Fibroadenoma - Symptoms, causes and treatment

Fibroadenoma or fibroadenoma mammae (FAM) is a type of benign tumor that forms in the breast. Fibroadenoma is characterized by a small lump in one or both breasts, which feels solid and easy to move

Fibroadenoma is one of the most common types of benign breast tumors experienced by women aged 15-35 years. This tumor is small in size with a dense texture and is easy to move.

Fibroadenoma can go away on its own, but in some cases it can enlarge and must be removed through surgery.

Types of Fibroadenoma

Fibroadenoma is divided into several types, namely:

• Simple fibroadenomaSimple fibroadenoma is the most common type of fibroadenoma, but it is not at risk of turning malignant. Fibroadenoma is often experienced by young women.

• Complex fibroadenomaComplex fibroadenoma contains cells that can grow quickly. This type of fibroadenoma usually occurs in elderly women.

• Juvenile fibroadenomaJuvenile fibroadenoma usually affects women aged 10–18 years. This type of fibroadenoma can enlarge, but usually shrinks over time.

• Giant fibroadenomaThis type of fibroadenoma can enlarge up to 5 cm in size so it must be removed so as not to press on the surrounding breast tissue.

• Phyllodes tumorPhyllodes tumors are usually benign, but can also turn malignant. The doctor will suggest this tumor to be removed.

Fibroadenoma Causes and Risk Factors

The exact cause of fibroadenoma is not yet known. However, this condition is thought to be related to the activity of the hormone estrogen. This allegation arises because fibroadenoma often appears when women are of reproductive age.

In addition, fibroadenoma often occurs in women with the following factors:

• 15–35 years old
• Has a family history of breast cancer
• Take birth control pills before the age of 20
• Pregnant
• Undergoing hormone replacement therapy

Fibroadenoma Symptoms

Fibroadenoma is sometimes not realized by the sufferer. In some cases, patients only realize that there is a fibroadenoma in their breasts when they do a breast self-examination (BSE), or when they undergo a mammogram or ultrasound.

Fibroadenoma is characterized by a lump in one or both breasts. Usually, fibroadenoma lumps are 1–5 cm in diameter, but some are up to 15 cm. The lump has the following characteristics:

• No pain
• Feels chewy and dense
• Round in shape with a bumpy edge that is easy to feel (the border feels firm)
• Easy to move

Although generally painless, fibroadenoma lumps can be painful if the sufferer enters the menstrual period. Lumps can also enlarge when the patient is pregnant or breastfeeding and shrink after entering menopause.

When to see a doctor

Fibroadenoma is the most common breast lump in women. These lumps are not malignant so you don't have to worry too much. However, it is advisable to consult a doctor if you experience a lump accompanied by the following symptoms or signs:

• The lump feels different from the surrounding tissue
• The lump is growing fast
• The size, shape and appearance of the breasts have changed
• Pain in the breast does not go away even after the menstrual period has passed
• Breasts are red, wrinkled, or itchy
• Abnormal discharge from the nipple
• Nipples inward

Fibroadenoma Diagnosis

The doctor will ask questions related to the patient's symptoms, followed by a physical examination of the lump in the patient's breast. After that, the doctor will carry out supporting examinations, such as:

• Mammography, to see fibroadenoma lumps using X-rays
• breast ultrasound, to see the structure of the breast tissue and detect whether the lump in the breast is solid or filled with fluid
• Biopsies or tissue sampling of lumps in the breast with the help of ultrasound, to assess changes in cells or tissue in the breast

Fibroadenoma Treatment

Fibroadenomas generally don't need to be treated. However, patients still have to check with the doctor regularly so that changes in lumps can be detected early.

In some cases, there are certain conditions that the doctor can consider to remove a fibroadenoma, including:

• The lump develops into cancer
• Patient has a family history of cancer
• The lump enlarges to change the shape of the breast, and is painful
• Patient concerns
• The biopsy examination of the patient's lump is not normal

Fibroadenoma removal procedure can be done by:

• Lumpectomy

  Lumpectomy is performed to remove fibroadenoma lumps. In addition to treating fibroadenoma, tissue samples from this procedure can also be further examined to determine the type of cells and tissues that are growing in the lump.

• Cryotherapy

  Cryotherapy aims to freeze and destroy fibroadenoma tissue. This procedure is performed using argon gas or liquid nitrogen.

Please note, fibroadenoma can still reappear even after it has been removed. If this occurs, further examination and a biopsy will need to be performed to determine whether the new lump is a fibroadenoma or cancer.

Fibroadenoma Complications

In the majority of cases, fibroadenoma does not cause complications and does not increase the patient's risk of developing breast cancer. However, the risk of breast cancer will increase if the type of fibroadenoma suffered is a complex fibroadenoma or phyllodes tumor.

Fibroadenoma Prevention

As mentioned above, it is not yet known what causes fibroadenoma. Therefore, how to prevent it is also unknown. However, you can detect changes in your breasts by doing a breast self-examination (BSE).

BSE should be done between the 7th and 10th days after menstruation. The method is as follows:

1. Stand straight in front of a mirror and observe for changes in the shape or surface of the breast skin, as well as swelling or changes in the nipples.
2. Raise your arms up by bending your elbows and placing your hands behind your head, then push your elbows back and forth while observing the shape and size of your breasts.
3. Put your hands on your waist and lean your shoulders forward while pushing your elbows forward, then tighten your chest muscles and look at your breasts.
4. Raise your right arm up and bend your elbow until your left hand touches the top of your back, then touch and press the entire right breast to the armpit area using the fingertips of your left hand. Do tactile circularly, vertically and horizontally.
5. Pinch both nipples gently and see if any fluid comes out.
6. Put a pillow under your right shoulder in a lying position. Do palpation on the right breast as in step number 4 while continuing to observe the breast. Repeat the same steps on the left breast.

If you notice a lump, see a doctor, and take the following steps to prevent the condition from getting worse:

• Restricting consumption of alcoholic beverages
• Consuming food with complete and balanced nutrition
• Exercise regularly
• Maintaining ideal body weight