2. DEFINITION
Benign breast
tumor
Painless Unilateral
Solid, Not fluid-
filled, Lump
"Breast
Mouse" (high
mobility)
“A marble-like”
mass
Comprising
both epithelial
and stromal
tissues
Located under
the skin of the
breast
Variable in size
Access on 9 February 2022 on https://www.ncbi.nlm.nih.gov/books/NBK535345/
5. ANATOMY
Cont.
Schwartz, S. and Brunicardi, F., 2019. Schwartz's principles of surgery. 11th ed. New York: McGraw-Hill Medical, pp.544-546.
6. ETIOLOGY
Debatable
Hormonal etiology -->
increased sensitivity of
breast tissue to
estrogen --> Grows
during pregnancy and
tends to shrink during
menopause.
Take oral
contraceptives before
20 years of age -->
suffer from
fibroadenoma at higher
rates
Access on 9 February 2022 on https://www.ncbi.nlm.nih.gov/books/NBK535345/
7. EPIDEMIOLOGY
Early age (commonly age 14 to 35 years)
>>> Adolescents
<<< postmenopausal women (shrink after menopause)
10% of the world's female population suffers from fibroadenoma once
in a lifetime.
Access on 9 February 2022 on https://www.ncbi.nlm.nih.gov/books/NBK535345/
8. PATHOPHYSIOLOGY
• Arises from stromal and epithelial connective tissue
cells.
• Contain receptors for both estrogen and
progesterone --> proliferate during pregnancy
because of excessive production of female
reproductive hormones.
Hormona
l
• Mediator complex subunit 12 (MED12) gene
Genetics
Access on 9 February 2022 on https://www.ncbi.nlm.nih.gov/books/NBK535345/
12. History and Physical
Age --> the most important factor.
A family history of breast cancer. Female
patients who have first-degree relatives
with breast cancer --> should be monitored
and observed more carefully for malignant
features
>>> occurs in the upper outer quadrant of
the breast.
History
Access on 9 February 2022 on https://www.ncbi.nlm.nih.gov/books/NBK535345/
16. EVALUATION
Diagnostic Mammogram
• A mammogram uses x-rays --> suspicious masses in women > 35 years.
• Appears as a distinct area from other breast tissue, with smooth round edges.
• Mammographic features : variable from a well-circumscribed discrete oval mass hypodense or isodenseof
breast glandular tissue to a mass with macro lobulation or partially obscured margins.
• Involuting FAM in older (postmenopausal) 🡪 contain calcification, often producing the classic, coarse popcorn
calcification appearance.
Breast Ultrasound
• Ultrasound (US) 🡪 uses sound waves 🡪 to detect in women < 35 years.
• US easily differentiates solid from the cystic masses.
• US features : well-circumscribed, round to ovoid, or macrolobulated mass with generallyuniform
hypoechogenicity.
Minimally invasive biopsy
• If necessary
Woodard S, Schetter S, Millington K. Diagnosis and imaging characteristics of a juvenile fibroadenoma in a 2-year-old patient: a case report. Radiol Case
Rep. 2018 Feb;13(1):6-10.
Namazi A, Adibi A, Haghighi M, Hashemi M. An Evaluation of Ultrasound Features of Breast Fibroadenoma. Adv Biomed Res. 2017;6:153.
Neville G, Neill CO, Murphy R, Corrigan M, Redmond PH, Feeley L, Bennett MW, O'Connell F, Browne TJ. Is excision biopsy of fibroadenomas based solely on
size criteria warranted? Breast J. 2018 Nov;24(6):981-985.
19. MANAGEMENT
Majority of cases --> no treatment (shrink and
disappear over time)
Surgery 🡪 If their size is large and
compressing other breast tissues, continues
to increase in size
Access on 9 February 2022 on https://www.ncbi.nlm.nih.gov/books/NBK535345/
20. Lumpectomy or excisional biopsy
• Removes the FAM and sends it to the laboratory (for further
evaluation).
Cryoablation
• Use a cryoprobe 🡪 to freeze and destroy the cellular structure
of fibroadenoma.
• A core needle biopsy must be performed before cryoablation
🡪 to confirm the FAM.
MANAGEMENT
Cont.
Access on 9 February 2022 on https://www.ncbi.nlm.nih.gov/books/NBK535345/
24. PROGNOSIS
Good 🡪 benign mass
(shrinks in size over
time >>> cases)
Access on 9 February 2022 on https://www.ncbi.nlm.nih.gov/books/NBK535345/
25. COMPLICATIONS
Breast cancer risk may
slightly increase in patients
with a complex
fibroadenoma.
This type of lesion may
contain calcified breast
tissue.
Access on 9 February 2022 on https://www.ncbi.nlm.nih.gov/books/NBK535345/
26. REFERENCES
■ Access on 9 February 2022 on
https://www.ncbi.nlm.nih.gov/books/NBK535345/
■ Atlas of Breast Surgery
■ Woodard S, Schetter S, Millington K. Diagnosis and imaging characteristics
of a juvenile fibroadenoma in a 2-year-old patient: a case report. Radiol Case
Rep. 2018 Feb;13(1):6-10.
■ Namazi A, Adibi A, Haghighi M, Hashemi M. An Evaluation of Ultrasound
Features of Breast Fibroadenoma. Adv Biomed Res. 2017;6:153.
■ Neville G, Neill CO, Murphy R, Corrigan M, Redmond PH, Feeley L, Bennett
MW, O'Connell F, Browne TJ. Is excision biopsy of fibroadenomas based
solely on size criteria warranted? Breast J. 2018 Nov;24(6):981-985.
