Discovering a lump in the breast is always alarming, but what many women feel is actually a fibroadenoma, the most common type of benign breast tumor.
It’s an abnormality, but “not in a bad way,” of normal breast development, said Dr. Deanna Attai, past president of the American Society of Breast Surgeons and an assistant clinical professor of surgery at the David Geffen School of Medicine at the University of California Los Angeles.
About 10% of women will have fibroadenomas over their lifetimes, but it’s unclear what causes them to develop.
“My mom had them, I have them, my sister has them. We don’t know if there’s an actual hereditary component or that it’s just so common,” Attai told TODAY.
“This is just something the breast tissue does, but we don’t have a really good idea of why.”
Animal advocate and model Beth Stern, the wife of Sirius radio star Howard Stern, recently revealed doctors found a 1/2 inch growth on her breast six months ago that turned out to be a fibroadenoma. "I was a nervous wreck," she wrote on Instagram in September.
Here’s what women need to know:
What is a fibroadenoma?
It’s a non-cancerous tumor made up of glandular tissue and connective tissue in the breast, according to the American Cancer Society.
“It’s a little bit of an abnormal growth, but not in the sense of a cancer where there’s the potential for harm,” Attai said.
Fibroadenomas account for 68% of all breast masses, studies have found. They tend to occur in women who are in their late teens, 20s and early 30s, and they are more common in African-American women, she added. They do seem to run in families and there may be a link to the use of birth control before age 20.
Estrogen seems to play a role because it’s “exceedingly rare” for men to develop fibroadenomas even though they also have breast tissue, Attai noted. These tumors also shrink in menopausal women, whose bodies naturally produce less estrogen.
What does a fibroadenoma feel like?
Most of the time, a woman will just feel a lump about an inch in diameter in her breast. It can be tender or painful, and sometimes the pain will fluctuate with the menstrual cycle — getting worse beforehand and settling down afterwards, Attai said.
These lumps are usually not fixed in place and will move if a woman touches them.
“We often describe them medically as feeling ‘rubbery.’ So not necessarily a hard, firm rock-like mass, but a little bit softer,” she noted.
Fibroadenomas tend to get to a certain size and stop growing. The majority of them do not continue to get larger and larger.
How are they diagnosed?
The lumps can show up on mammograms, but since they develop in women under 40 — before the age when the screening is recommended — patients usually just discover them on their own.
A breast ultrasound can help doctors determine whether it’s a benign tumor or something to worry about. A non-cancerous lump is smooth and has well-defined borders. If it doesn’t meet all the criteria for a benign lesion, a needle biopsy may be needed to confirm it’s a fibroadenoma.
Doctors consider the patient’s age, family history of breast cancer and other risk factors when deciding whether to biopsy or to monitor.
“Part of the message should be: Anything you feel that you’re not sure about, get it checked out. But benign masses, especially in younger women, are going to be the most common thing that we find,” Attai said.
Some women can develop multiple fibroadenomas, sometimes eight to 10 in each breast.
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Are fibroadenomas something to worry about?
Benign lesions do not turn into cancer, though they may slightly raise the risk of the disease, according to the American Cancer Society.
“What I very commonly tell patients is anyone can develop breast cancer, anywhere in the breast at any time, but this lesion doesn’t necessarily put you at increased risk,” Attai noted.
“The most common fibroadenomas that we see in young women probably are not associated with a significantly increased risk of breast cancer in the future.”
What is the treatment?
When the benign tumor doesn’t bother the patient or have any suspicious features, it’s OK to leave it in the breast and monitor it, Attai said.
But tumors that are getting larger should be removed. And patients often want the lumps taken out because they don’t like how they feel.
Besides surgery, women can opt for vacuum-assisted biopsy, which can take out the tumor through a small puncture site; or cryoablation, which is a freezing treatment that’s also done in the office under local anesthesia with a small puncture.
Treatment often depends on patient preference.
“A young woman who has a strong family history of breast cancer and is highly anxious might rather it just be removed so she gets the peace of mind that it’s gone and she knows for sure that it’s not malignant,” Attai said.
“A young woman who has no history of breast cancer and the fibroadenoma is not painful, and it’s not such a size that it’s distorting the breast — she might be very comfortable with just continuing to watch it.”