can fibroadenomas turn into breast cancer?
Since most fibroadenomas are noncancerous, the majority are left untreated and safe to leave alone.

Fibroadenomas are noncancerous (benign) breast tumors that are developed from glandular and stromal (connective) tissue.

Fibroadenomas are generally harmless and thus are not actively removed immediately after diagnosis.

  • The majority of fibroadenomas are left untreated.
  • Many women and their doctors conclude that the lump does not need to be removed. 
  • It is safe to leave fibroadenomas alone.
  • However, the patient should follow up with a doctor regularly and get it checked for possible changes.
  • They tend to shrink once a woman reaches menopause.

Though fibroadenomas generally do not cause cancer, it can be difficult for physicians and patients to be certain that a lump is not cancerous. To alleviate this fear, some of these lumps could be excised or have a biopsy performed.

Some fibroadenomas are removed if it is unpleasant or painful. If the fibroadenoma continues to grow, a healthcare professional may advise removing it before it becomes too large.

Usually, fibroadenomas do not increase the risk of breast cancer, however, large and complex lumps do have a slightly increased risk of development of breast cancer. Research suggests that only 0.002 to 0.125 percent of fibroadenomas develop into cancer.

What is a fibroadenoma?

A fibroadenoma is a noncancerous growth or lump that develops in the breast. 

Fibroadenomas are commonly seen in women in their 20s and 30s although they can occur at any age. Rarely fibroadenomas are seen in men.

The exact cause of the development of fibroadenomas is unclear. They may be connected to fluctuating hormone levels because they frequently arise during puberty or pregnancy and disappear after menopause.

The fibroadenoma's margins are well-defined, and the tumors usually have a definite shape. Even though fibroadenoma is not life-threatening, it may necessitate treatment especially if it causes discomfort. Fibroadenomas can develop in one or both breasts.

Some fibroadenomas are so tiny that they cannot be felt. When you can feel one, it is substantially different from the surrounding tissues.

Fibroadenoma tumors are typically movable (and not fixed to underlying breast tissue) and not painful. These tumors may have the texture of hard marble, as well as a smooth rubbery feel.

4 types of fibroadenomas

Fibroadenomas are of 4 different types, which include:

  1. Simple fibroadenoma: The majority are simple fibroadenomas, and are more frequent in younger people.
    • In most cases, your breast has a single mass with a distinct boundary and relatively homogenous cells (seen on lab examination).
    • A fibroadenoma does not increase your chances of developing breast cancer.
  2. Complex fibroadenoma: Complex fibroadenomas are uncommon, however, they get more prevalent as people age.
    • While they may have a distinct boundary, what is inside this type of fibroadenoma distinguishes it.
    • A complicated fibroadenoma will not appear as ordered and uniform as a simple one under a microscope.
    • Often, the cells divide quickly (hyperplasia) that may seem abnormal (atypia). 
    • A complicated fibroadenoma might increase the chances of developing breast cancer.
  3. Juvenile fibroadenoma: These are the most prevalent types of breast lumps seen in girls and teenagers aged 10 to 18 years.
    • They can grow to be huge, but most of them diminish with time.
  4. Giant fibroadenomas: They can grow to be more than two inches long.
    • If they push on or compress the surrounding tissues, they may need to be removed.

SLIDESHOW

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How to perform a breast self-examination to detect fibroadenomas

You can perform a self-check to detect the presence of fibroadenomas and other lumps in your breast.

The best time to perform this test is one week after the menstrual period starts because the breasts will be less swollen and tender making it easy for you. This self-examination does not cause any pain or discomfort.

Steps to perform a self-examination breast test

  1. Take off all your clothing above the waist and lay down.
  2. Lying down distributes your breasts uniformly over your chest, making lumps or alterations easier to detect.
  3. Use your fingers to feel all the tissue in your breast from the collarbone to the bottom of the bra line and from the armpit to the breastbone.
    • Do not use your fingertips but use the pads of your three middle fingers. 
  4. Check your right breast with your left hand's middle fingers and use your right hand's middle fingers for the left breast.
    • You may use the up-and-down or spiral design approach.
    • Slowly move your fingers in little coin-sized circles.
  5. To feel all your breast tissue, use three different amounts of pressure. To feel the tissue near to the skin's surface, use little pressure.
    • Firm pressure is used to feel your tissue near to your breastbone and ribs, while medium pressure is used to feel a bit deeper.
  6. When feeling for lumps, strange thicknesses, or alterations of any type, avoid raising your fingertips away from the skin.

In addition to lying down, you may examine your breasts while standing or in the shower. Soapy fingertips glide smoothly across the breast, making changes easier to detect.

