Diagnosis and management of fibroadenomas in the adolescent breast

Abstract

Fibroadenomas are benign breast masses that can present a management challenge in adolescent populations. Most fibroadenomas may be managed conservatively without surgery, but those masses that are symptomatic or increasing in size may require surgical excision. In adolescents, the implications of surgical intervention in the breast are unclear, and there is little outcomes data. In this article, the authors discuss the presentation, diagnosis, and management of fibroadenoma in adolescents. Key considerations for physicians in treating these masses in this population are reviewed.

Keywords: adolescent; breast; fibroadenoma.

Fig. 1

(A) Enlarging fibroadenoma of the left breast and giant fibroadenoma of the right breast in a 17- year-old female. (B) Giant fibroadenoma measuring 5.7 × 5.8 × 5.0 cm. Note the solid, multinodular, well-circumscribed features of the mass. The left breast fibroadenoma (not shown) measured 2.7 × 2.4 × 2.2 cm. (C) Intraoperative incision planning by the breast surgeon and the plastic surgeon. Immediate breast reconstruction was planned due to the large size of the right breast mass and anticipated breast asymmetry following excision. Local advancement flaps of superior and inferior breast tissue were performed via a vertical scar mastopexy approach. (D) Right breast defect postresection of giant fibroadenoma, involving the upper-outer quadrant. (E) Postoperative result at one year. (Courtesy of Valerie Lemaine, MD, MPH, FRCSC)