Fibroadenomas: When to Consider Removal and Cancer Risks

Q: Fibroadenomas: When to Consider Removal and Cancer Risks

Fibromas can be classified into： fibroadenomas and fibrocystic disease. <br>Fibroadenomas are benign tumors that commonly occur in young women and are unlikely to transform into malignancy. <br>They are usually less than 2 centimeters in size and can be monitored with regular ult

Fibroma

Hello, I would like to ask about my mother (44 years old).
She has a small growth near her breast that resembles a polyp, and it seems to be increasing in size.
Does it need to be removed? Also, regarding a fibroma, if it appears benign on ultrasound, is there a possibility that it could become malignant if tested via needle aspiration? If the fibroma is benign, does it need to be removed? What would happen if it is removed? And if it is malignant, what are the implications? Is there a direct relationship between fibromas and breast cancer?

Wuming, 10~19 year old female. Ask Date: 2007/02/03

Dr. Xie Wenhuai reply Breast and Thyroid

Fibromas can be classified into: fibroadenomas and fibrocystic disease.
Fibroadenomas are benign tumors that commonly occur in young women and are unlikely to transform into malignancy.
They are usually less than 2 centimeters in size and can be monitored with regular ultrasound.
If they exceed 2 centimeters, surgical intervention and pathological examination are recommended.
Fibrocystic disease is more prevalent in married women who have given birth and has a slightly higher chance of malignant transformation, although the risk remains low.
Regular ultrasound examinations or mammograms should be performed.
Your mother has small nodules in her breast, and it is advisable for her to see a surgeon for evaluation.

Reply Date: 2007/02/03

More Info

Fibroadenomas are benign breast tumors that are most commonly found in young women, typically between the ages of 15 and 35. They are characterized by their firm, rubbery texture and can vary in size. While fibroadenomas are generally considered non-cancerous, there are several factors to consider when determining whether removal is necessary and understanding the associated cancer risks.

When to Consider Removal
1. Size and Growth: If a fibroadenoma is growing or has reached a size that is concerning (typically over 2-3 cm), it may warrant removal. Larger fibroadenomas can cause discomfort or cosmetic concerns, prompting patients to seek surgical intervention.

2. Symptoms: If the fibroadenoma is causing pain, tenderness, or any other symptoms, removal may be recommended.
3. Uncertainty in Diagnosis: If there is any uncertainty regarding the diagnosis, such as atypical features on imaging or if the needle biopsy results are inconclusive, surgical excision may be advised to ensure accurate diagnosis and rule out malignancy.

4. Patient Preference: Some patients may prefer to have the fibroadenoma removed for peace of mind, especially if they are concerned about the potential for changes over time.

Cancer Risks
Fibroadenomas themselves are not cancerous and do not directly increase the risk of breast cancer. However, it is important to note that:
- Complex Fibroadenomas: These may have features such as cysts or calcifications and have a slightly higher association with breast cancer compared to simple fibroadenomas. If a fibroadenoma is classified as complex, closer monitoring or removal may be recommended.

- Breast Cancer Risk Factors: While fibroadenomas are benign, women with a history of breast cancer in their family or other risk factors (such as genetic mutations like BRCA1 or BRCA2) should discuss their individual risk with their healthcare provider.

Follow-Up and Monitoring
If a fibroadenoma is diagnosed as benign and is not causing any symptoms, regular follow-up with imaging (such as ultrasound or mammography) may be sufficient. The frequency of follow-up will depend on the size and characteristics of the fibroadenoma, as well as the patient's overall breast health.

What If It Becomes Malignant?
If a fibroadenoma were to undergo malignant transformation (which is extremely rare), it would typically be treated as breast cancer. The treatment would depend on the type and stage of cancer, and could involve surgery, radiation, and/or chemotherapy.

Conclusion
In summary, while fibroadenomas are benign and generally do not pose a cancer risk, their management should be individualized based on size, symptoms, and patient preference. If your mother has a fibroadenoma that is increasing in size or causing discomfort, it would be prudent to consult with a breast specialist or surgeon to discuss the potential for removal and any necessary follow-up. Regular monitoring and open communication with healthcare providers are key to managing breast health effectively.

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