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This question was answered on Fri 26, Mar 2010 12:04pm by Dr J Singh
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Small fibroadenoma (1 in each breast ~ 0.5 cm)



Asked by Unregistered (Female; 40; YES; My first mammogram and breast ultrasound showed 2 small fibroadenoma (one in each breast, around 6 mm
(1/4"); Relevant drugs:None )
on Fri 26, Mar 2010 08:17am :

My yearly mammogram (first one) showed dense breast and follow-up ultrasound showed two small fibroadenoma (one in each breast) about 1/2cm. Radiologist wrote that there is no evidence of cancer and to repeat ultrasound in 6 months to check fibroadenoma. I suffer from health anxiety and I am freaked out. I asked my gynaecologist if I should do a biopsy and he referred me to a breast specialist. I am so anxious and have really hard time to focus on anything but worries. I have no family history of breast cancer and know that fiboradenoma are benign growth. I've read a lot about them and know what they are made of. Almost all articles say that breast cancer is not more likely to develop in fibroadenoma than in any other breast tissue. I cannot stop thinking that radiologist might have missed something. I don't know if I should do a biopsy or wait for follow-up ultrasound. I guess I'll see what the breast specialist says. Thank you so much!!!
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Answer by Dr J Singh (doctor) on Fri 26, Mar 2010 12:04pm:

Hello, Welcome to the forum and thanks for posting. I can understand the dilemma and anxiety that you are having due to sudden change of events. Fibroadenoma is the commonest benign tumor in women. Fibroadenoma is a tumor composed of glandular (related to gland) and fibrous (containing fibres) tissues. Although it is relatively common in women less than 40 years of age, it is approximately 8-10% in women older than 40 years. It is true that fibroadenomas are benign in nature, but because they contain epithelium, a risk of neoplasia exists, as in other locations in the breast. The risk of a breast carcinoma occurring within a fibroadenoma is about 3%( as mentioned in emedicine). There are many methods of diagnosis, chief ones being ultrasonography, mammography, CT scan, MRI and biopsy of the lumps. Mammography cannot distinguish whether a mass is a fibroadenoma, a cyst, or a carcinoma with certainty because of some overlap in the findings . Similarly ultrasonography is not 100 % reliable because sometimes fibrocystic disease with complicated hypoechoic cysts and, rarely, smooth carcinomas may mimic fibroadenoma. Hence the best method of investigation is image guided biopsy of the lesion. Depending on the size of the lesion, biopsy can be FNAB(fine needle aspiration biopsy), core biopsy, incisonal biopsy and excisional biopsy. In this technique(FNAB), a thin, hollow needle is inserted into the mass under radiological guidance to extract cells that will be examined under a microscope. I suggest you to go ahead with the biopsy that your gynecologist has planned for you. I hope it helps. Take care and please do keep us posted in case you have any additional doubts. Kind regards.

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Comments:

Comment by Dr Rowena S, MD on Fri 26, Mar 2010 09:53pm:
Hi, Welcome to the forum. I do understand the anxiety you are facing right now. In addition to Dr. Anand's post, we should also consider the risk factors for breast cancer such as increasing age, sex, a personal or family history, inherited genes ( BRCA1 and BRCA2 ), radiation exposure, obesity, early onset of menstruation, later onset of menopause, having your first child at an older age, postmenopausal hormone therapy, and drinking alcohol. It is good that you do not have any history of breast cancer. You can wait for your appointment with the breast specialist for further evaluation or to ease any worry or anxiety, you proceed to the biopsy. Six months is indeed a long wait and it is better to be proactive about your health at this point. Take care and do keep us posted.

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