Breast Fibroadenoma A fibroadenoma is a benign (non-cancerous) tumor in the breast. They are generally described as firm, smooth lumps under the skin. Some people describe them as being like a small, painless marble that can be moved under the skin.
There are two main types. Simple fibroadenomas have a uniform appearance and are not associated with an increased risk for breast cancer. Complex fibroadenomas contain other types of cells or are mixed with other types of tissue. Researchers estimate they account for about 16 percent of all fibroadenomas. Women who have complex fibroadenomas are about two times more likely to develop breast cancer.
Researchers say fibroadenomas are the most common type of benign breast tumor in premenopausal women. They are most commonly found in adolescent girls and young women. Some women may only have one, while others may have multiple fibroadenomas.
The exact cause of fibroadenomas isn’t known. However, their growth appears to be fueled by estrogen, progesterone, pregnancy and lactation. At menopause, many fibroadenomas start to shrink and may disappear.
Treating Fibroadenomas When a suspicious lump is found, doctors have no way of knowing if it is a malignant or benign tumor unless they do a biopsy. When the diagnosis of fibroadenoma is made, patients have two options. First, since simple fibroadenomas are not likely to become cancerous, doctors may take a “wait and see” approach. Intervention is only necessary if the lump becomes very large or starts to change. Second, the lump can be surgically removed.
Kambiz Dowlat, M.D., Breast Surgeon with Rush University Medical Center in Chicago, says many teens don’t like to hold off treatment because they don’t like having a lump in their breast and, if the lump is large, it may cause embarrassment. On the other hand, surgery isn’t a preferred treatment because it can leave a visible scar.
Novilase for Fibroadenomas There’s a new treatment for some patients with fibroadenomas, called Novilase. Novilase destroys the tumor with laser energy. To perform the procedure, the location of the lump is confirmed on an MRI or ultrasound. Dowlat says ultrasound is better for teens because they tend to have dense breast tissue, which doesn’t provide good images for an MRI. A local anesthetic is used on the breast to numb the tissue. Then, using the images for guidance, a needle is inserted through a puncture wound in the breast and pushed deeper until the tip reaches the center of the tumor. Next, a laser fiber is inserted through the needle to the tumor. When the laser is activated, the energy produces heat. Doctors monitor the treatment with imaging scans and an interior thermometer to ensure the tumor is being treated and normal tissue isn’t harmed.
Dowlat says the treatment kills the tumor cells. Initially, the tumor swells from the effects of the heat. In fact, the size of the tumor may increase over the next week as a reaction to the laser treatment. Then, over the next several months, the tumor shrinks. Since Novilase is minimally invasive, recovery is fast. Patients go home immediately after the treatment, take over-the-counter pain medicine and apply ice packs to the area. Unlike surgery there is no scar, no deformity and no risk for infection.
Novilase is approved for treatment of fibroadenomas that are 2 centimeters or less in diameter. Dowlat says, in the future, he would like to try the technology on patients with breast cancer.
For information on the Novilase system: Novian Health
For information on fibroadenomas: American Cancer SocietyNational Cancer Institute