The vast majority of the lumps women find in their bosoms are not malignant tumors. They are much more likely to be relatively harmless cysts, or a fibroadenoma. Here we answer some of the most frequently asked questions on fibroadenoma symptoms, causes and treatments.
What is a fibroadenoma?
A fibroadenoma is a benign breast tumor that’s typically found in younger women. According to the American Society of Breast Surgeons Foundation (ASBSF), roughly ten percent of American women will receive a diagnosis of fibroadenoma before they reach age 30, with African-American women being especially susceptible to the tumors. Some estimates indicate that a full 20 percent of Afro-American women will develop fibroadenomas at some point in their lives.
Essentially, a fibroadenoma is really nothing more than an overgrowth of fibrous and glandular breast tissue – which of course doesn’t mean it can’t be scary should you find one. A fibroadenoma tumor consists of breast tissue and stromal tissue and can occur simultaneously in one or both breasts.
What does a fibroadenoma feel like?
In general, these tumors are not a source of significant discomfort, but unlike cancerous tumors, fibroadenomas tend to be in synch with one’s menstrual cycle, with some women reporting they can be tender or even painful while they are menstruating.
They’re usually quite small, sometimes so small they can be hard to detect through touch alone. They’re actually most easily distinguished by their mobility. However, when you can feel them they are quite distinct from other breast tissue, being somewhat rubbery with a detectable round, circular shape and clearly defined edges. When you press on one, it moves around as though it’s trying to slip out from under your fingers.
The vast majority of fibroadenomas (90%+) are under one inch in size. They usually remain small, and with time might even disappear altogether. However, should a biopsy reveal highly active cell growth, also know as atypical hyperplasia, your physician might recommend that you have it surgically removed, as this condition actually does increase the risk of your developing breast cancer in the future.
What causes a fibroadenoma to develop?
While it’s yet to have been proven categorically, the general consensus within the medical community is that hormones, in particular estrogen, likely plays a leading role in the growth and development of these tumors. Nevertheless, the exact reasons why some women will develop a fibroadenoma tumor and what causes them to evolve has yet to be determined.
Anecdotal evidence indicates that certain dietary stimulants, such as tea, coffee, soft drinks, and chocolate, may also play a partial role in their development, but no scientific studies have as yet been conducted to confirm this hypothesis.
What is known is that women who used oral contraception in their teenage years are at higher risk of developing fibroadenoma tumors. The growths can change size, and often even shrink with menopausal women. Occasionally, they quietly resolve on their own, disappearing without treatment. At the same time, they might also grow significantly larger, particularly if you get pregnant.
Are fibroadenoma tumors usually cancerous?
No. In fact, they never are.
Can a fibroadenoma turn into cancer?
Not exactly, but certain kinds of fibroadenoma tumors indicate you have a slightly higher risk of developing cancer in the future.
What are the different kinds of fibroadenoma tumors?
There are two kinds of fibroadenoma tumors: simple fibroadenomas and complex fibroadenomas. Complex fibroadenomas are, as their name suggests, more complicated and need to be taken a little more seriously, as they can slightly increase your risk of developing breast cancer.
According to the American Cancer Society, women with the complex variety of fibroadenoma in their breasts are approximately one and a half times more likely to develop breast cancer than women with simple fibroadenomas. In addition to the slightly increased cancer risk, complex fibroadenomas contain calcium deposits and relatively large fluid-filled sacs called macrocysts. Large, in this context, means that they can be seen without a microscope.
How are fibroadenomas diagnosed?
The chances are that you probably discovered a lump in one or both of your breasts before it was ever brought to the attention of your physician. And it’s just as likely that you were probably pretty scared when you first discovered it. Discovering a lump in your breast isn’t something you want to be lackadaisical about, after all, it could just as easily be a symptom of breast cancer as a benign cyst or a simple, non-threatening fibroadenoma tumor.
Upon informing your doctor about the lump (or lumps) you’ve discovered in your breasts, he or she will first conduct their own in-office examination before sending you for a breast ultrasound or mammogram. A breast ultrasound involves having a handheld transducer moved over your breast to create an image on a monitor, while a mammogram involves having an X-ray taken of your breast while it is squeezed between two flat surfaces.
Later, a small piece of the tumor will be extracted and a biopsy performed to determine the type of fibroadenoma you have, and to ensure it’s not something potentially serious that could lead to breast cancer.
How are fibroadenomas removed?
There are three primary methods doctors use to excise fibroadenoma tumors: one is an operation called an excision biopsy, and the other two are non-surgical procedures known as a vacuum assisted excision biopsy and cryoablation.
This is the procedure doctors follow to remove fibroadenomas that are particularly large or of the complex fibroadenoma variety, those which slightly increase your vulnerability to breast cancer. It’s conducted using a local or general anesthetic with the incision ideally closed with dissolvable stitches, hence removing the need to return a few days later to have your non-dissolvable stitches removed.
Vacuum assisted excision biopsy
The beauty of this approach is that it’s essentially a non-surgical option to excise smaller fibroadenomas.
After a local anesthetic is injected, your doctor makes a small cut in your skin from which a hollow probe connected to a vacuum device is inserted. From there the fibroadenoma is simply sucked out by the vacuum until every last bit of the offending tissue is removed. The only real drawback to this approach is that it usually leaves some bruising and can be a source of discomfort for a few days afterward.
Take note that if you opt to have your fibroadenoma removed, while neither procedure will likely affect the shape of your breast, you could possibly be left with a slight dent from where it was removed.
This is another, relatively new, non-invasive option to remove fibroadenomas. The basic ideas is to use extreme cold to destroy the tumor, negating the need for surgery. With cryoablation, a thin metal probe is passed through the center of the tumor, guided with the assistance of ultrasound. The tip of the probe is then reduced to an exceptionally cold temperature (-256 degrees Fahrenheit), which promptly freezes and kills the fibroadenoma. It’s relatively painless, no harm is done to the surrounding tissues, and next to no scarring results from the procedure.
Cryoablation has been approved by the FDA and tends to be a less expensive option should your insurance not cover fibroadenoma removal.
Do all fibroadenomas need to be treated or excised?
Absolutely not. Upon receiving a diagnosis confirming you have a fibroadenoma, the decision to treat it or not will depend on a number of factors you will discuss with your physician. Among them:
- The severity of your symptoms (pain)
- Your family history with respect to breast cancer
- The scars resulting from the surgery to remove them
- Whether the fibroadenoma is large enough to noticeably change the shape of your breast
- The results of your biopsy
Should you and your physician decide to surgically remove any fibroadenomas you may have, it’s important for you to recognize that they occasionally grow back. If you ultimately prefer to leave them untreated, the importance of going for regular mammograms and conducting relatively frequent self-examinations is increased because of the correlation between fibroadenomas and the slightly heightened risk of developing breast cancer.
Should you notice any change in the size of shape of your fibroadenoma, it’s important to notify your doctor immediately and arrange for any further testing he or she recommends.
Do fibroadenomas ever shrink without treatment?
Yes, they can, and sometimes even disappear entirely, but it’s rare and not something you would want to count on.
How much does it cost to have fibroadenoma removed?
For starters, be sure to check with your health insurance provider as it’s quite possible you’re covered for a procedure of this sort, given it’s not considered purely cosmetic. However, if you do need to pay out of pocket to have a fibroadenoma removed, it will likely cost you somewhere between $4,000 and $6,000 in most regions of the United States. This applies to both a vacuum assisted excision biopsy and a general excision biopsy procedure.
Cryoablation, assuming you can find a board-certified doctor in your area who has experience with the procedure, is generally a little less expensive at approximately $2,300-$3,500.