Breast Fibroadenoma

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