  1. Place one arm over your head while standing in the shower and softly bathe your breast on that side.
  2. Then, using the flat surface of your fingers rather than your fingertips, rub your hand lightly over your breast, feeling for any lumps or thickened regions.
  3. You may stand in front of a mirror to see any changes in your breasts.

If you notice a lump, check your other breast immediately. If you locate the same type of lump in the same location on the other breast, both are most likely normal.

Consult a doctor immediately if you find any of the following changes:

  • Any fresh mass that may or may not be uncomfortable to touch
  • Unusually thick areas
  • Any changes in your breast or nipple skin, such as puckering or dimpling
  • Discharge from your nipples that is sticky or bloody
  • One breast has grown unusually large
  • One breast is particularly low in comparison to the other

Performing breast self-examination has been found to increase anxiety and stress among people if they observe even a slight change in their breasts. This may lead to unnecessary doctor visits and examinations, such as biopsies.

Due to this, some experts do not recommend breast self-examination, but other experts do support a medical examination saying it helps detect lumps early.

How to diagnose a fibroadenoma

You may visit a doctor if you notice any changes in your breast or feel a presence of a lump. 

The doctor determines the type of lump using the following tests:

  1. Physical examination: The doctor palpates your breast and feels for the presence of a mass. If a mass is noted to be present, they may order further tests.
  2. Mammogram: A special X-ray machine that detects and shows the presence of both cancerous and noncancerous changes in the breast. You will stand in front of the machine and your breast rests against a plate while X-ray images are being taken.
  3. Ultrasound: Ultrasound imaging of the breast creates images of the inside anatomy of it by using sound waves. It helps diagnose breast masses or other abnormalities discovered in a physical exam or on a mammography or breast magnetic resonance imaging. Ultrasound is noninvasive, nonhazardous, and does not use radiation.
  4. Image-guided core needle breast biopsy: This procedure is done under the influence of anesthesia. A needle is inserted into the breast with the guidance of any imaging technique (such as ultrasound). The needle is inserted into the lump and tissue is extracted. The tissue will be sent to the lab for analysis to determine if the lump is benign or cancerous.

What are different treatment options for fibroadenomas?

Fibroadenomas frequently resolve on their own. Those that have not been removed diminish after menopause. Depending on your symptoms and investigation reports, your doctor may advise you to remove them or monitor them.

Monitoring

Monitoring makes the most sense in the following circumstances:

  • Continuous monitoring is done if lumps are fibroadenomas and not breast cancer. This ensures that the lump is not growing.
  • If removing them would need to remove enough surrounding breast tissue to alter the form and texture of the breast. This may make subsequent mammograms more difficult to read. When this option is chosen, it is critical to have frequent breast examinations and imaging to ensure that the fibroadenoma does not grow.

Recommendations for removal of fibroadenoma include:

  • Rapid growth
  • Painful lump
  • The result of the biopsy is unclear 
  • Concern about the presence of breast cancer

Surgical options

  • Vacuum-assisted excision biopsy
    • Vacuum-assisted excision biopsy is an outpatient treatment that requires tiny incisions and local anesthetic.
    • The fibroadenomas are then collected by the doctor using suction equipment and an ultrasound to guide them.
    • As this surgery is less invasive, no stitches are necessary.
  • Lumpectomy
    • An excision biopsy, often called a lumpectomy, takes roughly an hour to accomplish.
      • After the stitches are removed, your doctor will apply either dissolvable or regular stitches to close the wound.
      • This is frequently indicated if the fibroadenoma is quickly developing or more than 2 cm in size.
      • This procedure is done if the patient requests the removal of the lump. 
      • The removed fibroadenoma is sent for biopsy.
    • This is a significant surgical operation that is conducted under general anesthesia. Most patients, however, do not require an overnight hospital stay and may go home the same day as their procedure.
  • Cryoablation
    • With the use of a cryoprobe, the fibroadenoma is frozen. This destroys the fibroadenoma cells. Before cryoablation, a core needle biopsy must be conducted to confirm the presence of a fibroadenoma.
  • Radiofrequency ablation
    • This procedure employs high-frequency radiation to kill the fibroadenoma while focusing the energy beam to avoid damaging adjacent tissues.

QUESTION

A lump in the breast is almost always cancer. See Answer

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Medically Reviewed on 12/23/2021
References
Image Source: iStock Images

American Cancer Society. Fibroadenomas of the Breast. https://www.cancer.org/cancer/breast-cancer/non-cancerous-breast-conditions/fibroadenomas-of-the-breast.html

Breastcancer.org. Fibroadenoma. https://www.breastcancer.org/symptoms/benign/fibroadenoma

The University of Michigan Health System. Breast Self-Examination. https://www.uofmhealth.org/health-library/hw3791