Fibroadenoma

Question 1

What is a fibroadenoma?

Answer 1

Fibroadenoma = benign breast tumours caused by abnormality of normal development, characterised by focal hyperplasia of stromal and epithelial tissue (collagenous mesenchyme) in one breast lobule
• Giant fibroadenoma = >5cm diameter or >500g

Question 2

What is the aetiology of fibroadenoma?

Answer 2

• Occurs as an aberration of normal lobular development

* Partially hormone related

Question 3

What are the risk factors for fibroadenoma?

Answer 3

• Pre-menopasual
• Low intake of fruit and veg
• Low number of live births

Question 4

What is the epidemiology of fibroadenoma?

Answer 4

• Most patients usually present <30 years of age
• Frequently regress after menopause
• Most common breast tumour in adolescent women
• Incidence declines with increasing age

Question 5

What are the symptoms of fibroadenoma?

Answer 5

• Breast lump

Question 6

What are the signs of fibroadenoma?

Answer 6

Breast lump
o Discreet, with smooth surface
o Painless, without skin or deep fixation
o Extremely mobile – “breast mice”

Question 7

What are the investigations for fibroadenoma?

Answer 7

Ultrasound
o Oval/round solid lump, lobulated

Mammogram
o Oval/round circumscribed lump, with coarse calcifications

Biopsy
o Epithelial and stromal elements

Question 8

What is the management of fibroadenoma?

Answer 8

• Observation and reassurance
• Excision - If painful, large (>4cm) or growing rapidly
• Cryoablation

Question 9

What are the possible complications of fibroadenoma?

Answer 9

• Giant fibroadenoma

* Slightly increased with cancer with complex fibroadenoma (abnormal cysts, calcifications)

Question 10

What is the prognosis of fibroadenoma?

Answer 10

• 1/3 regress
• 1/3 stay the same
• 1/3 get bigger