A fibroadenoma is a painless, non-cancerous breast tumour that is a solid, not fluid-filled, lump. These firm, rubbery masses with regular borders are often variable in size. The term fibrodomena combines the words “fibroma,” meaning a tumour which consists of fibrous tissue, and “adenoma,” a tumour of gland tissue.
Fibroadenoma is commonly regarded as a tumour of the breast and is conceptualised to represent a harmless overgrowth of breast tissue. It is hormone-dependent and may increase in size during pregnancy, and shrinks with the rest of the breast after menopause. Fibroadenoma is the most popular tumour of the breast. It occurs in 25 per cent of asymptomatic women, usually, this tumour is common among women in their reproductive life between the ages of 15 and 35. This tumour usually occurs in premenopausal women (women who have not reached the age of menopause or stopped menstruating) and may increase during pregnancy, breastfeeding, or estrogen therapy.
Fibroadenomas are usually noticed during your breast self-exam (a type of examination for breast health) and will surface on mammograms and ultrasounds. Fibroadenomas are often illustrated as round, painless breast lumps, which are usually smooth. Although fibroadenomas have a specific texture on physical examination and appearance on breast ultrasound, the only way to ascertain that a breast lump is a fibroadenoma is through a biopsy. Usually, fibroadenomas may not need treatment unless they are large, fast-growing, or cause painful symptoms.
Most fibroadenomas are not related to direct growth in breast cancer risk. Although, there appears to be a little increase in risk with a “complex fibroadenoma.” This type of fibroadenoma is a fibroadenoma that includes one or more of the following non-cancerous tissue elements, it is regarded to be larger than 3 millimeters; sclerosing adenosis; epithelial calcifications; or papillary apocrine change. According to research, about 15% of fibroadenomas are categorized as complex. Fibroadenomas are sensitive to the body’s hormonal changes. They constantly vary during the menstrual cycle, often becoming more visible and prominent and more tender before a period begins. Fibroadenomas can become bigger especially during pregnancy and while breastfeeding. They do not usually interfere with a woman’s ability to breastfeed her baby. It is estimated that approximately one-third of fibroadenomas if not treated, will reduce in size or even disappear totally. A further one-third will grow in size, with the rest types staying the same in size.
Types of Fibroadenoma
What are the types of fibroadenoma?
Fibroadenomas can be simple or complex or giant.
Simple fibroadenomas often have a diameter of 3 cm and lack an internal cyst.
Complex fibroadenomas are greater than 3 cm and contain internal cysts.
Large, rapidly expanding adenomas are known as giant fibroadenomas.
Causes of Fibroadenoma
Fibroadenomas are not harmful or cancerous and having one doesn’t significantly determine the risk of developing breast cancer. Fibroadenomas contain some common breast tissue cells, and these cells can lead to cancer, like all the cells in the breast. The chance of cancer growing in a fibroadenoma is no higher than the chances of cancer developing elsewhere in the breast. The major causes of Fibroadenoma are unknown. Hormones such as oestrogen may play a role in the development of tumors. The use of oral contraceptives before the age of 20 has been researched to have an association with a higher risk of developing fibroadenomas. These tumors may grow rapidly in size, especially during pregnancy. During menopause, they often shrink. It’s also possible for fibroadenomas to stop on their own. Even though this could be a possibility, there are no studies that have scientifically established a relationship between consuming stimulants and increased Fibroadenoma.
The causes of fibroadenoma are uncertain, but medical experts believe that the situation has a hormonal cause related to the increased sensation of breast tissue to the female reproductive hormone. Fibroadenoma usually increases during pregnancy and tends to reduce during menopause.
Most fibroadenomas are less or partially sensitive to the influence of sex hormones, especially estrogen (female sex hormones). Estrogen is higher in women of reproductive age than in prepubescent girls or postmenopausal women, possibly this explains the increased prevalence of fibroadenoma in that age range. Since sex hormones control the production of normal breast tissue, this simply means that fluctuations in sex hormone levels can similarly stimulate the unusual production of breast tissue cells in a fibroadenoma.
Age is the most significant factor in the case of fibroadenoma. Therefore, when understanding the causes of fibroadenoma, age is the most important factor which should be considered.
A family history of breast cancer is also one important factor to be considered as genetics plays a huge role in medical situations. Female patients who have relatives who have relations with a history of breast cancer should be monitored and observed more carefully for threatening signs than those without this family history.
