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A fibroadenoma is a benign (noncancerous) breast lump that occurs mainly in women under 35 years old. It is the most common type of lump found in teenagers and women in their early 20s. Unlike breast cysts, which are fluid-filled lumps, fibroadenomas are solid lumps made up of fibrous tissue and gland cells. Fibroadenomas often happen as a single lump, but sometimes they are found in groups in both breasts.

Fibroadenomas are usually painless and don't increase the risk of cancer

Although fibroadenomas are usually painless, in some women they become tender before the menstrual period. Fibroadenomas may gradually increase in size over time, but they tend not to change with the menstrual cycle.

Fortunately, having one or several fibroadenomas does not increase the risk of developing breast cancer.

A fibroadenoma is diagnosed through mammogram, physical exam, fine-needle aspiration, and, at times, a biopsy

On a mammogram (X-ray of the breast), a fibroadenoma appears as an oval-shaped, well-defined lump with a smooth surface. In contrast, a cancerous lump appears as a more irregularly shaped lump that extends out into the surrounding tissues.

In a physical examination, a fibroadenoma feels slippery and smooth, like a hard marble, and moves freely within the breast. However, it is not always possible to tell the difference between a fibroadenoma and a fluid-filled cyst. Therefore, your doctor may decide to do a simple procedure in the office called fine-needle aspiration.

The fine-needle aspiration procedure takes only a few seconds and causes no more pain than having a blood test. The procedure involves inserting a very thin needle attached to a syringe into the lump (see Figure 1). If the lump is a cyst, the fluid in the cyst will be drawn into the syringe, and the lump will disappear. If the lump is solid, a small sample of cells will be removed and examined under a microscope to rule out the possibility of a cancerous tumour.

Fine needle aspirations

Figure 1

A doctor inserts a thin needle attached to a syringe into the lump to draw out fluid or a small sample of tissue.

At this point, your doctor will evaluate all of the test results, including the mammogram, physical exam, and results from the cell sample. They will also consider other factors such as how long you have had the lump, your age, and medical history. Even if the cell sample shows benign cells, your doctor may still recommend a final procedure to confirm this result, called a surgical biopsy.

A surgical biopsy is a minor surgical procedure that removes a small piece of the lump, or the entire lump itself if it is small. A surgical biopsy is done using a local or general anesthetic. The tissue from the lump is then sent to a laboratory to confirm whether it is benign.

Can fibroadenomas be left in the breast?

Yes. Since fibroadenomas are benign, it is safe to leave them where they are. However, you should continue to have regular follow-up breast examinations by your doctor.

Urve Kuusk, MD 
in association with the MediResource Clinical Team 
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