Fibroadenoma

Question 1

Definition of a fibroadenoma

Answer 1

Is a benign breast tumour which only remains in the breast tissue (doesn’t spread)

Question 2

Aetiology of a fibroadenoma

Answer 2

• Seen in premenopausal women (<35), can occur up to menopause
• They are very common
• Can appear during pregnancy
Very common breast lump

Question 3

Pathophysiology of a fibroadenoma

Answer 3

• Cellular proliferation of stroma and glandular tissue (breast ducts)
• Increased OESTROGEN may increase growth; hence the fibroadenomas may grow during pregnancy and shrink during menopause
• Affects breast lobule
• 1/3 would regress, 1/3 stay the same and 1/3 get bigger

Question 4

History and examination of a fibroadenoma

Answer 4

• Usually painless/ non-tender
• May have discomfort before menses
• Well-defined lump/swelling: Usually 1-2cm
• MOBILE mass: ‘breast mouse’, moves under the skin
• Smooth

Question 5

Investigations for a fibroadenoma

Answer 5

TRIPLE ASSESSMENT:
• Clinical Examination

• Imaging:
‣ Ultrasound: If young (<35). Is able to detect cysts
‣ Mammogram: If older (usually used for 50-70 year old’s breast cancer screening). Has 2 views

• Biopsy:
‣ Fine needle biopsy: takes small amount of fluid and tissue (good for cystic lesions). Fast and easy way to biopsy
‣ Core needle biopsy: larger sample, good for solid breast cancer

Question 6

Treatment for a fibroadenoma

Answer 6

1) Observation and Reassurance: If small, nothing needs to be done (hormone levels changes may reduce the size on its own)

If LARGE:
Surgical excision may be considered

Question 7

Complications of a fibroadenoma

Answer 7

• Recurrence
• Multiple lumps

Question 8

Prevention and prognosis of a fibroadenoma

Answer 8

Breast screening

Very good prognosis