Managing Fibroadenomas: When to Monitor or Consider Surgery

What should be done if a fibroma is detected?

Hello Doctor, I previously had a breast ultrasound examination and a 1 cm fibroadenoma was found in my right breast.
The doctor I consulted suggested that regular monitoring would be sufficient, so I plan to have an ultrasound every three to five months.
However, I came across some information online suggesting that surgical removal might be necessary, and that benign tumors can change over time.
After reading this, I feel quite anxious and I'm unsure of what to do.
Do you have any recommendations? Thank you.

Mei Mei, 30~39 year old female. Ask Date: 2011/05/09

Dr. Yang Mingqi reply Breast and Thyroid

Please schedule an appointment with the breast surgery department.
Wishing you well.

Reply Date: 2011/05/09

More Info

Fibroadenomas are benign breast tumors that are most commonly found in young women. They are typically round or oval in shape, firm to the touch, and can move slightly when pushed. The management of fibroadenomas often depends on their size, symptoms, and the patient's age and preferences.
In your case, since your ultrasound revealed a 1 cm fibroadenoma in your right breast, and your doctor has recommended regular monitoring, this is a common approach. Fibroadenomas are usually asymptomatic and do not require surgical intervention unless they are large, causing discomfort, or if there are changes in their characteristics over time. Regular follow-up with ultrasound every 3 to 6 months is a standard practice to ensure that the fibroadenoma remains stable.

The concern about the potential for changes in a fibroadenoma is valid. While most fibroadenomas remain stable, there are instances where they can grow or change. If a fibroadenoma increases in size or if there are any suspicious changes noted on imaging, further evaluation may be warranted. This could include a biopsy to rule out any atypical cells or malignancy, although this is rare.

Surgical removal of a fibroadenoma may be considered if:
1. The fibroadenoma is large (typically over 2-3 cm).

2. There are changes in the fibroadenoma's appearance on imaging.

3. The patient experiences discomfort or anxiety related to the fibroadenoma.

4. There is a family history of breast cancer or other risk factors that may necessitate a more aggressive approach.

It's important to remember that the majority of fibroadenomas do not turn into breast cancer. The risk of malignancy in a fibroadenoma is very low, and most women with fibroadenomas can safely monitor them without surgical intervention.
If you are feeling anxious about the situation, it may be helpful to discuss your concerns with your healthcare provider. They can provide reassurance and clarify the reasons behind the monitoring strategy. Additionally, if you feel uncomfortable with the idea of monitoring alone, you can always seek a second opinion from another breast specialist.

In summary, regular monitoring of your fibroadenoma is a reasonable approach, especially given its small size. Continue to follow your doctor's recommendations for follow-up ultrasounds, and do not hesitate to voice any concerns you may have during your appointments. If any changes occur or if you feel that the fibroadenoma is causing you distress, discuss the possibility of surgical removal with your healthcare provider.

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