Which are the symptoms?
The typical presentation of a fibroadenoma is in a woman of reproductive age with a mobile palpable breast lump. Being hormonal sensitive, fibroadenomas could enlarge in time.
- breast lump
- breast pain
- breast asymmetry
How is it diagnosed?
The fibroadenoma is usually diagnosed after self-examination by the same patient or during a clinical examination by the doctor. On ultrasound it appears like a well-circumscribed, round to ovoid, or macrolobulated mass with generally uniform hypoechogenicity. Intralesional sonographically detectable calcification may be seen in ~10% of cases. On mammography a fibroadenoma looks like a discrete oval mass hypo- or isodense to the breast glandular tissue or a mass with macrolobulation or partially obscured margin. Involuting fibroadenomas in older patient may contain calcification, often producing the classic "popcorn calcifications". On MRI fibroadenomas are seen as hypointense or isointense compared with adjacent breast tissue in T1, hypo- or hyperintense in T2 and after contrast agent injection the curve describes a slow initial contrast enhancement followed by a persistent delayed phase (type I enhancement curve). A core biopsy is indicated in selected cases (doubtful/suspicious imaging, enlarging lumps, complex lesions etc..) to confirm the diagnosis of fibroadenoma.
How is it treated?
Fibroadenomas are benign lesion with minimal or no malignant potential. In most cases they do not need any treatment and a regular imaging follow-up is recommended. In some special situations like enlarging lesions, suspicious features, cosmetic issues or patient peace of mind, the surgical removal of the lump is indicated. This operation is called lumpectomy and can be performed as a day surgery procedure.