Fibroadenoma

Ricarda Schwarz studied medicine in Würzburg, where she also completed her doctorate. After a wide range of tasks in practical medical training (PJ) in Flensburg, Hamburg and New Zealand, she is now working in neuroradiology and radiology at the Tübingen University Hospital.

More about the experts All content is checked by medical journalists.

Fibroadenoma is the most common benign lump in the female breast. It is made up of connective and mammary gland tissue that feels like rubber. Most often it occurs in women between the ages of 20 and 24, but it also occurs during menopause. If it deforms the breast and bothers the affected person, the fibroadenoma can be removed. Here you can read everything you need to know about the causes, symptoms and treatment options for fibroadenoma.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. D24

Fibroadenoma: description

Fibroadenomas are the most common benign lumps in the breast (breast) in women between the ages of 20 and 40. However, they can also occur in older women who are going through menopause and who are taking hormone therapy. If women take the pill, however, they occur less often.

A fibroadenoma develops from the mammary gland and connective tissue and feels as rough as rubber. Those affected usually do not feel fibroadenoma pain. You often discover the lump by accident when it is two to three centimeters tall. Usually it is a single lump, but more rarely, multiple fibroadenomas can develop. Both breasts are affected in five to ten percent of cases.

The fibroadenoma rarely grows larger than three centimeters. It can even resolve on its own with age. For young women, however, there is a special shape that grows very quickly and can change the shape of the breast. Since it is a benign lump, from a medical point of view it is not absolutely necessary to remove the fibroadenoma. In some cases, and at the patient's request, the knot can be removed. Very rarely (0.1 to 0.3 percent of those affected) can develop breast cancer from the fibroadenoma. Therefore, affected women should have their breasts checked regularly by the gynecologist.

Fibroadenoma: symptoms

The fibroadenoma is usually asymptomatic. Women therefore discover a rough lump in their breasts by chance. Sometimes there are several knots close together. If the gynecologist palpates the breast (mamma) during the annual check-up, almost no woman feels pain from the fibroadenoma. Sometimes, however, the fibroadenoma breast feels tight, especially before your period. Some women find this uncomfortable or slightly painful.

In rare cases, and mostly in younger women, there is a rapidly growing type of this knot. Then the fibroadenoma can change the shape and size of the breast. The chest may bulge slightly and appear enlarged.

Fibroadenoma: causes and risk factors

Fibroadenoma cells are stimulated to multiply by female sex hormones (estrogens). If the concentration of these hormones increases, for example during hormone treatment or during pregnancy, many new glandular and connective tissue cells are created. They can form a tough lump called a fibroadenoma. If women take the pill for a long time, it reduces the risk of it developing. If a fibroadenoma has already been removed in the past, residual cells may remain in the breast during the operation and grow again into a lump.

Fibroadenoma: examinations and diagnosis

Most women notice a fibroadenoma on their own when they palpate their breasts. In order to be able to make the diagnosis, the doctor first asks about symptoms and the history (anamnesis). The doctor must rule out that it is a malignant change (breast cancer). He checks whether the shape of the breast has changed and feels the breast and armpits. If he discovers a noticeable lump or another unclear change, the following examinations can follow:

Sonography

With a special ultrasound device, a fibroadenoma can usually be clearly identified and differentiated from other nodes. The doctor applies gel to the chest and armpit and systematically scans the chest with the ultrasound head. This examination is not painful. At most the cold ultrasound gel can be perceived as uncomfortable.

Mammography

This is a special X-ray examination that is also carried out for regular early breast cancer detection from the age of 50.For the X-ray, the breast is pressed between two plates. Most women find this painful. However, it is not harmful and necessary to spread healthy mammary gland tissue and differentiate a malignant lump from a fibroadenoma. Most of the time, this examination provides a more detailed diagnosis. Mammography is rather unsuitable for young women. Your breast tissue is still so dense that it is difficult to identify changes.

Magnetic resonance imaging (MRI)

In certain cases, magnetic resonance imaging is necessary to diagnose or rule out fibroadenoma. These include women who have had breast surgery, have silicone implants or have had breast cancer in the past. Changes in dense glandular tissue can also be clearly seen in the MRI. For the examination, the patient is sometimes given a contrast medium injected into a vein. During the exposure in the examination tube, they must lie as free of movement as possible. Magnetic resonance tomography does not produce any harmful radiation.

Punch biopsy

Despite the above-mentioned examination options, it is sometimes not possible to obtain a clear result. In this case, a punch biopsy can help make the diagnosis. This examination will also be carried out if one of the other examinations led to a conspicuous result and should now be further clarified. Using a kind of pistol (similar to earring shooting), the doctor removes a cylindrical piece of tissue from the knot. The chest is usually anesthetized locally beforehand so that there is as little pain as possible. The tissue sample is then examined by a tissue specialist (pathologist) under a microscope. He can clearly determine whether it is a fibroadenoma or another lump.

Lump removal (excision)

For larger fibroadenomas, rapid growth, and women older than 40, the doctor will usually surgically remove the entire lump and have it examined in the laboratory.

Fibroadenoma: treatment

If the diagnosis of fibroadenoma could be made with one of the examinations described, no further treatment is absolutely necessary from a medical point of view. The fibroadenoma breast should only be examined regularly by the gynecologist. In this way, he can quickly recognize if the tissue has changed maliciously and yet needs to be treated differently.

However, if the lump grows very quickly and changes the shape of the breast, many women choose to have the fibroadenoma removed. If someone in the family has breast cancer, this small operation is also recommended. Depending on where the fibroadenoma is located and how big it is, the operation can change the shape of the breast. Also, despite the surgery, some fibroadenoma cells sometimes remain in the breast. These cells can then form a node again. Even after an operation, the breast should be thoroughly palpated once a month shortly after menstruation, if possible. The gynecologist explains to his patients how they can best do this themselves.

Doctors often recommend having a fibroadenoma removed before pregnancy. The hormonal balance changes during pregnancy. The hormones send a signal to the fibroadenoma cells to multiply. If the fibroadenoma grows faster as a result, it can lead to discomfort. After a fibroadenoma is removed, most mothers can breastfeed without problems. However, milk congestion can occur a little more often.

Fibroadenoma: disease course and prognosis

A fibroadenoma is a benign tumor. If it is not removed, it can remain in the same size. During the menopause, the proportion of female sex hormones in the body decreases, so that a fibroadenoma can even regress on its own. If, on the other hand, the hormone level increases, for example during pregnancy or under hormone therapy, the fibroadenoma can also become larger. Incompletely removed nodes can grow back (relapse).

Breast fibroadenomas do not increase the risk of developing breast cancer. However, if a woman has several of these lumps, malignant tumors are somewhat more likely to be found in their vicinity. Only every 1,000 to 3,000 fibroadenoma turns into a malignant tumor. While this is a very small risk, a woman with fibroadenoma should regularly palpate her breast.

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