multiple fibroadenomas and surgical excision?

[hippos]

I am a 24 year old female with no family history of breast cancer. I discovered a lump in my right breast 3 years ago that was round, movable, well-circumscribed, and the doctors did an ultrasound and a fine needle biopsy and said it was likely a fibroadenoma. I've had it ultrasounded every 6 months since then. It has grown in size slightly, in number (now there are a cluster of 4 rather than just 1), and have become more lobulated. Recently, my doctor referred me for a core needle biopsy, but they weren't able to do it because of how close to the skin the lumps are located and their size (3mm in longest dimension each). When I saw a surgeon, she strongly recommended I get them surgically excised because they have grown and multiplied in number and said that was the only way to know for sure that this isn't cancer. But, my PCP said it would be fine to watch and wait (although I'm not sure what end point to watch and wait for). I would prefer not to get them surgically excised unless necessary because I don't want an scar there because they are located rather high, but if that is the only way to rule out cancer, since the fine needle biopsy is not very reliable, is surgery the best way to go? I also have been told that fibroadenomas tend to grow rather than shrink for women in their 20's, and if so, isn't it then always better to get them removed while they are small rather than when they become larger? Also, is it normal to have a cluster of four fibroadenomas or is that indicative of something of concern? Thanks!

[CCF-RN,MSN-rf]

Dear hippos:  The reason to biopsy a fibroadenoma is to determine for sure that it is a fibroadenoma.  Otherwise, these are not harmful, although many women have them removed just so they don't worry.  You might consider a second opinion with a breast specialist to be sure the core biopsy is not possible and also to determine other options for removal with minimal to no scarring should you need to take that route.  Fibroadenomas are fairly common in your age group.

[hippos]

sorry, correction to last posting, I meant 3cm.

[surgeon]

fibroadenomas are very common at your age; it's not unusual for them to be multiple or clustered. I would assume it wasn't the surgeon who said a core biopsy couldn't be done; I'd consider asking her to do one. Given your age, and the nature of the tumors, I'd say a core biopsy would be very reassuring, if consistent with fibroadenoma. It ought to be possible to do it from a bit of a distance from the tumor, even if it's very near the skin, and I'd think a surgeon would be more comfortable doing that than would a radiologist.

[ritavv]

I had a cancerous tumor removed 3 years ago that was very high on the breast.  My excellent surgeon made the incision closer to my areola and then went upward to get the tissue.  You'd be amazed how a scar will eventually blend in on the breast.  I had a fibroadenoma removed when I was 18 and I forget that I even had surgery there because the white scar blends in with my skin.

[Vienna]

Hi hippos,

I don't know if you're still regularly reading messages on this board, but I thought I'd give it a shot.  I was wondering if you opted for the surgical excision and what the results were...provided of course that you're willing to share here.

The reason I'm asking is because my situation is incredibly similar to yours.  I discovered 3 lumps back in April and all were diagnosed as fibroadenomas.  I originally thought they were cysts and actually posted a message in error to that effect.  I think it may have been due to my worrying and state of anxiety at the time that caused me to misinterpret the results.

I went for a biopsy yesterday and am now beside myself with worry waiting for the results.  All 3 of the lumps have grown and apparently there is also another one that has shown up on the ultrasound.  They are all palpable but one is lobular---similar to your situation.  The waiting has increased my anxiety tenfold to the point where I can't think straight.  I'm hoping you had a successful outcome.

Thanks for any input...

Vienna

[Joemclean1]

My wife who is 30 years old recently found a lump in her left breast.  She saw her PCP, who referred her to a radiology center.
The said they thought it was a cyst, but referred her to a breast surgeon/specialist anyway.  The specialist performed an ultrasound, and concluded that it was not a cyst, and that he wanted to perform a biopsy.  However, he was leaving the next day to attend a breast cancer conference, and scheduled the biopsy for 3 weeks from now.  My first question is should she be overly concerned, and secondly, is it right to wait three weeks to get this done.

Thanks,
Concerned/confused husband

[vicklady]

I just found a lump in my right breast.  I also have a similar lump in my left breast in the same area but it's not as large.  I went to see my GYN and she told me its either cyst or (fibro-something- I can't remember what she called it but I believe it was fiboradenomas).  She sent me for a sonogram and I had one done.  When they did it they couldn't even see the lump on the screen, everyone felt it but it was very hard to see on the screen.  The radiologist had to come in and do the test.  He said everything felt normal but he did see quite a few cyst but never really told me what the lumps in my breast were.  they are fairly large and they move around and that's all I know about it.  The radiologist said he also saw "fibro granular tissue".  Atleast I think that's what I heard him call it but when I tried to look it up on the internet nothing under that name would come up.  They sent me for a mammogram and it came back negative for cancer.  I should be happy but I'm still very very concerned.  I have no idea what these lumps are.  I'm a 24 year old african american with no known family history of breast cancer. Is there a chance that what I have is fibroadenomas?  i know I need definate confirmation from my physician but how come nothing showed up on my sonogram and nothing was detected by the mamogram (mammogram).  If its not a cyst or cancer what could it be?

