Fibroadenomas: When to Seek Further Evaluation and Treatment

Fibroma

Hello Doctor, recently I have noticed that my breasts sometimes express a milky or clear fluid.
I visited an obstetrician-gynecologist who said it was related to prolactin levels.
However, a breast surgeon mentioned that it was not a concern, and I have not experienced this before.
After a few days of squeezing, I can get a little bit of fluid out.
I have also had breast ultrasounds done at different surgical clinics, but the opinions on my symptoms vary.
Some say it could be a fibroadenoma, while others suggest it might be due to glandular enlargement.
Both of these sound quite alarming.

Could you please clarify if the ultrasound results depend on the operator's skill and experience? Which doctor should I consult? If the fibroadenoma appears benign, is it necessary to perform a fine needle aspiration? Should I follow up at a general surgical clinic or at a large hospital's obstetrics and gynecology department? I am quite confused.
Thank you.

op8971, 20~29 year old female. Ask Date: 2008/09/17

Dr. Li Guanghan reply Obstetrics and Gynecology

Hello! Welcome to our hospital's breast surgery department.
We have specialized breast surgeons available.
Wishing you peace and good health.

Reply Date: 2008/09/17

More Info

Understanding fibroadenomas and when to seek further evaluation and treatment can be quite complex, especially when you are experiencing symptoms like discharge from the breast. Fibroadenomas are benign tumors of the breast that are most commonly found in young women. They are typically painless, firm, and mobile upon examination. The presence of a fibroadenoma does not usually lead to breast cancer, but it is essential to monitor any changes in your breast tissue.

From your description, it seems that you have experienced some discharge from your breast, which can be concerning. Discharge can be caused by various factors, including hormonal changes, which you mentioned were attributed to prolactin levels by your gynecologist. Prolactin is a hormone that can stimulate breast tissue and cause discharge, especially if levels are elevated.
The differing opinions from the specialists you consulted may stem from the complexity of breast conditions. Breast ultrasound is a common imaging technique used to evaluate breast lumps or abnormalities. The accuracy of ultrasound can indeed depend on the operator's experience and the quality of the equipment used. If the ultrasound shows a well-defined, solid mass, it is likely a fibroadenoma, but further evaluation may be warranted if there are atypical features or if the mass changes over time.

Regarding the management of fibroadenomas, if the ultrasound suggests that the mass is benign, many doctors may recommend a "watchful waiting" approach, meaning that you would have regular follow-ups to monitor the fibroadenoma for any changes. However, if the fibroadenoma is large, symptomatic, or if there are any concerns about its characteristics, a fine needle aspiration (FNA) biopsy may be recommended to rule out any atypical cells. This procedure is minimally invasive and can provide more information about the nature of the lump.

As for where to seek further evaluation, it is generally advisable to follow up with a breast specialist or a breast surgeon, especially if you have concerns about the discharge or the characteristics of the fibroadenoma. A breast specialist can provide a comprehensive evaluation and determine the best course of action based on your specific situation. If you feel uncertain about the opinions you've received, seeking a second opinion from another breast specialist or a breast clinic may also be beneficial.

In summary, while fibroadenomas are typically benign and do not require aggressive treatment, it is essential to monitor any changes in your breast tissue and seek further evaluation if you notice new symptoms or if the characteristics of the lump change. Regular follow-ups with a breast specialist can help ensure that any potential issues are addressed promptly. Remember, your health and peace of mind are paramount, so do not hesitate to advocate for yourself and seek the care you feel is necessary.

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