Breast Fibroadenoma Treatments

Treatment Methods To Deal With a Breast Fibroadenoma

Fibroadenoma of the Breast
What treatment options are available for breast fibroadenomas?. Art © A.D.A.M.

How are breast fibroadenomas treated? Is there a chance they will come back? And can they increase the chance you will develop breast cancer?

Breast Fibroadenomas

Breast fibroadenomas are non-cancerous breast tumors that are made up of stroma (fibrous connective tissue that supports the mammary gland) and adenosis (lobes that have developed hyperplasia).

Fibroadenomas can be felt during your monthly breast self-exam and will show up on mammograms and ultrasounds.

Women in their 20s or 30s are most likely to develop a breast fibroadenoma, which may grow larger during pregnancy or breastfeeding (lactation.)

Inside a Breast Fibroadenoma - Simple vs Complex

Most fibroadenomas are the simple types—there’s  usually just one of them in your breast, with a definite border and very uniform cells. A simple fibroadenoma does not raise your risk for breast cancer.

Complex fibroadenomas are less common, and while they may have a definite border, it's what is inside this kind of fibroadenoma that makes it different. A complex fibroadenoma will not look organized and uniform like a simple fibroadenoma. Even though complex fibroadenomas don't become cancerous, they may contain a collection of small cysts, calcifications, enlarged breast lobules, papillomas and different kinds of hyperplasia.

When atypical hyperplasia occurs, however, it can raise your risk of developing breast cancer.

Diagnosing a Breast Fibroadenoma

A breast fibroadenoma will usually feel smooth, firm and rubbery. It may move within your breast tissue when you're doing your breast self-exam, and it is not likely to feel painful or tender. Most of these benign lumps are between one and three centimeters (½  to 1 ½ inches), but some may grow as large as five centimeters (around 2 ½ inches).

Your radiologist will be able to see a fibroadenoma on your screening mammogram, and an ultrasound will help distinguish it from a fluid-filled cyst. But the most definite way to get a diagnosis of fibroadenoma is with a breast biopsy.

Cautions with Breast Fibroadenomas

It's important to point out a few cautions with fibroadenomas. These benign breast lumps are most common in women under the age of 35. In women older than age 35, a definitive diagnosis is more important. A breast biopsy is one way to do this, though a breast biopsy only samples one part of a lump. We now know that many breast lesions, both benign and cancerous are heterogeneous. This means that the cells in one part of the tumor may be different than those in another part of the tumor. There have been cases in which a breast biopsy has revealed a fibroadenoma, but after removal, when the entire lesion is evaluated by a pathologist, cancer has been present as well.

Treatments for a Breast Fibroadenoma

If your doctor has confirmed a diagnosis of a fibroadenoma, there are several different treatment options available.

  • Watch and wait is one approach. Since fibroadenomas are not always troublesome and sometimes shrink on their own, just keeping an eye on their progress is the least invasive way to handle them.
  • Lumpectomy, or surgical removal of a fibroadenoma, can be done if you're worried about keeping it in your breast. Depending on the relative size of this lump and your breast, a lumpectomy may cause a change your breast's size or shape. New fibroadenomas may grow in the neighborhood of the first lump, so you should know that surgery is not a guarantee that you'll never have another fibroadenoma. On the other hand, your fibroadenoma can be carefully examined by the pathology lab to make sure the diagnosis was correct (a biopsy isn't 100 percent effective in making a diagnosis as it only samples one part of the lump) and breast cancer can be ruled out.
  • Laser ablation is a non-surgical way to get rid of a fibroadenoma. In your surgeon's office, an ultrasound-guided laser device is used to destroy the fibroadenoma, leaving behind only a tiny scar, no sutures, and no change in breast shape. There's no general anesthesia needed and it can usually be done as a same-day surgery procedure.
  • Cryoablation is a fast, efficient way to freeze a fibroadenoma. In one office visit, cryoablation simply freezes the lump so that healthy tissue can take over. This procedure takes less than 30 minutes and results in a tiny scar.
  • Radiofrequency ablation (RFA) removal of fibroadenomas is another way to take an unwanted lump out of your breast without resorting to a lumpectomy. Using local anesthesia and ultrasound guidance, a six to eight-millimeter cut is made above the fibroadenoma. Through this cut, a surgical wand is inserted and then tipped by a knife that is heated by radiofrequency current. This helps cut through the breast tissue without causing much bleeding. Once it reaches the target, small wires and robotic arms capture the fibroadenoma and extract it.
  • Mammotome breast biopsy systems can now be used as a fairly non-invasive way to remove fibroadenomas. In less than an hour, and under local anesthesia, a six-millimeter (1/4 inch) cut is made over the fibroadenoma. Then with ultrasound guidance, a Mammotome probe is threaded into the lump, which vacuums out sections of the tissue. Recovery is quick and your scar will be quite small.
  • High-frequency focused ultrasound (HFU) is a relatively new treatment that has been used for fibroadenomas, and sometimes, even for breast cancer. HFU can apparently cause the selective destruction of deep tissues without damaging surrounding healthy tissue.
  • Homeopathic treatments have also used to prevent or treat breast fibroadenomas, though there are few controlled studies looking at these procedures. Herbal tonics, teas, ointments, or homeopathic pills have been used in traditional cultures for fibroadenomas. Hot compresses of water, castor oil, or ginger tea have been tried as well, for the relief of breast tenderness which may or may not be due to a fibroadenoma. It's important to note that without a biopsy, and possibly removal of the fibroadenoma, there is always a chance that a breast cancer could be missed, and therefore treatment delayed.

Bottom Line on Breast Fibroadenomas

It's clear from the list of treatment options above that there are many different options for treating a breast fibroadenoma. Fibroadenomas are fairly diverse, and this may be responsible for some of the variety.

In general, most fibroadenomas do not increase the risk that you will develop breast cancer, though the less common complex fibroadenomas can be associated with an increased risk. Some "lumps" may also be a combination of more than one condition, for example, a fibroadenoma plus a breast cancer, and this should be kept in mind.

The only way to get a conclusive diagnosis of a fibroadenoma is with a breast biopsy. While this can cause some anxiety, it may also be the best way to reduce anxiety as well, since a tissue diagnose can assure you of what you are really dealing with.

Keep in mind that there are many types of breast lumps, only one of which is a fibroadenoma. If you have a breast lump, even if you feel certain that it is only a fibroadenoma, get it checked out. There are, unfortunately, too many people who have dismissed a breast lump as being "only" a fibroadenoma, only later to learn that they actually had breast cancer.

Sources:

Cavallo Marincola, B., Pediconi, F., Anzidei, M. et al. High-Intensity Focused Ultrasound in Breast Pathology: Non-Invasive Treatment of Benign and Malignant Lesions. Expert Review of Medical Devices. 2015. 12(2):191-9.

Li, P., Xiao-Yin, T., Cui, D. et al. Evaluation of the Safety and Efficacy of Percutaneous Radiofrequency Ablation for Treating Multiple Breast Fibroadenoma. Journal of Cancer Research and Therapeutics. 2016. 12(Supplement):C138-C142.

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