Fibroadenoma

Question 1

What is fibroadenoma?

Answer 1

Fibroadenomas are benign tumours that consist of a mixture of fibrous and epithelial tissue. They originate from the lobules, the milk-producing glands in the breast.

Question 2

Describe the epidemiology of fibroadenoma

Answer 2

Fibroadenomas are most commonly seen in young women, with the highest incidence occurring in the early 20s. They are particularly common during periods of reproductive hormonal change such as puberty, pregnancy, and perimenopause.

Question 3

What causes fibroadenoma?

Answer 3

The exact cause of fibroadenomas is unclear. However, they seem to be influenced by reproductive hormones, as they often enlarge during pregnancy and shrink after menopause.

Question 4

What are the presenting symptoms/ signs of fibroadenoma?

Answer 4

• A firm, non-tender breast mass
• The mass is rounded and has smooth edges
• The mass is highly mobile upon palpation, often referred to as having a “rubbery” consistency
• The mass typically does not grow beyond 3cm in diameter

Question 5

What investigations are used to diagnose/ monitor a fibroadenoma?

Answer 5

While fibroadenomas are benign, patients usually undergo a triple assessment to exclude more serious pathology. This includes:

1. Clinical examination
2. Imaging (usually ultrasound and/or mammogram)
3. Needle biopsy (fine needle aspiration or core biopsy)

Question 6

How are fibroadenomas managed?

Answer 6

Management of fibroadenomas can vary depending on the size, number, patient age, and symptoms:
1. Conservative management: Many fibroadenomas do not require treatment and will regress naturally after menopause.
2. Surgical excision: This may be required if the fibroadenoma is large, growing, causing significant symptoms, or if there is diagnostic uncertainty after triple assessment.