Recurrent fibroadenomas

[razorback38]

I am a 38yoWF.  I have a history of 3 different open biopsies that have found sclerosing adenosis of the left breast and 3 fibroadenomas of the right breast.  I currently have one mass in the left breast and 3 masses in the right breast that are being followed by u/s and mammogram every 6mos., most likely all fibroadenomas.  Mammograms are not very helpful, though, because my breast tissue is very dense and quite often the masses are not even evident on the films.  One of the masses in the right breast has grown by ~2.2mm in the last 6mos. and the radiologist recommends a core needle biopsy (BI-RADS 4).  My breast surgeon, who I trust implicitly, has told me at this point the decision is entirely up to me.  I have decided to wait and see what happens w/the next u/s and mammogram, and she is comfortable w/that.  In addition to my history, the radiologist tried a core needle biopsy of one of my fibroadenomas last year (prior to the open biopsy--just to see if it was a cyst) and not only was it difficult for her to do but it was incredibly painful, supposedly due to my dense breast tissue.  I know that this past experience is influencing my decision to wait and I just want to make sure that doesn't sound absolutely crazy.  Thank you!

[hokie]

I am a 35yr old female that is scheduled to have my second lumpectomy on Thursday. The doctors tell me that it is another fibroadenoma and it has doubled in size in a year (1 1/2 inches). I have very dense breast and every time I go to have a mammogram I end up having an ultrasound and a biopsy. My question is, am I going to have to go thru this for the rest of my life and knowing that it is not cancerus do I need to go every year? I had my first lump removed when I was 21 and started having mammograms every other year after that until last year when they found this knew lump. They also found that my duct was abnormal but after doing a biopsy on the discharge, it came back begnin. After reading some of the other comments in these posting I am concerned that eventually I  could have some real problems or am I just worrying to much?

[razorback38]

I am pleased to report that I had the core needle biopsy done last week and that it was indeed another fibroadenoma.  So far so good!  Thanks to everyone for all of their help and support!

[ALi273]

I too have had multiple biopsies, scares and a bad family history for BC.  My Surgeon has also mentioned   propylactic Mastectomy, but I haved opted for tamoxifen therapy.  I have been on it for about 14 months and so far so good.  I go for MRI's every six months and Mamo's and Ultrasounds every year.  It is very stressful.  In addition, I take a low dose of Lexapro because of all the stress it has created.  Since being on the tamoxifen, I have had good MRI's.  An area of concern, close to the chest wall is no longer there! Have you thought of tamoxifen as a possible option?  Best of luck to you!

[AuntDEE]

Hi All, I could use some advice right now as I'm not sure what to do. I had a Lumpectomy in March 2004 for D.C.I.S. No other treatments. Since then I have had 1 biopsy in August of last year and bilateral lumpectomys within the past 3 months. Both showing atypia ductal hyperplasia. I am 41 years old and Doctors have suggested I have a propylactic Mastectomy with reconstructive surgery. I know it sounds extreem, but don't know if I can continue with this fear.Already nervous about the next mammo, ultrasound, MRI. Very strong family history, I had an Aunt who died at 33 from B.C.and would like this all behind me. Any advice would be greatly appreciated. My prayers are with all who are going through this.

[Twocapes]

Razorback - please keep us posted.  This board and the people who post (patients and professionals) have been a tremendous help to me.

[razorback38]

Twocapes and Christie2004, thank you both so much for your comments.  Christie2004, I do think that for me an elective mastectomy would not be an option at this time, but I could certainly understand your choice to do that given your circumstances.  I don't think that I could blame you one bit!  I greatly appreciate your input also, Twocapes, because I have a feeling that I will be going through many more breast biopsies in my lifetime (similar to your circumstances).  I admire both of your courageous choices and your options, which seem to have worked well for both of you.  I will think about it some more, but I am leaning now toward having the core needle biopsy.  It was good for me to hear of someone having many benign fibroadenoma biopsies and then having one come up cancerous, simply because I know that I have become very complacent.  I rarely do the BSE any more due to all of the various lumps and bumps that I always encounter!  This has been a great reminder for me.  Thanks very much.

[Christie2004]

12 years ago, I also had a suspicious mammo, but was advised due to my young age and lack of family history of breast cancer, to watch and repeat in 6 months.  This was a small, non-palpable area of calcifications.  A needle biopsy wasn't offered to me and I didn't even know a thing about them.
I wasn't comfortable waiting, had a biopsy and was diagnosed with infiltrating ductal carcinoma.
Had a mastectomy with reconstruction.

Then each and every mammo on the other side started showing funky things, and after 2 biopsies I elected a mastectomy on the other side.  I couldn't live with the uncertainty and frequent abnormal mammos.  

I had EXCELLENT cosmetic results with reconstruction, and have NEVER had a moments regret over my decision.  I don't have to worry (much) about it any more, no more mammos and the accompanying fear when I get the dreaded call that something was found.  

While this decision was right for me, it certainly may not be right for everyone and was considered overkill by my surgeon, to be sure.  
It is an option that is not often discussed, but elective mastectomy IS an option and I just wanted you to be aware, if you hadn't already considered it.  Plastic surgery has come a long, long way since I had my mastectomies, and mine turned out darn good even back then.  I have to change into scrubs every day with the other nurses I work with, and most don't know I've even had mastectomies.

[Twocapes]

Yes, rather than opt for another surgical biopsy, I decided to give the "new technology" a try.  I had a radiologist who specializes in breasts - mammograms, ultrasounds, and core needle biopsies.  She had done two previous (benign) ones on me and when she didn't seem too happy and called it sort of "funky looking", I figured the pathology would not come back in my favor.  I went on to have a lumpectomy with clear margins and a sentinel node biopsy at the same time which proved completely negative.  So after chemo and radiation, I can say I am free and clear and have no doubt that I will continue to do well.  Ironically, one year after my surgery (almost to the day), another "area" was found and I underwent a core needle biopsy on the other side.  This, too, proved to be another fibroadenoma.  My latest mammogram also is negative.

[razorback38]

Thank you so much for your insight!  I really appreciate that.  That's exactly what I was wondering...I think that I have become complacent, and I know that my fear of the discomfort from the biopsy has been a large factor also.  I know that fibroadenomas are benign and that cancer associated with them is very rare, but where do you draw the line?  I have been curious as to how often biopsies of "ultrasound diagnosed" fibroadenomas turn out to be cancerous.  I guess that it's a very slim chance, especially for my age and family history, but your posting was a very good wake-up call for me.  So your cancer was picked up by a core needle biopsy?

Thanks again!

[Twocapes]

Dear Razorback38 - Please don't become complacent about fibroadenomas.  From the age of 25 to 58 I had about seven (I lost count) removed surgically and just recently started having needle core biopsies.  Luckily I did not wait or ignore one in January, '04 as it turned out to be an infiltrating ductal carcinoma.  Since I was so diligent, I was surprised at the size (2.5 cm) but there were also two small fibroadenomas in the specimen plus I, too, have very dense, fibrous breast tissue.  The odds are with you that you have a benign lesion, but for peace of mind, I wouldn't hesitate.

[razorback38]

I forgot to add that I do not have any family history of breast cancer, I started my periods at the age of 11 and I have never had any children.  Thanks again!

[CCF-RN,MSN-rf]

Dear razorback38:  A BIRAD 4 is defined as a suspicious abnormality. Most category 4 abnormalities are benign but may require biopsy since this category can be malignant in 25-50% of cases.  It is based on the interpretation of the radiologist.  It ultimately is up to you as to when/whether to proceed with a biopsy.