Breast Fibromas: When is Surgery Necessary?

Breast fibroma

Hello Doctor: I have been diagnosed with a breast fibroadenoma measuring approximately 1.5 centimeters.
I have consulted two different hospitals and received two different management approaches; one suggested that I only need to be monitored for 1-2 years, while the other recommended surgery.
The discrepancy is quite confusing for me.
Could you please clarify: at what size does a breast fibroadenoma typically require surgery? Are there any potential complications from the surgery? Will the tumor itself continue to grow? I would greatly appreciate your insights.
Thank you!

Kunrao de binghuan, 20~29 year old female. Ask Date: 2004/10/28

Dr. Lin Kecheng reply Surgery

Dear Patient,
Generally speaking, when a physician diagnoses a fibroma, it is often done through ultrasound.
In your case, being a 25-year-old female with a 1.5 cm mass, here are some considerations:
1.
Benefits of surgery: The excised tissue can be sent for pathological examination to determine whether it is benign or malignant, and removing it will alleviate any further concerns.

Drawbacks of surgery: As a young woman, there may be concerns about scarring.
2.
Regarding follow-up every 1-2 years, it is essential to confirm the benign nature of the fibroma, while also noting that tumors may gradually increase in size.
The decision on how large a breast fibroma must be before surgery is entirely dependent on the physician's clinical assessment (benign, malignant, or rate of growth).
3.
I recommend seeking a third opinion from a breast specialist.
I typically perform a fine needle aspiration biopsy of the breast tumor and send the cells for examination to confirm whether it is a fibroma or a malignant tumor.
If it is benign, I suggest follow-up every three months, and if it exceeds 2 cm, surgical treatment is indicated.
If it is malignant, immediate surgical intervention is necessary.
Wishing you good health.

Reply Date: 2004/10/28

More Info

Breast fibromas, also known as fibroadenomas, are benign tumors that commonly occur in the breast tissue. They are typically characterized by a well-circumscribed, firm mass that can vary in size. The management of breast fibromas can vary significantly based on several factors, including the size of the tumor, the patient's age, symptoms, and the results of imaging studies and biopsies.

When is Surgery Necessary?
1. Size and Symptoms: Generally, the size of a fibroadenoma can influence the decision to proceed with surgery. While many fibroadenomas under 2 cm can be monitored with regular follow-ups, larger tumors or those that cause discomfort may warrant surgical intervention. In your case, with a fibroadenoma measuring approximately 1.5 cm, the recommendation for surgery may depend on whether you are experiencing any symptoms, such as pain or tenderness, and the characteristics of the lesion as determined by imaging and biopsy.

2. Growth Potential: Fibroadenomas can sometimes grow over time, although many remain stable in size. If there is evidence of rapid growth or changes in the characteristics of the tumor, surgical removal may be recommended to rule out the possibility of malignancy, especially if there are atypical features noted in imaging or biopsy results.

3. Patient Preference: Ultimately, the decision to undergo surgery can also be influenced by your personal comfort level and preferences. If the presence of the fibroadenoma is causing significant anxiety or concern, discussing surgical options with your healthcare provider may be beneficial.

Risks and Complications of Surgery
Surgical removal of a fibroadenoma is generally considered safe, but like any surgical procedure, it carries some risks. Potential complications can include:
- Infection: As with any surgical procedure, there is a risk of infection at the incision site.

- Scarring: Depending on the size of the incision and the surgical technique used, scarring can vary. Most surgeons aim to minimize scarring, but it is a possibility.

- Changes in Breast Sensation: Some patients may experience changes in sensation in the breast after surgery, which can be temporary or, in rare cases, permanent.

- Recurrence: Although fibroadenomas are benign, there is a small chance that they can recur after surgical removal.

Monitoring and Follow-Up
If you choose to monitor the fibroadenoma instead of undergoing surgery, regular follow-up appointments are essential. Typically, follow-up imaging (such as ultrasound) is recommended every 6 to 12 months to assess for any changes in size or characteristics. If the tumor grows or if new symptoms arise, a reassessment of the need for surgery may be warranted.

Conclusion
In summary, the decision to proceed with surgery for a breast fibroma depends on various factors, including the size of the tumor, symptoms, growth potential, and personal preference. It is essential to have an open discussion with your healthcare provider about the risks and benefits of surgery versus observation. If you are feeling uncertain due to differing opinions from different healthcare providers, seeking a third opinion or discussing your concerns in detail with your current provider can help clarify the best course of action for your specific situation. Remember, your comfort and peace of mind are paramount in making this decision.

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