Breast Lump Excision

Understanding Fibroadenomas

Fibroadenomas are noncancerous breast lumps that commonly occur in women. They are typically round with distinct, smooth borders and are easily movable under the skin. Fibroadenomas are the most common benign breast lumps, accounting for 50% of all breast biopsies performed.

When Does Surgery Become Necessary

Surgery becomes necessary when the fibroadenoma is large, grows quickly, or causes symptoms such as pain or discomfort. It is also recommended when results from an imaging test or biopsy are concerning to the healthcare provider. In patients with a family history of breast cancer or known changes of complex fibroadenoma, excision without delay is advised.

Overview of the Surgical Procedure

The standard treatment for fibroadenomas is surgical excision, also known as an excisional breast biopsy or lumpectomy. The procedure involves a surgeon using a knife to remove the entire fibroadenoma. The surgery is typically performed under general anaesthesia and takes about an hour.

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Related Concerns

Fibroadenomas are generally harmless and do not increase the risk of breast cancer. However, large fibroadenomas can cause discomfort and may distort the shape of the breast.

Causes of the Issues

The exact cause of fibroadenomas is unknown, but they are thought to be related to reproductive hormones as they are more common in women of reproductive age and can increase in size during pregnancy or with hormone therapy.

Treatment Approaches

Treatment options for fibroadenomas include observation, medication, and surgery. The choice of treatment depends on the size, location, and number of fibroadenomas, as well as the patient's age, health status, and personal preference.

Service Overview

Surgical excision of a fibroadenoma is a definitive solution that involves removing the entire lump. This procedure not only alleviates symptoms but also prevents an unsightly appearance.

Step-by-Step Guide to Excision of Breast Lump/Fibroadenoma

1. The patient is given general anesthesia.
2. The surgeon makes a small cut on the breast.
3. The lump and some of the normal breast tissue around it are removed.
4. A pathologist examines a sample of the removed tissue to ensure all the fibroadenoma has been taken out. ### Conditions Warranting Excision of Breast Lump/Fibroadenoma The surgery is recommended when the fibroadenoma is large, grows quickly, or causes symptoms such as pain or discomfort. It is also recommended when results from an imaging test or biopsy are concerning. Lifestyle considerations such as discomfort during physical activities or cosmetic concerns may also warrant the procedure. ### Benefits of Excision of Breast Lump/Fibroadenoma The surgery can alleviate symptoms, prevent an unsightly appearance, and provide definitive diagnosis. It also eliminates the need for ongoing monitoring of the lump. ### Risks of Excision of Breast Lump/Fibroadenoma Potential risks include infection, bleeding, changes in breast shape, and scarring. There's also a small chance that the lump could grow back. ### Preparation for Surgery Patients are advised to stop smoking, maintain a healthy weight, and avoid certain medications that can increase bleeding risk. ### Pre-surgery Procedures and Checks Before the surgery, patients undergo a physical examination, mammogram or ultrasound, and possibly a biopsy. Blood tests are also done to check overall health. ### Postoperative Care After the surgery, patients are given pain medication and instructions on how to care for the surgical site. Follow-up appointments are scheduled to remove stitches and check recovery progress. ### Recovery and Rehabilitation Recovery time varies but most patients can resume normal activities within a week. Gentle exercises may be recommended to prevent stiffness. ### Alternatives to Surgery Alternatives include observation, medication, and minimally invasive procedures such as cryoablation or vacuum-assisted biopsy. ## References
5. Mayo Clinic. (2022). Fibroadenoma - Diagnosis and treatment. [online] Available at: https://www.mayoclinic.org/diseases-conditions/fibroadenoma/diagnosis-treatment/drc-20352756 [Accessed 8 Dec. 2023].
6. NCBI. (2023). Management of Breast Fibroadenomas. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497021/ [Accessed 8 Dec. 2023].
7. Mount Sinai. (2023). Breast lump removal Information. [online] Available at: https://www.mountsinai.org/health-library/surgery/breast-lump-removal [Accessed 8 Dec. 2023].
8. Healthdirect. (2023). Excision biopsy of a breast lump. [online] Available at: https://www.healthdirect.gov.au/surgery/excision-biopsy-of-a-breast-lump [Accessed 8 Dec. 2023].
9. Breast Cancer Now. (2023). Fibroadenoma. [online] Available at: https://breastcancernow.org/about-breast-cancer/breast-lumps-and-benign-not-cancer-breast-conditions/fibroadenoma/ [Accessed 8 Dec. 2023].

• Mayo Clinic. (2022). Fibroadenoma - Diagnosis and treatment. Available at: https://www.mayoclinic.org/diseases-conditions/fibroadenoma/diagnosis-treatment/drc-20352756
• NCBI. (2023). Management of Breast Fibroadenomas. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497021/
• Mount Sinai. (2023). Breast lump removal Information. Available at: https://www.mountsinai.org/health-library/surgery/breast-lump-removal
• Breast Cancer Now. (2023). Fibroadenoma. Available at: https://breastcancernow.org/about-breast-cancer/breast-lumps-and-benign-not-cancer-breast-conditions/fibroadenoma/