Fibroadenoma

Encyclopedia of Medicine, Apr 06, 2001 by Mercedes McLaughlin

Fibroadenomas are benign breast tumors commonly found in young women. Fibroadenoma means "a tumor composed of glandular (related to gland) and fibrous (containing fibers) tissues."

Breast fibroadenomas, abnormal growths of glandular and fibrous tissues, are most common between the ages of 15 and 30, and are found in 10% of all women (20% of black women). They are found rarely in postmenopausal women.

Described as feeling like marbles, these firm, round, movable, and "rubbery" lumps range from 1 cm-5 cm in size. Giant fibroadenomas are larger, lemon-sized lumps. Usually single, from 10-15% of women have more than one.

While some types of breast lumps come and go during the menstrual cycle, fibroadenomas typically do not disappear after a woman's period, and should be checked by a doctor.

The cause of breast fibroadenomas is unknown. They may be dependent upon estrogen, because they are common in premenopausal women, can be found in postmenopausal women taking estrogen, and because they grow larger in pregnant women.

Fibroadenomas usually cause no symptoms and may be discovered during breast self-examination, or during a routine check-up.

When the doctor takes a complete medical history, they will ask when the lump was first noticed, if there were any symptoms or changes in lump size, and if there is any personal or family history of breast disease.

The doctor thoroughly feels the breasts (palpates). Tests are done, usually including mammography or ultrasound scans, or surgical removal of cells or tissue for examination under a the microscope (biopsy).

Diagnostic tests include:

• Mammogram. An x-ray examination of the breast.
• Ultrasound scan. A technique that uses sound waves to display a two-dimensional image of the breast, showing whether a lump is solid or fluid-filled (cystic).
• Fine-needle aspiration biopsy. A minor procedure wherein fluid or cells are drawn out of the lump through a small needle (aspirated).
• Core biopsy. A procedure wherein a larger piece of tissue is withdrawn from the lump through a larger needle.
• Incisional biopsy. A surgical procedure wherein a piece of the lump is removed through an cut (incision).
• Excisional biopsy. A surgical procedure wherein the entire lump is removed through an cut (incision).

Most insurance plans cover the costs of diagnosing and treating fibroadenomas.

Performed usually in outpatient settings, breast fibroadenomas are removed by lumpectomy, or surgical excision under local or general anesthesia. Sometimes lumps in younger women are not removed but are monitored by self-examination, yearly doctor check-ups, and mammograms. Surgery is generally recommended for women over 30, and for lumps that are painful or enlarging.

Alternative treatments for breast fibroadenomas include a low-fat, high-fiber, vegetarian-type diet; a reduction in caffeine intake; supplementation with evening primrose oil (Oenothera biennis), flax oil, or fish oil and vitamins E and C; and the application of hot compresses to the breast. In addition, a focus on liver cleansing is important to assist the body in conjugation and elimination of excess estrogens. Botanical remedies can be useful in hormone balancing, as can acupuncture and homeopathy. Massaging the breasts with castor oil, straight or infused with herbs or essential oils, can help fibroadenomas reduce and dissipate, as well as keep women in touch with changes in their breast tissue.

Breast fibroadenomas are not cancerous. The lumps recur in up to 20% of women. A small number of lumps disappear on their own.

Breast fibroadenomas cannot be prevented. They can be discovered early by regular breast self-examination.

• Books
• Giuliano, Armando E. "Breast: Fibroadenoma of the Breast." In Current Medical Diagnosis and Treatment, edited by Lawrence M. Tierney, Jr., et al. Stamford, CT: Appleton & Lange, 1996.
• Hacker, Neville F. "Breast Disease: A Gynecologic Perspective." In Essentials of Obstetrics and Gynecology, edited by Neville F. Hacker, et al. Philadelphia, PA: W.B. Saunders Company, 1992.
• Loecher, Barbara, Sara Altshull O'Donnell, and the Editors of Prevention Magazine. "Breast Problems. Soothing Tactics for Pain, Tenderness, and Worry." In New Choices in Natural Healing for Women. Drug-Free Remedies From the World of Alternative Medicine. Emmaus, PA: Rodale Press, 1997.
• Love, Susan M., and Karen Lindsay. "Lumps and Lumpiness." In Dr. Susan Love's Breast Book. Reading, MA: Addison-Wesley Publishing Company, 1995.
• Rosenthal, M. Sara. "Is It Cancer?" In The Breast Sourcebook: Everything You Need to Know About Breast Cancer Detection, Treatment, and Prevention. Los Angeles: Lowell House, 1996. Periodicals
• Deckers, Peter J., and Andrew Ricci, Jr. "Pain and Lumps in the Female Breast." Hospital Practice 28 (February 1992): 67-73, 77-78, 87-94.
• Delaney, Lisa. "Breast Protection At Your Fingertips." Prevention Magazine (July 1994): 81-83, 86-87, 137.
• Donegan, William L. "Evaluation of a Palpable Breast Mass." The New England Journal of Medicine 24 (September 1992): 937-942.
• Dupont, William, D., David L. Page, and Fritz F. Parl. "Long-Term Risk of Breast Cancer in Women with Fibroadenoma." The New England Journal of Medicine 7 (July 1994): 10-15.
• Glaser, Vicki. "Benign Breast Disorders." Patient Care 14 (April 1997): 140-151. Organizations
• American College of Obstetricians and Gynecologists. 409 12th Street, SW, Washington, DC 20024. (202) 638-5577. http://www.acog.org.