Difference between revisions of "Fibroadenoma natural history, complications and prognosis"

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==Overview==
 
==Overview==
 
Most patients with fibroadenoma are asymptomatic. If left untreated, patients with fibroadenoma may progress to develop a painless, mobile, and well-circumscribe [[breast]] lump. Fibroadenoma is a benign tumor that rarely develops any complications. Fibroadenomas commonly enlarge during [[pregnancy]] and involute after the age of [[menopause]]. The prognosis is generally excellent, and the 5-year survival rate of patients with fibroadenoma is almost equal to the normal population.
 
Most patients with fibroadenoma are asymptomatic. If left untreated, patients with fibroadenoma may progress to develop a painless, mobile, and well-circumscribe [[breast]] lump. Fibroadenoma is a benign tumor that rarely develops any complications. Fibroadenomas commonly enlarge during [[pregnancy]] and involute after the age of [[menopause]]. The prognosis is generally excellent, and the 5-year survival rate of patients with fibroadenoma is almost equal to the normal population.

Latest revision as of 03:33, 14 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ifeoma Odukwe M.D. [2] Haytham Allaham, M.D. [3]

Overview

Most patients with fibroadenoma are asymptomatic. If left untreated, patients with fibroadenoma may progress to develop a painless, mobile, and well-circumscribe breast lump. Fibroadenoma is a benign tumor that rarely develops any complications. Fibroadenomas commonly enlarge during pregnancy and involute after the age of menopause. The prognosis is generally excellent, and the 5-year survival rate of patients with fibroadenoma is almost equal to the normal population.

Natural History

  • The peak age of women at the time of diagnosis of a fibroadenoma is in their twenties.[1]
  • It takes about 12 months for most fibroadenomas to gain a size of 2 to 3 cm, wherefore they remain unchanged for several years.[2]
  • The lifetime of a fibroadenoma is about 15 years.[2]
  • After 5 years, there is approximately 50% likelihood of resolution of a fibroadenoma. Among the 50% not likely to resolve spontaneously, about 25% will not change and 25% will enlarge in size during follow up.[2]
  • Most fibroadenomas decrease in size via loss of cellularity or infarction with resultant calcification and hyalinization.[3]
  • The incidence of fibroadenoma evolving into a carcinoma is reported to be 0.002 to 0.0125%.[2]
  • More than 70% of fibroadenomas present as a single mass, and 10%–25% of fibroadenomas present as multiple masses.[3]
  • Fibroadenomas tend to grow during pregnancy and shrink after menopause.[4]

Complications

  • Fibroadenoma is a benign tumor that rarely develops any complications.[5]

Prognosis

  • The prognosis is generally excellent, and the 5-year survival rate of patients with fibroadenoma is almost equal to the normal population.[5]
  • In adolescents, the mass regresses completely between 10 and 40% of the time.[6]
  • Though not yet quantifiable, patients with fibroadenoma may be at increased risk of developing invasive breast cancer later in life. This risk is increased in women with complex fibroadenomas (fibroadenomas with cysts, sclerosing adenosis, epithelial calcifications, papillary apocrine changes, or more than 3mm in diameter), proliferative disease, or a family history of breast cancer.[6][7]

References

  1. Deschênes L, Jacob S, Fabia J, Christen A (July 1985). "Beware of breast fibroadenomas in middle-aged women". Can J Surg. 28 (4): 372–4. PMID 2990650.
  2. 2.0 2.1 2.2 2.3 Greenberg R, Skornick Y, Kaplan O (September 1998). "Management of breast fibroadenomas". J Gen Intern Med. 13 (9): 640–5. PMC 1497021. PMID 9754521.
  3. 3.0 3.1 Lee M, Soltanian HT (2015). "Breast fibroadenomas in adolescents: current perspectives". Adolesc Health Med Ther. 6: 159–63. doi:10.2147/AHMT.S55833. PMC 4562655. PMID 26366109.
  4. Ajmal M, