Intermediate and long‐term outcomes of fibroadenoma excision in adolescent and young adult patients

Abstract

Fibroadenomas are benign breast masses that often occur in adolescence and young adulthood. Primary management options include observation or surgical excision, but little is known about long‐term outcomes after fibroadenoma excision in adolescents. In the present study, we reviewed the medical records of females aged 13‐35 years who underwent fibroadenoma excision at our institution from 1986 through 2010. Patients were included if they had excision of at least 1 fibroadenoma (confirmed by histopathology) smaller than 5 cm in maximal diameter. We collected information pertaining to clinical presentation, management, and outcomes. In addition, an investigator‐designed long‐term outcome survey was sent to 138 eligible participants to assess patient satisfaction, as well as the recurrence of fibroadenoma, and the need or desire for further surgical intervention. Most patients (126 of 138) underwent 1 operation for fibroadenoma excision. Three women underwent immediate breast reconstruction at fibroadenoma excision. Fifty‐seven patients completed the investigator‐designed survey (response rate, 41.3%) with a median follow‐up time of 13.5 (range, 2.0‐26.7) years. Nine of 55 patients (16.4%) reported postoperative breast asymmetry and the desire to pursue reconstructive surgery. Three survey responders reported breast pain. Fourteen of 56 women (25.0%) reported the diagnosis of 1 or more additional fibroadenomas after the initial excision; another 7 reported recurrence of the mass at the site of excision. Most survey participants were satisfied with the aesthetic outcome of their fibroadenoma excision; however, a small proportion believed that they would benefit from reconstructive breast surgery. The recurrence and development of additional fibroadenomas should be addressed by providers during counseling for treatment options and postoperative follow‐up.

A retrospective evaluation of pediatric breast fibroadenomas with mid‐term follow‐up results

“…Most interactions with the patient lack clear information about the chances of recurrent or metachronous tumor development after excision because of limited data. A survey study among females who had undergone < 5 cm fibroadenoma excision between the ages 13 and 35 years showed a cumulative rate for a newly developed fibroadenoma after excision was 40.8% within a median follow‐up time of 13.5 years 8 . This is a very similar figure obtained in our study.…”

Zur Therapie von Phylloides-Tumoren der Brust – eine Aufarbeitung von 66 Fällen mit Literaturübersicht

“…In einer retrospektiven Auswertung nach offener Exzision von Fibroadenomen ergab sich eine vergleichbare lokale Rezidivrate von 12 %, die des Auftretens weiterer Fibroadenome in derselben Brust von 25 % nach durchschnittlich 13 Jahren [16]. Unsere Rezidivrate lag für die benignen PT bei 3 % (1 von 38), 47 % (7 von 15) bei borderline und 38 % (5 von 13) bei malignen PT.…”

The Recent Research and Care of Benign Breast Fibroadenoma: Review Article

“…2) If it is becoming painful for the patient. 3) If there is any confusion in diagnosis between fibroadenoma and may other condition [12]. Then it is always better to take the lumps out and there is a new method that has recently come out into medical practice that is vacuum assisted fibroadenomas resection [13].…”