Management of fibroadenoma of the breast

Abstract

Background: Fibroadenoma is a common cause of discrete breast lumps in young women. There is agreement that fibroadenomas can be diagnosed preoperatively with a high degree of confidence and that some of the lesions thus diagnosed will resolve, possibly obviating the need for excision. There is, however, wide disagreement over the propotion of fibroadenomas that resolve spontaneously and therefore the benefit that accrues from an expectant policy. Objectives: This study aimed to audit the management of fibroadenoma on one unit and clarify their natural history over a 3 years period. Methods: Acohort of one hundred women with 115 fibroadenomas diagnosed using a triple assessment of clinical examination, cytology and imaging (sonomamography) have been followed for aminimum of 3 years. Results: In all, 81 of the fiobroadenomas have been excised. In four cases the histology revealed bieng disease other than fiobroadenoma; there were no neoplasms. The sensitivity of cytology and sonomsmmography for the diagnosis of fiobroadenoma were 84% and 98% respectively. Thirty-four fiobroadenomas have not been excised. Of 25 fiobroadenomas that have been reassessed after at least 3 years of follow-up, 13 (52%) have reduced in size, 4 (16%) are unchanged in size and 8 (32%) have grown. No patient has developed a carcinoma at the site of presumed fiobroadenoma. Conclusion: This study confrims that an expectant management policy of fiobroadenomas has not resulted in misdiagnosis of of carcinomas. Further, since a signification proportion of fiobroadenomas remain static or reduce in size over a 3 years period many women can avoid excision.