A fibroadenoma is a common, solid, non-cancerous breast tumor that develops from the glandular and connective tissues of the breast. These lumps are highly prevalent, with up to 10% of women experiencing one at some point in their lives, most frequently between the ages of 15 and 35. Understanding its typical characteristics and when to seek medical advice for changes is important.
Are Fibroadenomas Typically Painful
Fibroadenomas are typically painless masses that feel firm, rubbery, and smooth, with distinct, round borders. A defining characteristic is their mobility, which has led to them being nicknamed a “breast mouse” because they seem to move away when pressed. If a woman is experiencing pain, it is often due to normal hormonal fluctuations in the breast tissue surrounding the lump, rather than the fibroadenoma itself.
Why Fibroadenomas Can Cause Discomfort
When discomfort does occur, it is frequently linked to hormonal sensitivity, as fibroadenomas contain receptors for the female reproductive hormone estrogen. This sensitivity can cause the lump or the surrounding breast tissue to swell and become tender just before the menstrual period begins. The discomfort is usually transient, mirroring the cyclical nature of hormonal changes.
In some cases, the sheer size of the fibroadenoma can lead to a feeling of localized tenderness or ache. While most fibroadenomas are small, averaging 1 to 3 centimeters, a giant fibroadenoma can grow larger than 5 centimeters, potentially compressing adjacent tissues and nerves. Furthermore, persistent prodding or manipulating the lump can irritate the tissue, leading to localized soreness independent of the lump’s internal structure.
How Doctors Diagnose Fibroadenomas
The process of diagnosing a fibroadenoma begins with a thorough physical examination, where the doctor assesses the lump’s characteristics, such as its mobility, firmness, and distinct borders. This is typically followed by imaging studies to visualize the internal structure of the mass and determine if it is solid or fluid-filled. An ultrasound is often the first imaging choice for women under 35, as it uses sound waves to clearly show if the mass is solid.
For women over 35, a diagnostic mammogram is commonly used, which may reveal a well-defined, round or oval mass with smooth edges. However, imaging alone cannot provide a definitive diagnosis, especially as some fibroadenomas can be difficult to distinguish from a rare tumor called a phyllodes tumor.
The most accurate diagnostic step is a core needle biopsy, where a small tissue sample is extracted from the lump using a hollow needle. The extracted tissue is then sent to a pathologist for microscopic examination to confirm the presence of benign fibrous and glandular tissue. This biopsy is crucial for ruling out any possibility of malignancy or atypical cellular changes.
Monitoring and Treatment Options
If a lump is confirmed to be a simple fibroadenoma, the most common management approach is “watchful waiting,” also known as surveillance. This involves regular follow-up appointments, often every six to twelve months, to monitor the lump’s size and characteristics using physical exams and ultrasound imaging.
Surgical removal, or excisional biopsy, is typically reserved for specific situations, such as rapid growth or a size greater than 2 to 3 centimeters. Atypical or complex features found during the biopsy, which carry a slightly increased risk, may also prompt a recommendation for removal. Furthermore, if the fibroadenoma is causing significant, persistent pain or if the patient experiences anxiety about the mass, removal may be performed.
Alternative, less invasive options like cryoablation, which freezes the tumor, are sometimes used for smaller lesions confirmed to be benign. For any associated discomfort, over-the-counter pain relievers or wearing a supportive bra can help manage generalized tenderness. The decision to remove the fibroadenoma involves weighing the benefits of removal against the potential for scarring and changes to the breast contour.