Fibroadenomas

Fibroadenomas are the most common benign tumors of the breast, consisting of fibrous and glandular tissue. They typically occur in young women, most often in the late teens and early 20s, though they can be found in adolescents and, less commonly, older women. Clinically, they present as a single, well-circumscribed, mobile, firm or rubbery lump that is usually painless. They may be slow-growing and can enlarge during pregnancy or with hormonal fluctuations. Some people have multiple fibroadenomas.

Histologically, a fibroadenoma is a well-defined mass composed of a capsule with proliferative stroma surrounding duct-like glands. The process is hormonally responsive, with growth linked to estrogen exposure and often decreasing after menopause. It is not cancerous.

Diagnosis is based on clinical examination and imaging. In younger patients, ultrasound is the preferred initial modality and typically shows a solid, oval, well-defined, homogeneous lesion. Mammography may be used in older patients or when there is diagnostic uncertainty. Core needle biopsy or excision is performed if imaging findings are indeterminate or if the lesion demonstrates rapid growth, pain, or skin changes.

Management ranges from observation to surgical excision. Small, stable, asymptomatic fibroadenomas may be monitored with periodic imaging. Larger or enlarging lesions, or those causing discomfort, are commonly removed with lumpectomy or vacuum-assisted biopsy. Recurrence can occur if residual tissue remains.

Prognosis is excellent; fibroadenomas are benign with no overall increase in breast cancer risk, though very rare complex variants may warrant closer follow-up. Patients should seek evaluation for rapid growth, fixation to skin or nipple retraction, or new skin changes.