests fibroadenoma, and in women in their 20s or younger. In postmenopausal women, however, breast lesions should be biopsied because of the greater chance of malignancy. Giant juvenile fibroadenomas should also be biopsied, as they resemble malignancies.

Treatment procedure The treatment session consisted of five steps: pretreatment ultrasonography, positioning, planning, energy setting, and treatment with HIFU pulses in the defined volume. [doi.org]

[…] approval in Europe and Korea for the treatment of breast fibroadenoma. [fusfoundation.org]

Outlook (Prognosis) If the lump is left in place and watched carefully, it may need to be removed at a later time if it changes or grows. In very rare cases, the lump is cancer, and will need further treatment. [account.allinahealth.org]

Differential Diagnosis A fibroadenoma can be confused with: Breast cyst Breast carcinoma Phyllodes tumor Breast lymphoma Metastasis to the breast from another primary site Prognosis Prognosis of fibroadenoma is good because it is a benign mass which shrinks [ncbi.nlm.nih.gov]

On the other hand, some cases of "malignant" phylloides have an excellent prognosis. These tumors present in women of all ages, with the majority ranging from 35 to 54 years. [bccmiami.com]

Prognosis Breast fibroadenomas are not cancerous. The lumps recur in up to 20% of women. A small number of lumps disappear on their own. Prevention Breast fibroadenomas cannot be prevented. [medical-dictionary.thefreedictionary.com]

Etiology Causes of fibroadenoma are debatable, but professionals believe that the lesion has a hormonal etiology related to the increased sensitivity of breast tissue to the female reproductive hormone estrogen. [ncbi.nlm.nih.gov]

It is thought that increased estrogen receptor sensitivity is responsible for the etiology of GF [ 1 ]. [link.springer.com]

The etiology incriminated is changes in plasma estrogen levels and changes in the estrogen%progesterone ratios. Breast Fibroadenoma Causes Of Breast Fibroadenoma Fibroadenomas are benign tumors composed of stromal and epithelial cells. [doctortipster.com]

Conclusion For such a common tumor, relatively little is known about the etiology and risk factors of FA. [panafrican-med-journal.com]

We conducted a molecular epidemiological case-control study of 70 breast fibroadenoma cases without cellular atypia and 172 healthy female controls. [ncbi.nlm.nih.gov]

[…] condensation, no cytologic atypia, no mitotic figures > 3/10 HPF Excision is curative Terminology Also called juvenile fibroadenoma Giant fibroadenoma: terminology used inconsistently; refers to size, often children but not a distinct histopathologic entity Epidemiology [pathologyoutlines.com]

Further possible causes are: certain immunosuppressive drugs Carneyís complex Epstein-Barr virus 3 Epidemiology Fibroadenomas particularly often occur in young women between the ages of 20 and 30 years, but they can basically occur from puberty on. [flexikon.doccheck.com]

Epidemiology of Fibroadenoma Fibroadenomas are believed to be under-reported with an estimated incidence of 13% in women examined in a clinic. [lecturio.com]

Introduction Clinical definition benign solid tumor of the breast with epithelial and stromal components Epidemiology incidence common in women 15-35 years of age second most common benign breast mass most common breast tumor in women under 30 demographics [step2.medbullets.com]

Genetics Mediator complex subunit 12 (MED12) gene is also important in the pathophysiology of fibroadenomas. [ncbi.nlm.nih.gov]

Pathophysiology of Fibroadenoma Fibroadenomas arise from the lobular structures of the breast; hence they are usually formed during menarche. During menarche, distinct areas of lobular hyperplasia form, which is a normal physiological change. [lecturio.com]

[…] incidence common in women 15-35 years of age second most common benign breast mass most common breast tumor in women under 30 demographics mostly women in males may be associated with anti-androgen treatment risk factors use of oral contraceptives pregnancy Pathophysiology [step2.medbullets.com]

[…] self-examination.2 The incidence of fibroadenoma has also been shown to directly correlate with body mass index (BMI), with peak incidence seen with BMI 25 to 29.9 kg/m.2 Increased parity and the use of oral contraceptives appear to decrease fibroadenoma risk.2 Pathophysiology [jaocr.org]

Prevention Breast fibroadenomas cannot be prevented. They can be discovered early by regular breast self-examination. [medical-dictionary.thefreedictionary.com]

None of these preventive measures prevents 100% of all breast cancers. Even prophylactic mastectomy cannot remove all breast tissue, so some of these women still get breast cancer. Got a question for our experts? Submit it here [thechart.blogs.cnn.com]

Prevention Breast fibroadenomas cannot be prevented. They can be discovered early by regular breast self-examination. Resources ORGANIZATIONS American College of Obstetricians and Gynecologists. 409 12thStreet, S.W., PO Box 96920. [encyclopedia.com]

Fibroadenoma of the Breast is difficult to prevent, because it is most likely caused by abnormal or fluctuating reproductive hormone levels Since prevention is generally not possible, it is important to be aware of the risk factors of breast lumps. [dovemed.com]

1. Dupont WD, Page DL, Parl FF, et al. Long-term risk of breast cancer in women with fibroadenoma. N Engl J Med. 1994;331(1):10–15.
2. Wu YT, Chen ST, Chen CJ, et al. Breast cancer arising within fibroadenoma: collective analysis of case reports in the literature and hints on treatment policy. World J Surg Oncol. 2014;12(1):335.
3. Williamson ME, Lyons K, Hughes LE. Multiple fibroadenomas of the breast: a problem of uncertain incidence and management. Ann R Coll Surg Engl. 1993;75(3):161–163.
4. Song BS, Kim EK, Seol H, et al. Giant juvenile fibroadenoma of the breast: a case report and brief literature review. Ann Pediatr Endocrinol Metab. 2014;19(1):45–48.
5. Chung EM, Cube R, Hall GJ, González C, Stocker JT, Glassman LM. From the archives of the AFIP: breast masses in children and adolescents: radiologic-pathologic correlation. Radiographics. 2009;29(3):907–931.
6. Greenberg R, Skornick Y, Kaplan O. Management of breast fibroadenomas. J Gen Intern Med. 1998;13(9):640–645.
7. Garcia CJ, Espinoza A, Dinamarca V, et al. Breast US in children and adolescents. Radiographics. 2000;20(6):1605–1612.
8. Smith RA. The evolving role of MRI in the detection and evaluation of breast cancer. N Engl J Med. 2007;356(13):1362-1364.
9. Harvey JA, Nicholson BT, Lorusso AP, Cohen MA, Bovbjerg VE. Short-term follow-up of palpable breast lesions with benign imaging features: evaluation of 375 lesions in 320 women. AJR Am J Roentgenol. 2009;193(6):1723–1730.