Fibromas: Concerns About Growth and Surgical Options

Lipofibroma

Hello Doctor: I would like to ask you about the fibroma that has developed above my chest.
Previously, when I went for an examination at Chang Gung Memorial Hospital, the doctor told me that surgery was not necessary and that I should just follow up every six months.
However, I recently noticed that my fibroma seems to have grown larger, and I am very worried about whether it could become malignant.
My grandmother and uncle both had cancer, and I have never had surgery or stitches before, so I am very afraid of surgery.
If surgery is required, will I need to be hospitalized? Will the incision be large? My fibroma is now 4.5 centimeters! I would like to know if the surgery would require general anesthesia or if local anesthesia would be sufficient.
I am really afraid of pain; can I have general anesthesia? Is surgery absolutely necessary? If surgery is not performed, what are the alternatives? I heard from a friend that the procedure requires 6 to 7 stitches, and I am really scared and feel lost! What should I do?

Ms. Tsai, 20~29 year old female. Ask Date: 2008/12/06

Dr. Chen Sirong reply Oncology

Ms.
Tsai, 1.
If you are concerned, you can go to another hospital for a second opinion.
2.
If the doctor says it is benign but you still feel worried or unhappy, it might be better to consider surgery to remove it.
3.
The incision may be greater than 4.5 centimeters; the perception of incision size is subjective—some may think it is large, while others may think it is small.
Personally, I care more about how well the doctor sutures it, so that it will be less noticeable in the future.
4.
General anesthesia is an option.
5.
You can choose to have surgery, seek a second opinion, or continue to follow up with your current physician.
I suggest you ask yourself what would make you feel more at ease and happy.
6.
If others can recover from severe car accidents, you can certainly overcome your inner fears.
- By Chen Si-Rong

Reply Date: 2008/12/06

More Info

Understanding fibromas, particularly in the context of breast health, can be a source of anxiety for many patients, especially when there are concerns about growth and potential malignancy. Fibromas, or fibroadenomas in the breast, are typically benign tumors that are most common in women aged 15 to 35. They are characterized by a firm, smooth, and movable lump in the breast tissue.
In your case, the fact that your fibroadenoma has grown to 4.5 cm is noteworthy. While many fibroadenomas remain stable in size, a significant increase in size can warrant further evaluation. It is understandable to be concerned about the possibility of malignancy, especially given your family history of cancer. However, it is important to note that the vast majority of fibroadenomas do not turn into breast cancer. The risk of a benign fibroadenoma becoming malignant is very low, but any changes in size or shape should be monitored closely.

Regarding your concerns about surgery, it is essential to have a thorough discussion with your healthcare provider. Surgical options typically include excisional biopsy or lumpectomy, where the fibroadenoma is removed along with a margin of surrounding tissue. The decision to proceed with surgery often depends on several factors, including the size of the tumor, any changes in its characteristics, and your personal comfort level with monitoring versus surgical intervention.

1. Surgical Necessity: If your fibroadenoma is growing, your doctor may recommend surgical removal to ensure it is not something more serious. If left untreated, there is a slight chance that it could cause discomfort or lead to further complications, although this is rare.

2. Surgical Procedure: Surgery for a fibroadenoma is usually performed as an outpatient procedure, meaning you would not need to stay overnight in the hospital. The size of the incision can vary depending on the size of the tumor, but it is generally small. Many patients are concerned about the cosmetic outcome, and most surgeons aim to minimize scarring.

3. Anesthesia Options: Surgery can be performed under local anesthesia, where only the area around the tumor is numbed, or under general anesthesia, where you would be asleep during the procedure. Your comfort is important, so discuss your fears about pain with your surgeon; they can help you choose the best option for your situation.

4. Recovery: Recovery time varies from person to person, but most patients can return to normal activities within a few days. The stitches used for the incision may dissolve on their own or need to be removed after a week or so, depending on the technique used.

5. Monitoring vs. Surgery: If your doctor suggests monitoring, it is usually because they believe the risk of malignancy is low. However, if you are uncomfortable with this approach, you have the right to seek a second opinion or request surgery.

In conclusion, while it is natural to feel anxious about the growth of a fibroadenoma, it is crucial to have open communication with your healthcare provider. They can provide you with the necessary information to make an informed decision about your treatment options. Remember, you are not alone in this process, and many women face similar concerns. Take the time to discuss your fears and preferences with your doctor, and together you can determine the best course of action for your health and peace of mind.

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