Fibroadenoma (SURG) Flashcards
Define fibroadenoma.
A benign breast tumour with fibrous and glandular tissue
(Benign overgrowth of collagenous mesenchyme of one breast lobule)
Who is fibroadenoma most common in?
Women 15-35 years old (most common breast tumour in women <35)
What is the cause of fibroadenoma?
Unknown but increased oestrogen during pregnancy or menstruation may stimulate growth
What is the risk of malignancy of fibroadenoma compared to a breast cyst?
No increased risk of malignancy (unlike breast cyst)
What are the clinical features of fibroadenoma? (5)
A ‘breast mouse’ - firm, smooth, mobile, rubbery lump
- well-defined, mobile mass
- smooth and firm
- most commonly solitary but may be multiple
- non-tender and painless
- rubbery consistence
Describe the history of a patient with fibroadenoma.
Asymptomatic, found incidentally, typical patient <40y
Describe the examination of a patient with fibroadenoma.
Smooth, rubbery, mobile mass
What investigations do we do for a breast lump?
Triple assessment:
- physical examination
- imaging (mammography if >35, USS if <35)
- biopsy (core needle biopsy or FNA)
What scans do we do in fibroadenoma and what would we see?
- US <35y: well-defined mass
- mammography >35y: well-defined mass which may have popcorn-like calcifications (areas of calcium that appear as big white dots/dashes)
- oval round, circumscribed lump
What does biopsy (FNA/core needle biopsy) show in fibroadenoma?
Epithelial and stromal elements
How do we manage fibroadenoma?
- observation and reassurance (refer for USS+/-FNA if in doubt)
- regular check-ups
- if >3cm –> surgical excision
- if large/rapid growth/causing discomfort etc –> surgical excision by excisional biopsy
What is a complication of fibroadenoma?
Complex fibroadenoma developing into a breast cyst
Describe the prognosis of fibroadenomas.
Good - most fibroadenomas are not associated with increased risk of breast cancer
