Do You Need Surgery for Breast Fibroadenomas? Expert Insights

Q: Do You Need Surgery for Breast Fibroadenomas? Expert Insights

Hello Ms. <br>Yang： Fibroadenomas can be detected through ultrasound. <br>If the margins are smooth and the internal ultrasound shows a homogeneous condition, it is generally confirmed to be benign. <br>However, if the size is 1.6 cm in an unmarried female, most physicians would

Does a breast fibroadenoma require surgery?

Thank you for taking the time to assist me.
My name is Yang, and I have a tendency to develop breast fibrocystic changes, with nearly ten cysts present in both breasts.
Seven years ago, I underwent a surgical outpatient procedure for benign breast fibrocysts upon my doctor's recommendation.
Recently, I had an examination at another hospital and discovered that I have developed a fibroadenoma on both sides, with one measuring approximately 1.6 cm and located deeper within the breast tissue.
The doctor interpreted the ultrasound as benign but recommended surgical removal under general anesthesia with the aid of a localization needle.
I am quite concerned and would like to ask whether surgery is necessary for the adenoma.
Is general anesthesia the appropriate course of action? If surgery is required, will it affect my ability to breastfeed in the future after childbirth? I assure you that any advice you provide will remain confidential and will not be shared, even if it differs from my attending physician's opinion.
I have been hesitant about whether to proceed with surgery.
I kindly request your opinion for my consideration.
Thank you, doctor.

Miss Yang, 30~39 year old female. Ask Date: 2006/11/27

Dr. Lin Kecheng reply Surgery

Hello Ms.
Yang: Fibroadenomas can be detected through ultrasound.
If the margins are smooth and the internal ultrasound shows a homogeneous condition, it is generally confirmed to be benign.
However, if the size is 1.6 cm in an unmarried female, most physicians would consider performing a fine needle aspiration biopsy for cytological examination.
For married females, surgical excision might be considered.
If the lesion is located deeper and measures 1.6 cm, general anesthesia could be an appropriate management option, and it should not affect future childbirth or breastfeeding.
You can rest assured.
Wishing you good health and all the best.

Reply Date: 2006/11/27

More Info

When it comes to the management of breast fibroadenomas, the decision to undergo surgery is often nuanced and depends on several factors, including the characteristics of the tumor, patient symptoms, and individual preferences. Fibroadenomas are benign tumors composed of glandular and stromal tissue, and they are quite common, especially in younger women.

Understanding Fibroadenomas
1. Nature of Fibroadenomas: Fibroadenomas are typically well-circumscribed, mobile masses that can vary in size. They are usually painless, but some patients may experience discomfort, especially if the tumor is larger or located in a sensitive area of the breast. In your case, the recent identification of a 1.6 cm fibroadenoma, despite being classified as benign, raises questions about management.

2. Surgical Indications: Surgery is not always necessary for fibroadenomas. The decision to proceed with surgical excision often hinges on factors such as:
- Size: Larger fibroadenomas (generally over 2 cm) may be more likely to warrant surgical removal, especially if they cause discomfort or if there is uncertainty about the diagnosis.

- Symptoms: If the fibroadenoma is causing pain or discomfort, surgical removal may be recommended.

- Changes in Appearance: If there are changes in the characteristics of the fibroadenoma, such as rapid growth or irregular shape, surgery may be indicated to rule out malignancy.

3. Surgical Techniques: The procedure for removing a fibroadenoma can often be performed under local anesthesia, but in some cases, general anesthesia may be recommended, particularly if the tumor is deep or if the surgeon prefers it for patient comfort. The use of localization techniques, such as a localization needle, helps ensure accurate removal of the tumor.

Concerns About Surgery
1. Impact on Future Breastfeeding: Generally, surgical removal of a fibroadenoma does not significantly impact future breastfeeding. However, the specific location of the tumor and the surgical technique used can influence this. It is essential to discuss your concerns about breastfeeding with your surgeon, who can provide insights based on the planned approach.

2. Recovery Time: Recovery from fibroadenoma surgery is typically quick, with many patients returning to normal activities within a week. However, full recovery can vary based on individual circumstances and the extent of the surgery.

3. Second Opinions: Given your history of multiple fibroadenomas and the recent recommendation for surgery, seeking a second opinion can be beneficial. Different surgeons may have varying approaches to management, and understanding all your options can help you make an informed decision.

Conclusion
In summary, while surgery for fibroadenomas is often considered based on size, symptoms, and changes in characteristics, it is not universally required for all cases. The decision should be made collaboratively with your healthcare provider, considering your specific situation, preferences, and concerns. If you feel uncertain, discussing your worries about anesthesia, recovery, and future breastfeeding with your doctor can provide clarity and help you feel more comfortable with your decision. Always remember that your health and peace of mind are paramount, and it’s essential to choose a path that aligns with your values and lifestyle.

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