Diagnosis and Treatment of Fibroadenoma
Fibroadenomas may create a lump that can be examined and detected by a doctor or patient, or they may be found on a mammogram or a breast ultrasound that is done for a different reason.
In 80% of cases, there is a single fibroadenoma. On most occasions, there can be numerously scattered throughout the breasts. They can be soft, especially before a female’s menstrual period.
When a fibroadenoma can be felt as a lump, it is usually oval and smooth. They can be examined by the patient by just holding the breast to be sure that lumps do not exist in the breast.
While fibroadenomas may be seen on a mammogram, they are often seen more easily on an ultrasound of the breast. The diagnosis of fibroadenoma can be detected by taking a sample of cells from the affected area of the breast for a pathologist to examine under the microscope. This can be done with a neat needle biopsy or a core biopsy, often under the control of ultrasound. It is most times difficult to tell the distinct difference between fibroadenomas and other benign breast lumps on the fine needle or core biopsy. In a few cases, fibroadenomas may consist of very active or “atypical” (abnormal) cells on a biopsy. Fibroadenomas with atypical cells will usually need to be removed surgically and examined.
Research has shown that doctors can detect a fibroadenoma through a normal physical examination if it is large enough. If the doctor detects or suspects a fibroadenoma, they will confirm the suspicion by conducting an imaging test, such as a mammogram, an ultrasound, or both. The doctor may also recommend a biopsy to ascertain that the lump is a fibroadenoma. The individual will receive a local anesthetic, after which the medical doctor will cut out a small sample of the lump to be sent to a laboratory for testing.
How a fibroadenoma is treated is dependent on some factors, such as:
- its size
- whether it shows painful symptoms such as a lump
- the age of the individual
- biopsy results
Fibroadenomas that are bigger than 3 cm in size, are usually painful, are rapidly growing in size, or show concerning features on imaging scans or biopsies, will usually be treated surgically.
Fibroadenomas can also be managed without surgery, especially in younger women. A fibroadenoma that is not removed surgically is usually monitored for some time.
As it has been said that fibroadenoma is not usually harmful as it is non-cancerous, without treatment it can be left alone to shrink but in cases of complex fibroadenoma, surgery could be done to remove lumps if such causes discomfort to the patient.
Diagnostic Mammogram
A mammogram uses x-rays to assess suspicious lumps in women above 35 years of age. Fibroadenoma on a mammogram is a well-defined area from other breast tissue, with smooth round edges.
Breast Ultrasound
Ultrasound makes use of sound waves to understand and evaluate the features of fibroadenomas in women younger than 35 years of age. Necessarily, a less invasive biopsy may be performed through a core needle biopsy.
Simple Preventive Measures for Fibroadenoma
These preventive measures may be helpful but are not guaranteed in Fibroadenoma management.
Having lower or regulated estrogen levels: While there is no specific way to prevent fibroadenoma development in the breast, a decreased risk is associated with reduced production and estrogen exposure during hormonal contraception (oral birth control), late puberty, or early menopause.
Maintaining a healthy lifestyle: A healthy lifestyle has also been associated with a lowered risk of having a fibroadenoma, including not smoking, frequent exercise, and maintaining a healthy body weight. Some researchers have even found a relationship between lower fibroadenoma risk and the intake of a diet rich in fruits and vegetables.
Breast massage: Massaging your breast regularly or frequently is also a good way of lowering Fibroadenoma in females. Most times, a fibroadenoma will reduce and disappear on its own without any treatment or medical intervention. This is mostly true for hormone-sensitive fibroadenomas, which are especially likely to shrink after menopause. With proper monitoring and body maintenance, fibroadenomas can otherwise be left alone as long as they do not give the patient significant discomfort.
The majority of breast problems in young women are identified on an incidental breast exam either by the patient or the healthcare practitioner. Even though fibroadenomas are non-cancerous lesions, sometimes it is important to confirm the histology. Healthcare workers including nurse practitioners should never conclude that all firm, rubbery breast lumps are benign. If ever in doubt, get a radiologist or medical surgeon to perform a biopsy. Missing a harmful breast lesion in a young female can lead to critical outcomes.
Conclusion
No matter the type of fibroadenoma you have it is important to first note that it’s not a harmful tissue and as such should not be confused with cancerous cells, for better diagnosis always visit your doctor for proper medical advice and consultation. Remember that your health is your wealth!!
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