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Treatment of fibroadenoma without surgery | Is it possible?

Has your doctor informed you that the lump in your breast is a fibroadenoma? Do not be alarmed. These types of lumps are commonly-occurring breast lumps that are benign or non-cancerous.

It is important to remember that breast lumps cannot be identified as benign or cancerous without proper examination and maybe a biopsy. Always get any new breast lump checked by a doctor to rule out breast cancer. 

Overview of fibroadenoma

Fibroadenomas are considered to be one of the most common forms of benign breast tumours. They can occur in women of any age, however, are more commonly seen in premenopausal and younger women (20 years-30 years of age). In many cases, they shrink and disappear once the woman hits menopause.

Fibroadenoma gets its name from the words “fibroma” and “adenoma”. Basically, it is a tumour made up of fibrous and glandular tissue. These tumours may grow in size, shrink and even disappear over time, with changes in hormone levels. Their average size ranges from 1 to 2.5c ms in diameter. They can also grow larger (if they are bigger than 5cm in diameter, they are called giant fibroadenomas). 

Read: What to expect when you are diagnosed with Breast cancer

Symptoms of fibroadenoma

The normal breast tissue often feels lumpy in healthy women. So, you must seek medical help if you observe one or more of the following symptoms.

  • Detection of a new breast lump
  • Observation of other changes in the breasts
  • Increase in the size of a breast lump that is already under medical observation
  • The distinct appearance of an existing lump from the surrounding breast tissue

Also, the following pointers depict some of the unique characteristics of fibroadenomas. 

  • Solid breast lumps
  • Can be moved under the breast skin
  • Firm or rubbery texture
  • Do not cause any pain

Nevertheless, you cannot conclude that it is a fibroadenoma merely by sensing these characteristics of the lump. As such, it’s best to consult your doctor for the correct diagnosis. Your doctor would ask you to take a mammogram or an ultrasound, subject to your age and physical condition, whether pregnant or not. 

How do you detect fibroadenomas? 

A fibroadenoma lump will feel firm, smooth, rubbery or hard to touch. It will have a well defined shape and is usually painless. If you push them, they are easily movable under the skin. They can increase in size, especially during pregnancy and shrink and disappear after you hit menopause. 

The normal breast tissue often feels lumpy in healthy women. Breasts also differ in shape, size and texture amongst women. Performing routine breast self examinations will help you familiarise yourself with your breasts. This will in turn make it easy to detect any changes in the form of size or lumps, immediately. Fibroadenomas seldom cause pain. 

This video explains how to perform breast self-examination.

Always remember, you cannot differentiate between a benign (noncancerous) lump or a cancerous lump. Seek immediate medical help if you notice any new growth in your breast or your underarms or any changes in existing lumps. 

For women over the age of 40 years, annual breast cancer screening combined with mammograms are recommended to minimise the risk of detecting breast cancer at later stages. 

Causes of fibroadenoma

Although the true underlying cause of fibroadenomas is still unclear, research suggests that it might be linked to the changing levels of your reproductive hormones. This is probably why they occur mainly during your reproductive years, grow in size during pregnancy or if you undergo hormonal therapy. It is also likely why they shrink and disappear after you hit menopause. 

Types of fibroadenoma

If you’re considering fibroadenoma removal without surgery, you should know the types of fibroadenomas. 

1. Complex fibroadenoma

Complex fibroadenoma can change over time through hyperplasia, a condition that causes an overgrowth of cells. Your pathologist would make its diagnosis after reviewing your biopsy tissue. 

2. Juvenile fibroadenoma

Juvenile fibroadenoma commonly occurs in girls and adolescents. While some of these breast lumps may grow, most of them tend to shrink over time and disappear. 

3. Giant fibroadenoma

Unlike ordinary lumps that are about one to two centimetres in size, giant fibroadenomas can grow larger than two inches. Your doctor would prescribe fibroadenoma breast treatment to remove it since it can press on or replace other breast tissue. 

