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August 3rd, 2011
08:03 AM ET

Is a breast fibroadenoma a precursor to cancer?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Question asked by Heena from Hyderabad, India
I had fibroadenoma [a benign breast tumor] and had it removed with surgery. I am 31 and I want to know if I can take precautions to prevent breast cancer or other related problems.

Expert answer
You give me an opportunity to remind women about breast health. Women should always consult a physician if they feel an abnormality in the breast, and especially a breast mass.

There are a number of masses that occur within the female breast. Most masses are not cancer. I emphasize this, hoping to keep women from panicking if they do find a mass.

Among the benign masses, most are only an inconvenience and of no threat, but some are associated with increased long-term risk of breast cancer.

A fibroadenoma is a benign mass of fibrous and glandular tissue. Fibroadenomas are most commonly found in women aged 15 to 35. They increase in size with estrogen stimulation and regress after menopause.

These masses can often be felt in the breast, and can be seen on ultrasound, mammogram and magnetic resonance imaging. One out of every five women with a diagnosed fibroadenoma has more than one.

Fibroadenoma is one of a group of benign masses that are collectively called "proliferative lesions without atypia." Other tumors in this category include ductal hyperplasia, intraductal papillomas, sclerosing adenosis, and radial scars.

Some women will have a fibroadenoma mixed with other proliferative lesions. A pathologist generally makes the diagnosis of fibroadenoma after a piece of the mass has been removed through a needle biopsy or the entire mass has been removed through a small incision.

There are two types of fibroadenomas. They are called simple and complex. Simple fibroadenomas are not correlated with an increased risk of breast cancer and often the only treatment given is surgical removal of the mass and the routine follow-up that all normal risk women should undergo. It is actually not necessary to remove all of a proven simple fibroadenoma, although most women do want it removed.

A complex fibroadenoma is associated with a modest increase in long-term risk of breast cancer. When I say modest, a woman with this mass is 1.5 to 2 times more likely to develop breast cancer in her lifetime than women in general.

To give some perspective, some BRCA1 and BRCA2 genetic mutations increase risk of breast cancer by a factor of 7 to 11 times. The treatment of a complex fibroadenoma is complete surgical removal followed by enhanced surveillance or enhanced screening for breast cancer.

For routine surveillance, most encourage women at normal risk, under age 40, to practice breast awareness and get routine clinical breast examinations.

Breast awareness is the concept that women should know how their breasts normally look and feel and seek assessment of any breast change promptly from their health care provider.

Over the past two decades, most respected organizations that make recommendations have de-emphasized systematic monthly breast self-examination. Think of the newer recommendation as more of a daily, quick, less thorough examination as opposed to the intense once-a-month examination.

The movement away from monthly breast self-examination recognizes that most breast masses found by the patient are found while dressing or in the shower, even among those who did the intense monthly examination.

In addition to breast awareness, most respected recommendations also encourage women of normal risk under 40 to undergo a clinical breast examination by a health care provider who is specifically trained to do it. This clinical exam should be done on a regular basis (every one to three years).

Most recommend that normal-risk women age 40 and older get annual mammography and breast clinical examination. Enhanced surveillance for a woman at high risk needs to be planned by a trained health care provider taking into account the woman's specific risk factors, such as whether her pathology has more than just a complex fibroadenoma, her breast density, her age, her genetic risks and her family history.

There is no definite answer as to what the appropriate follow-up should be. A woman in her 20s and 30s whose breasts are not very dense might get annual mammography and once or even twice a year clinical breast examination. A woman of the same age with more dense breasts might be given regular ultrasound or magnetic resonance imaging with routine clinical breast examination.

Women who maintain an ideal body weight and exercise regularly do have a lower risk of a number of diseases to include breast cancer. Women over age 35 and at a very high risk for breast cancer might consider taking tamoxifen or raloxifene.

These are anti-estrogen drugs that are FDA approved for reducing breast cancer risk. These drugs do have a risk of side effects that must be considered in making a decision. Women at extremely high risk can also consider prophylactic mastectomy.

None of these preventive measures prevents 100% of all breast cancers. Even prophylactic mastectomy cannot remove all breast tissue, so some of these women still get breast cancer.

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soundoff (18 Responses)
  1. Dr. Darian L. Smith

    Not one mention of Potassium Iodide? WOW.
    A natural substance the body needs which, in a large dose (12.5 mg + ) can cause reduction or elimination of fibroid tumors.
    It also modulates thyroid function, which is a correlate of breast cancer.

    August 3, 2011 at 10:51 | Report abuse | Reply
    • Maryelin

      Ive been taking birth control pils for 9 years. I recently found a lump and the doctor thinks its fibroadenoma. After reading up on it it mentions estogen levels. Woud stoping the pills decrease the risk of these lumps reaccuring. We don't have history of cancer inthe family, and this is the first and im 31.

      July 28, 2012 at 11:27 | Report abuse |
  2. LH

    Fibroid tumors are not synonymous with cancerous tumors. Please educate yourself, "doctor" (chiropractor?)