[Bet63]

I know its scary when you find a lump. I'm not a doctor or anything...just a woman who been where you are many times. The term the radiologist probably used was fibro glandular, which from what I know is describing breast tissue. Being young as you are, and the fact that there is also a similar feeling lump in your other breast, its probably just breast tissue or possibly a fibroadenoma. I was 22 when I found my first lump (I'm 40 now)and it was a fibroadenoma, which are fairly common in young women. They are harmless and may cause breast pain. Cysts are common as well and can cause pain. As for why nothing showed up on the mammogram is a mystery to me too. I recently found 2 lumps and had a "normal" mammogram. The explanation I got was that its just normal breast tissue. My Surgeon's advise was to watch them for a couple of menstrual cycles to see if there is any change. The point in your cycle may also affect what you are feeling. The best time to check your breasts is about a week after your cycle. Even though you have no family history of breast cancer its important to check your breasts regularly. I hope I have been of some help to you. You won't get an answer from the staff here unless you actually post a question (not a comment) They are very helpful and very much much appreciated. If you are really worried about this lump you could request a biopsy and find out for sure what it is. That's the only way to kow for sure. They may be able to do a needle biopsy if they can feel the lump.
Good luck and I hope I have eased your fear somewhat here. There are many of us who have been there and know what your're going through.
Take care
Bet

[marias]

Over the past several years I have had 3 lumps removed- 2 right side, 1 left side, and just found another one via ultrasound on my 3 month check post-excisional biopsy, which I will have a core biopsy done on tomorrow. First 2 were fibroadenomas, 1 was a fibroadenosis (?), all benign, and I am not worried about tomorrow because I know chances are it will be benign too. However, even if it turns out to be cancerous, I will still be relieved that it was found and can be dealt with. I have been dealing with a breast specialist each time - several mammograms were read as "normal" by the radiologist ...see you next year, even when I could feel a solid lump. My surgeon ultrasounded each time and said there's only one way to know what it really is, and I am much relieved to have had excisional biopsies done, and know that they are truly benign.  Even my surgeon has a hard time finding where he did the surgery, because the scars are so well hidden.  The excisional biopsy was well worth the peace of mind, rather than the "wait and see" philosophy.  From what I've read-most lumps are benign, and I'd rather know sooner than later if it was cancer so I could hit it as early as possible. Sadly, I know several women who had lumps and never did anything about it because it "might be CANCER"--several years went by, and it WAS cancer, but too far advanced to do anything.  I don't go for the "stick your head in the sand" mentality when it comes to breast lumps. If you have a lump, have it biopsied, then you can move on with life.

[Jammy]

I have very recently been through a similar scary experience myself, and can relate to many of the comments I have read.  I have been having breast pain since before Christmas, and my gp could not feel any lumps at all.  I carried on getting pain, and at the beginning of March was refferred for a mammogram and a second opinion, the surgeon saw what he thought was a fluid filled cyst, but so deep in the breast that it could not be felt on the surface.  He reccomended fine needle aspiration, and when this was carried out the lump was found not to be fluid, and the result has come back to be a fibroadenomas.  I am now going to have the lump removed next week, but am so very releaved that this is not sinsister.  I would not have known this and would have continued to worry had I not insisted on the investigations.   Please allways follow your instincts!!!

[charchar]

I have a daughter that is 17 years old and she had found a quite large lump in her right breast last month and just now told me and I took her to the dr. and she found another one but not as big the large one was 2cm by 1 and a half cm she recomended a ultrasound and we did and it wouldn't pick it up but they could feel it she says it hurts to wear her bra and she can't stand any pressure on it at all. The radiologist said it looked like a tissue build up and called it a normal ultrasound. The Dr. said she was gonna talk to a surgeon Monday and see what step we should take now . She(my daughter) feels like something isn't right because it hurts so bad . I never had anything like this . I have two Aunts(  on my mother's side) who has had breast cancer and had their breast removed and are fine now.But this doesn't sit very well . Can there possibly be any thing hiding under this tissue build up??? She wants it out and is worried about this tremendously. What should I expect from the surgeon? Should it be certain type of surgeon?

[guitargirl]

am new to this site.
have been searching around for info on fibroadenomas.  i'm 26 and had two fibroadenomas surgically removed from my left breast about one year ago.  i just saw my surgeon yesterday because i feel a brand new lump.  the two i had removed were large...about one inch in diameter.  my surgeon suggested having them removed because of their size.  
i don't know what he'll say about my latest findings.  i'm having an ultrasound tomorrow.

as far as lumps not showing on a mammography...i believe i heard somewhere that younger women with dense breast tissue shouldn't have mammograms because findings would be inconclusive.  go for a sonogram.
i also read that african american women account for a larger percentage of women who get fibroadenomas.

am just wondering if i'll be harvesting these things for the rest of my life.  could be worse, i suppose.  

-alli

[SnowWoman]

I went through a lot of the same questions you are when I was in my 20's.  I had a lump removed when I was 24 and a second surgery 1-1/2 years later in which they removed another lump, scar tissue from the first surgery and nearly 1/4 of my breast.  Everything was benign but still the idea of facing repeated surgeries was discouraging.  After going through the 2 surgeries and still having issues with pain and lumps, I consulted with a breast clinic and went through some different methods of monitoring.  This was 20+ years ago and things were different back then.  

The good news is that things did settle down with my breasts as I got older and I went relatively trouble free until last year when I had a fibroadenoma removed.

For the most part, if at your age you have repeated lumps that have been proven to be fibroadenomas in the past and new lumps are characteristically the same, you can have some assurance that monitoring is a valid option.  Fibroadenomas will often "go away" on their own with time and are harmless in themselves.  The key is to find someone who is knowledgable to monitor your situation and advise you of your options.  If you have a breast clinic in your area, make an appointment there.  Surgeons can be wonderful advisers (the one that contributes here is an example) but for many they only see one solution for a problem.

[anik854]

A related discussion, Multiple fibroadenomas was started.

[beefer02]

A related discussion, Multiple Fibroadenomas Management was started.