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Key Features

  • Common benign neoplasm

  • Most frequent in young women

  • Occurs somewhat more frequently and at an earlier age in black women

  • Multiple fibroadenomas in 10–15% of affected patients

Clinical Findings

  • Round or ovoid, rubbery, discrete, relatively mobile, nontender mass, 1–5 cm in diameter

  • Usually discovered accidentally

  • Rarely occurs after menopause unless patient is receiving hormone replacement therapy

Diagnosis

  • Breast ultrasonography useful in differentiating cystic from solid mass

  • Needle biopsy or fine-needle aspiration generally adequate for diagnosis

  • Excision with pathologic examination if diagnosis remains uncertain

  • Presumed fibroadenomas > 3 cm or 4 cm should be excised to rule out phyllodes tumors

  • Differential diagnosis

    • Fibrocystic disease or cyst

    • Breast cancer

    • Lipoma

    • Phyllodes tumor

    • Breast abscess

    • Intraductal papilloma

    • Fat necrosis

Treatment

  • No treatment is necessary if the diagnosis can be made by core needle biopsy

  • Excision with pathologic examination is performed if the diagnosis is uncertain

  • Cryoablation

    • Appears to be safe if the lesion is a biopsy-proven fibroadenoma prior to ablation

    • Not appropriate for all fibroadenomas because some are too large to freeze or the diagnosis may not be certain

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