    August 3, 2011 at 23:29 | Report abuse | Reply
  3. N.J.

    I have fibroadenomas and cysts with very dense breast tissue, but no family history of breast or ovarian cancer. The doctor doesn't seem worried and told me not to bother getting them removed as they're too close to the milk ducts. Should I get a second opinion or just wait and see?

    August 9, 2011 at 15:36 | Report abuse | Reply
  4. MM

    I have literally dozens of these tumors. How common is it to have this many? Removal and monitoring them is very difficult when dealing with so many.

    August 26, 2011 at 18:26 | Report abuse | Reply
  5. sobz

    i have 3 Fibros and have been told they are nothing to worry about as they are normal and non-cancerous, i am still worried about them because i get pains in my breasts...is this the same with others?

    September 7, 2012 at 05:29 | Report abuse | Reply
  6. CHRISTINE AMANDA

    HI. AM 20YRS OLD AND HAD A BREAST LUMP ON MY LEFT WHICH WAS LATER DISCOVERD BY MY DOCTOR TO BE A FIBROEDENOMA BUT HE TOLD ME NOT TO WORRY THAT IT WAS NORMAL AS TO MY AGE ALSO THE PROBLEM IS IT IS NOT YET REMOVED AND OF LATE HAVE STARTED FEELIN PAIN IN MY UPPER SIDE OF LUNGS COULD THIS BE A SIGHN OF CANCER?

    January 4, 2013 at 17:54 | Report abuse | Reply
  7. CHRISTINE AMANDA

    HI MY NAME IS CHRISTINE FROM KENYA AM 20YRS OLD AND HAD A BREAST LUMP ON MY LEFT WHICH WAS LATER DISCOVERD BY MY DOCTOR TO BE A FIBROEDENOMA BUT HE TOLD ME NOT TO WORRY THAT IT WAS NORMAL AS TO MY AGE ALSO. THE PROBLEM IS IT IS NOT YET REMOVED AND OF LATE HAVE STARTED FEELIN PAIN IN MY UPPER SIDE OF LUNGS COULD THIS BE A SIGHN OF CANCER?

    January 4, 2013 at 17:57 | Report abuse | Reply
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    April 24, 2013 at 09:58 | Report abuse | Reply
  9. toyin

    I am toyin frn nigeria, my woman age 23,discover a lump and it was diagonised to be fibroidmemoa,she was operated and the lump was removed,is it guaranteed dat itwont grow in her breast again,can it lead to cancer,can be treated. With any Drugs.thanks.

    July 29, 2013 at 20:03 | Report abuse | Reply
  10. kris Baylosis

    hi,im kris 27 yr old my question is last augt.8, i rcve my mdical result from the clinic that i have a consider fibro adenoma right breast do know what doest it mean?i have a plan to apply in abroad pls.help me to know what kind of firob that i have actualy it removing and i cant feel pain pls.help me.....thank you!!!!

    August 14, 2013 at 07:12 | Report abuse | Reply
  11. Salma Salah

    Hi .. I want to ask about fibroadenoma , if I did not remove it , it's OK or not ?

    I am 19 years old and I'm so scarry about the surgery ..

    advice me

    August 29, 2013 at 17:28 | Report abuse | Reply
  12. Dee

    Hi, im 19 years old and I just had my second lumpectomy. 2 years ago I had a fibroadenoma removed from my left breast and on November 8th, i just had 2 more removed from the same breast. Earlier this week, I developed a 5 cm seroma which was very painful. I was having pain with all 3 lumps and thats why i had them removed. I hope this helps some of you ladies with questions. Surgery was quick and its a very common procedure.

    November 24, 2013 at 03:29 | Report abuse | Reply
  13. m a taher

    My sister-in-law is feeling a breast lump which is fibroadenoma in FNAC, but she is still afraid as her cousin died of breast sarcoma and father died of metastatic thyroid cancer.

    March 9, 2015 at 07:45 | Report abuse | Reply
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  16. Nn

    Yearly mammogram? So old school. I study at a top Australian uni where we were given studies showing mammograms increase the chance of mutations in breast tissue. 6 DNA mutations is all it takes for a cell to become cancerous.

    People in 20-30s, don't get mammograms anyway because the breast density isn't suited for mammograms. Mammograms for breast density above 50 years old women. Get an ultrasound regularly instead.

    CNN published this. Unbelievable.

    September 12, 2017 at 03:40 | Report abuse | Reply
  17. Deccan-Clinic

    Hi, Very Nice article. Breast Cancer prevalence in women, as well as deaths, are increasing rapidly among Indian women, primarily because of changing lifestyle, increasing lifespan, low awareness and late detection. Breast cancer is the most common cancer diagnosed in Indian women
    You can also get best treatment & consultation on Breast cancer from One of the best expert in India, DR Anupama Mane at Deccan clinic.

    http://www.deccanclinic.com/blog/breast-cancer-treatment-pune/

    April 28, 2018 at 08:35 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.