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This question was answered on Mon 05, Oct 2009 12:53pm by Dr. A. Srivastava

fibroadenoma


    
Asked by ktamby (Female; 34; this was your answer to 1st ?-Hi, Since fibroadenomas are benign, treatment will vary depending on your diagnosis. If the fibroadenoma is small, painless and remains the same size, you would not need further treatment. You should just have follow-up ultrasounds. But fibroadenomas should be removed if you are over 40 years old. In your case, get repeated ultrasounds done and if in doubt get an FNAC (fine needle aspiration cytology) done. This is less painful than a biopsy. Hope this helps you. Take care and regards! ) on Mon 05, Oct 2009 12:09pm

I am a 34/female-2 years ago I had a Fibroadenoma removed(all cells normal nothing atypical). In the tissue that was removed the surgeon also removed part of a 2nd one. When I went back for my followup mammo/ultrasound the 2nd fibroadenoma appeared. My surgeon & I decided to do the watch & see(no biospy). I went back 6 months later and it got smaller(ultrasound). I just went back for my 1 year checkup(ultrasound) & it has not changed at all(same size-same shape). My doctor said she is 99.99% sure that it is a Fibroadenoma based on ultrasound(actually 3 now because I went back after 3 months, 6 months & then 1 year). My question is-Is this the normal route to take after one year of no change? you answered the above ? but I have another. Thank you for your response it was very helpful-one last ? If it was something other than a fibroadenoma like cancer it would have changed/grown by now(one year) right?
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Answer by Dr. A. Srivastava  on Mon 05, Oct 2009 12:53pm:

Hi, Welcome to AMD forum. I do not think that anything is a serious worry here as most of the breast lumps like what you have are benign or non-cancerous and commonly known as fibroadenoma. Thus, fibroadenoma is not a cancer and does not lead to cancer, but sometimes during physical examination of breast or mammogram a doctor cannot differentiate between a fibroadenoma or a cancer and therefore specific type of breast biopsy is indicated. These lumps are not strictly speaking should be called as disease at all as they are a simple overgrowth of the lobules or the breast tissue. Almost all women have similar kind of lumpy breasts and women find these are the areas of normal breast tissue which can become more prominent just before a period. So they may recur again. Also, they are most common in women under the age of 30s. Fibroadenomas can be diagnosed by a clinical examination, ultrasound and removing cells with a needle (needle aspiration-FNAC) as diagnosed in your case. It is not always essential that fibroadenoma needs to be removed. Also, if left alone, at least one in three of these lumps regresses or disappears within one or two years. If you are worried continuously about the lump or it gets bigger, you can opt to get it removed. Finally, at this point, your doctor should evaluate all of the test results, including the physical exam, mammogram, and results from the fine needle cell sample. Additionally, he or she would like to consider other factors such as how long you have had the lump, your age, and medical history. Even if the fine needle cell sample shows benign (non-cancerous) cells or confirms through ultrasound, your doctor should still recommend a final procedure to confirm this result, called a "Breast biopsy”. Hope this helps. Please do keep us informed if you have any other symptoms and doubts regarding your present health condition. Take care & enjoy.

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Comments:

Comment by Dr.Kokil Mathur on Tue 06, Oct 2009 03:43am: Hi Ktamby I can understand your concern. It is scary for any woman to find a lump in her breast and to live with it. Yes, cancer would have shown up in mamograms. Also there would have been a change in size of the lump or it would have become irregular if it was cancerous. The only thing of concern is that presence of multiple (more than 2) fibroadenomas increases the risk of cancer. You must do a self breast exam once a month. If you do not know the technique, you can learn from your doctor. Generally fibroadenomas are felt as firm, round, smooth, and rubbery nodules, and are movable. They are so mobile that they tend to slip away from your fingers when you examine them. A fibroadenoma may feel tender just before your period and may swell due to hormonal changes. Do not get perturbed regarding that and do not examine your breast too often. Since you and your doctor are watching the lump everything should be fine. If the fibroadenoma lump becomes large (more than three cm) and/or painful, or a biopsy shows atypical (very active) cells (as of now you do not have it), you can have it surgically removed. Generally any fibroadenoma found after 40 years is surgically removed however this is not a hard and fast cut off date. Also if other such fibroadenomas develop, then also a surgery should be planned. Generally fibroadenomas are observed by mammograms at 3-6 months interval. In women with a strong family history of breast cancers, the frequency may be 3 monthly. In others it may be twice a year. There is no fixed rule which one can follow in this. All I can say is that keep calm (difficult I know). The results so far are ok and you are clear as far as cancer is concerned. Both you and your doctor are following this up. So things should be fine and timely decision can be taken if need be in future to remove the fibroadenoma. Hope this helps. It is difficult to comment beyond this at this stage. Do consult your doctor as you have been doing and do as advised. Please let us know if there is any thing else and do keep us posted. We’ll do our best to solve your query timely. All the best! Take care!

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