Breast Fibroadenoma

BreastFibroadenoma

Detailed Overview

What isFibroadenoma?

Fibroadenomais a benign (non-cancerous) solid breast tumor composed of both glandularbreast tissue and fibrous(connective) tissue. It is the most common breast lump in young women.

Epidemiology

·        Most common in womenbetween 15–35 years of age.

·        Less common after menopause (unless the woman is on hormonereplacement therapy).

·        Can occur in one or both breasts.

·        Around 10% of womenwill develop fibroadenoma at some point.

Causes &Risk Factors

The exactcause is not fully understood, but factors include:

·        Hormonal influence: Estrogen plays a major role. Lumps oftenappear during reproductive years.

·        May enlarge during pregnancyor with oral contraceptives.

·        Usually shrink after menopause(due to reduced hormones).

·        Genetic factors may play a role (sometimes runs in families).

Characteristics:

·       Feels like a firm, smooth, rubbery, and mobile lump ("breastmouse" because it moves easily under the skin). Size: commonly 1–3 cm, butcan grow larger (giant fibroadenoma >5 cm).

·        Multiple fibroadenomas can occur in the same breast or bothbreasts.

·        Usually painless.

·        Size may stay the same, shrink, or grow slowly. Sometimes canenlarge during pregnancy or with hormonal changes.

Types of Fibroadenomas

1.    SimpleFibroadenoma

o   Mostcommon.

o   Homogeneousstructure.

o   Verylow risk of becoming cancerous.

2.    ComplexFibroadenoma

o   Containsother changes (cysts, sclerosing adenosis, calcifications, epithelialhyperplasia).

o   Slightlyhigher risk of breast cancer than simple type.

3.    GiantFibroadenoma

o   Largerthan 5 cm.

o   Rapidgrowth, common in adolescents.

4.    JuvenileFibroadenoma

o   Occursin teenagers.

o   Maygrow rapidly but usually benign.

🔹 Diagnosis:

·        Clinical breast exam.

·        Ultrasound (common in younger women).

·        Mammogram (in older women).

·        Biopsy (if there is any doubt).

·        FNAC (Fine-Needle Aspiration Cytology) or Core Needle Biopsy: To confirm diagnosis and ruleout cancer if there’s doubt.

Management & Treatment

Not allfibroadenomas need treatment. Management depends on:

·        Size of the lump.

·        Growth pattern.

·        Symptoms.

·        Patient’s age and concern.

1.Observation (Most cases):

·        Small, stable, painless fibroadenomas can simply be monitored.

·        Regular follow-up with clinical exams and ultrasound every 6–12months.

2. SurgicalRemoval:

·        Indicated if:

o   The lump is large(>3–4 cm).

o   It is growing in size.

o   Causes pain ordiscomfort.

o   There is uncertainty indiagnosis.

o   Patient prefers removal forpeace of mind.

·        Procedure: Excisionalbiopsy / Lumpectomy.

3. Minimally Invasive Treatments (in some centers):

·        Cryoablation: Freezing the fibroadenoma with a probe.

·        Radiofrequency ablation.

👉 In short: Fibroadenoma is a common, harmlessbreast lump in young women, caused by hormonal influence, and usually only requiresmonitoring unless it grows or causes problems.

Embolization & Breast Fibroadenoma

Embolization is mainly used for vasculartumors or lesions (e.g., arteriovenousmalformations, uterine fibroids, hemangiomas, aneurysms).

Current Non-Surgical Alternatives Instead of Embolization

Vacuum-Assisted BreastBiopsy (VABB)

What is VABB?

·        Minimally invasive procedure used to removebreast tissue samples (or sometimes the entire lump) using ahollow probe connected to a vacuum device.

·        Performed under imagingguidance – ultrasound, mammography (stereotactic), or MRI.

·        Compared to standard core needle biopsy, it allows larger tissue samples to be taken with fewer needle insertions.

How the Procedure Works

1.    Patient lies in position depending on imaging technique.

2.    Local anesthesia is given.

3.    A small incision (~3–5 mm)is made in the skin.

4.    A special vacuum-assistedprobe (7–11 gauge) is inserted under ultrasound or mammographyguidance.

5.    Vacuum sucks breast tissue into the probe → a rotating cutting deviceremoves samples.

6.    Multiple samples or entire lump can be removed through the sameentry point.

7.    A tiny clip/markermay be placed to mark the biopsy site (for future imaging follow-up).

8.    Pressure dressing is applied (usually no stitches needed).

Advantages

✅ Larger tissue sample = more accurate diagnosis.
✅ Can completely remove small benign lumps (e.g., fibroadenoma)without surgery.
✅ Minimally invasive (tiny scar, local anesthesia, outpatient).
✅ Quick recovery – patient can go home same day.
✅ Less pain and cosmetic deformity compared to open surgery.

Limitations

·        Lesions >3–4 cmusually not completely removable.

·        Not suitable for lesions close to skin, chest wall, or nipple insome cases.

·        Rare complications: bleeding, hematoma, infection.

·        If malignancy is found, definitivesurgery may still be required.

Role in Fibroadenoma

·        Excellent alternative to surgical excision for fibroadenomas (especially inyoung women who want to avoid scars).

·        Provides both diagnosis +removal in the same sitting.

·        Recurrence is rare if completely excised.

✅ Summary:

Vacuum-Assisted Breast Biopsy (VABB) is a safe, minimally invasive techniquethat allows both accurate diagnosis and, in many cases, complete removal ofbenign breast lumps (like fibroadenoma) without open surgery. It offerscosmetic benefits, quick recovery, and is increasingly used in

modernbreast centers. At BankersVascular Hospital, we provide advanced diagnosis and treatment ofbreast fibroadenoma using VABB, ensuring safe and effective care.