4. Phyllodes tumour

Phyllodes are benign in the beginning, but some tumours can become cancerous. Like giant fibroadenomas, your doctor would suggest the removal of phyllodes tumour.

What happens if fibroadenoma is left untreated?

In general, fibroadenomas do not cause any complications. However, complex fibroadenomas and phyllodes tumours can increase the risk of breast cancer slightly. If your doctor feels that your fibroadenoma is harmless, you might not require any particular treatment other than monitoring the lump for any changes in shape or size. If you do notice any change, you should get it re-examined by the doctor and seek the appropriate treatment.

How can you dissolve a fibroadenoma without surgery?

While fibroadenomas do not generally pose a risk if left untreated, many women still prefer to get them removed. This is not only for their peace of mind but also to preserve or restore the look and feel of the breast. 

Many women also choose to manage their fibroadenomas without surgery. This may be due to their apprehension of being operated on, or for any other personal preference. The choice of forgoing surgery must be based on your clinical breast exam, imaging test and biopsy. 

If you do decide for non surgical management of fibroadenoma, you must monitor the condition for any changes such as size or shape etc. 

Here are some protocols to follow if you decide on treating fibroadenoma without surgery

  • Monitor the fibroadenoma lump with regular follow-up visits to your doctor.
  • Take breast ultrasounds as per your doctor’s guidance to detect the changes in the size or appearance of the fibroadenoma lump.

Some other tips that can help you keep your breasts healthy include:

  • Avoid wearing tight-fitting bras. Opt for comfortable, cotton and supportive bras for daily use
  • Avoid overusing antiperspirants
  • Concentrate on your nutrition. Include collagen and vegetables in your diet daily. Eat more homemade meals and cut back on convenience foods
  • Get perioding screening tests and medical evaluation done to eliminate the risk of detecting breast cancer at later stages

If your fibroadenoma increases in size, has started paining or shows any other change, get it checked by a doctor immediately.

Fibroadenoma surgical removal procedures

In certain cases like the phyllode tumour, treatment of fibroadenoma without surgery is not possible. Alternatively, if the presence of the benign lump makes you anxious that you would want to forego fibroadenoma treatment without surgery, your doctor could arrange for excision.

Here are the surgical means to remove fibroadenomas.

1. Lumpectomy or excisional biopsy

In this surgical procedure, the surgeon would remove the breast tissue and send it to the lab to check for the risk of breast cancer.

2. Fibroadenoma cryoablation

Fibroadenoma cryoablation is a technique that is used to freeze the lump to destroy it. Here, the surgeon would insert a thin device called the cryoprobe through the breast skin to the fibroadenoma lump. From the device, a gas is released to destroy the tissue.

Over to you

Depending on the characteristics of the lump, your doctor would either propose treatment of fibroadenoma without surgery or strongly suggest removal of the lump. Discuss your family history, symptoms and medications or treatments you are on with your doctor. This information is significant in arriving at a speedy and accurate diagnosis. 

Even if you do not present with any breast problems, you should go for breast cancer screenings routinely (as advised by the doctor). This is because breast cancer can happen to anyone. Breast cancer also does not have any obvious symptoms in the early stages. Routine and regular breast cancer screening is your best bet to detect it in time. Remember early detection is the best protection against breast cancer. 

Also, read: Worried about an underarm lump? Find out what it means

Dr. Rohan Khandelwal
Author: Dr. Rohan Khandelwal
Dr. Rohan Khandelwal is a renowned surgeon who has completed his fellowship in breast oncology and advanced breast surgery from esteemed institutes like The Aiello Breast Center, University of Maryland. He has garnered over 17 years of clinical experience from some of the most reputed healthcare facilities across the country. He specializes in benign and cancerous breast disorders in both genders. He is also the editor in chief for the New Indian Journal of Surgery and Journal of Young Medical Researcher.
 
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