What is a Fibroadenoma?

Lumps detected during a breast examination or imaging scan can initially cause serious concern for many women. In particular, the most common questions asked by patients diagnosed with a ‘fibroadenoma’ are whether it is breast cancer and whether it will prevent them from having cosmetic surgery.

A fibroadenoma is one of the most common benign lumps found in the breast. It usually develops as a result of the combined proliferation of breast tissue and connective tissue. It is often felt as a well-defined, mobile and soft lump. Although it is most commonly seen in young women, it can also be detected in different age groups.

The vast majority of fibroadenomas are not cancerous and do not, in themselves, increase the risk of breast cancer. However, not every lump felt in the breast should be assumed to be a fibroadenoma. For this reason, the diagnosis must always be confirmed by breast imaging and, where necessary, by a breast surgeon.

In my plastic surgery practice, the diagnosis and treatment of patients presenting with fibroadenomas are carried out by general surgeons specialising in breast surgery who have experience in this field. My role, once the necessary assessments have been completed, is to draw up the most appropriate plan for the patient from a breast aesthetics perspective.

What are the symptoms of a fibroadenoma?

A fibroadenoma may not always cause symptoms. Small fibroadenomas, in particular, may be detected incidentally during a routine breast ultrasound or mammogram, without the patient having any symptoms.

Fibroadenomas that can be felt are usually perceived as a mass with well-defined borders, which is mobile and has a rubbery consistency. Many patients describe this as ‘a small marble moving inside the breast’. It usually causes no pain and does not result in symptoms such as redness or dimpling of the skin.

However, not every newly detected lump in the breast is necessarily a fibroadenoma. In particular, if the lump grows rapidly, causes pain, alters the shape of the breast or shows suspicious features on imaging, it must be assessed by a general surgeon specialising in breast surgery.

In patients with dense breast tissue or large breasts, however, a fibroadenoma may not be palpable. For this reason, breast ultrasound and, where necessary, mammography are of great importance not only for making a diagnosis but also for assessing other possible changes in the breast.

How is a fibroadenoma diagnosed?

A diagnosis of fibroadenoma is made by evaluating the patient’s symptoms, the physical examination and breast imaging techniques together. Breast ultrasound is one of the most commonly used imaging techniques in young patients. Depending on the patient’s age and clinical presentation, mammography may also be included in the assessment.

Many masses suspected to be fibroadenomas following imaging may be reported as benign findings, such as BI-RADS 2. In some cases, however, further investigations or a biopsy may be planned by a breast surgeon. This decision is based entirely on the characteristics of the mass and the imaging findings.

In my own practice, when planning breast aesthetics for patients, I consider it important to carry out an assessment using either a breast ultrasound or a mammogram, depending on the patient’s age and clinical condition. This ensures that the general health of the breast is assessed prior to cosmetic surgery, and that, where necessary, patients are referred for appropriate breast surgery.

Can Patients with Fibroadenomas Undergo Cosmetic Breast Surgery?

The short answer is yes. However, for this to be the case, the lump in the breast must first have been properly assessed and confirmed to be benign.

In my own practice, for patients planning breast augmentation, breast lift or breast reduction, I recommend that they undergo a pre-operative assessment using breast ultrasound and, where necessary, a mammogram, depending on their age and clinical condition. This ensures that the existing breast tissue is examined in detail and that the planning of the cosmetic surgery can be carried out more safely.

If imaging reveals a benign mass classified as BI-RADS 2 and consistent with a fibroadenoma, this does not preclude breast cosmetic surgery in most patients. However, each patient should be assessed on an individual basis, and where necessary, the opinion of general surgeons specialising in breast surgery should be sought.

However, the situation may be different in breast reduction or breast lift surgery. If a fibroadenoma is located within the breast tissue to be removed during the operation, it may be possible to remove it during the same procedure with appropriate planning. In this way, both aesthetic and surgical objectives can be achieved simultaneously, without the patient needing to undergo a second operation.

In some patients, however, breast surgery and plastic surgery teams can work together to plan the procedure so that both the removal of the mass and the aesthetic reconstruction of the breast can be carried out during the same operation. Thanks to local tissue repair techniques, which are used particularly in cases where the removal of large fibroadenomas is anticipated, it is possible to preserve the contour of the breast.

When Can Breast Aesthetic Surgery Be Performed After a Fibroadenoma Has Been Removed?

If a fibroadenoma has been removed by a breast surgeon in a separate operation, I prefer to wait for the breast tissue to heal before planning any cosmetic surgery. In my own practice, I generally consider a period of around six months to be appropriate.

During this recovery period, the tissues soften, swelling subsides and the breast’s new shape settles. This enables more accurate measurements to be taken and more predictable results to be achieved when planning cosmetic procedures such as breast augmentation or a breast lift.

As every patient’s recovery process is different, the exact timeline should be determined on the basis of the findings of the examination and the assessment by the breast surgeon.

Do Breast Implants Make It More Difficult to Monitor Fibroadenomas?

This is one of the most frequently asked questions by patients considering breast augmentation surgery. Contrary to popular belief, the presence of a breast implant does not, in itself, make it more difficult to monitor a fibroadenoma.

In fact, in many cases, the increase in breast volume makes it easier to assess the breast tissue during a mammogram. Nowadays, imaging techniques such as breast ultrasound, mammography and, where necessary, magnetic resonance imaging (MRI) can be used to assess both the breast tissue and the implants in detail.

For this reason, having previously been diagnosed with a fibroadenoma or having a breast implant does not prevent you from having regular breast check-ups. What is important is that these check-ups continue at the recommended intervals and that any new symptoms are assessed without delay.

Conclusion

A fibroadenoma is one of the most common benign lumps in the breast and, in many patients, does not indicate breast cancer. However, it is of great importance that every lump felt in the breast is properly assessed. For this reason, the process of diagnosis, follow-up and, where necessary, treatment should be planned by general surgeons specialising in breast surgery.

From a plastic surgery perspective, however, the presence of a fibroadenoma does not, in itself, preclude breast aesthetic surgery. In my own practice, I place great importance on pre-operative breast imaging and, where necessary, refer my patients to a breast surgeon first. For patients deemed suitable for cosmetic surgery following these assessments, it is possible to achieve safe and natural results through a personalised treatment plan.

The aim is not merely to achieve an aesthetically pleasing result, but also to plan the safest possible treatment process for patients, whilst prioritising breast health.