Fibroadenomas and Breast Inflammation: Symptoms and Treatment Options

Fibroadenoma & Mastitis?

Hello Dr.
Hsu,
I would like to ask you about a recent issue I've been experiencing.
I've been having a feeling of fullness and pain in my left breast (my menstrual period hasn't started yet), which feels similar to the sensations I get before my period.
When I touch the area near the lymph nodes, it feels like there is a movable lump.
Although I also feel something that seems like a lump in my right breast, it is not as painful as the left side.

I have researched online and found that my symptoms are very similar to those of a fibroadenoma.
Therefore, I would like to know if a fibroadenoma needs to be surgically removed (as I am really afraid of surgery).
The information I found suggests that it may not need to be removed.
If it doesn't require removal, what other treatment options are available? Is medication necessary? After treatment, is there a possibility that it could recur? What causes this condition? Are there any preventive measures? Can fibroadenomas turn into malignant tumors if left unchecked?
Before my period, does the breast fullness also cause lumps to be felt upon palpation? Is the premenstrual fullness similar to the sensations of a fibroadenoma or mastitis? Based on my symptoms, which condition is more likely? Or could it simply be caused by a blocked milk duct? I am quite worried...

What are the differences between fibroadenomas and mastitis? How can they be distinguished? Additionally, if I go for a consultation, what kind of examinations will the doctor perform? Will a physical examination be necessary?
I hope Dr.
Hsu can help clarify all my doubts...
Thank you!

Fanny, 20~29 year old female. Ask Date: 2003/10/24

Dr. Xu Junzheng reply Obstetrics and Gynecology

Fibroadenomas generally do not require surgical removal, but it is necessary to undergo examinations to check for any malignant potential.
Typically, the attending physician will perform a breast ultrasound examination, and palpation is not required.
Thank you.

Reply Date: 2003/10/24

More Info

Fibroadenomas and breast inflammation are common concerns for many women, particularly those in their reproductive years. Understanding the symptoms, treatment options, and distinguishing between these conditions is crucial for proper management and peace of mind.

Fibroadenomas are benign (non-cancerous) tumors that are most commonly found in women aged 15 to 35. They are typically firm, smooth, and movable lumps within the breast tissue. The symptoms you describe, such as the presence of a hard lump that feels movable and the associated pain, especially before your menstrual period, are consistent with fibroadenomas. These lumps can fluctuate in size and tenderness due to hormonal changes throughout the menstrual cycle.

In terms of treatment, fibroadenomas often do not require surgical removal unless they are large, symptomatic, or if there is uncertainty about the diagnosis. Many healthcare providers recommend a "watchful waiting" approach, particularly if the fibroadenoma is small and asymptomatic. Regular monitoring through clinical breast exams and imaging (like ultrasound or mammography) is usually sufficient. If the fibroadenoma grows or causes significant discomfort, surgical removal may be considered.

Regarding your concern about the possibility of fibroadenomas turning malignant, it is important to note that fibroadenomas themselves do not typically transform into breast cancer. However, having a fibroadenoma does not eliminate the risk of developing breast cancer, which is why regular check-ups and self-examinations are essential.

Breast inflammation, or mastitis, is another condition that can cause pain and swelling in the breast. It is often associated with infection, particularly in breastfeeding women, but can occur in non-lactating women as well. Symptoms of mastitis include localized pain, swelling, redness, and sometimes fever. If you experience these symptoms, especially if there is a hard lump that is tender to the touch, it may indicate an inflammatory process rather than a fibroadenoma.

To differentiate between fibroadenomas and mastitis, consider the following:
- Pain: Fibroadenomas may be tender, especially premenstrually, but mastitis typically presents with more acute pain and systemic symptoms (like fever).

- Lump characteristics: Fibroadenomas are usually smooth and mobile, while lumps associated with mastitis may feel more irregular and be accompanied by redness or warmth.

- Associated symptoms: Mastitis may present with flu-like symptoms, while fibroadenomas do not.

If you decide to seek medical advice, a healthcare provider will likely perform a clinical breast examination and may recommend imaging studies such as an ultrasound or mammogram to assess the lumps further. In some cases, a biopsy may be necessary to rule out malignancy.

In summary, while your symptoms may suggest fibroadenomas, it is essential to consult with a healthcare provider for an accurate diagnosis and appropriate management. Regular self-exams and professional evaluations are key to maintaining breast health. If you have any further concerns or notice changes in your breast tissue, do not hesitate to reach out to a healthcare professional.

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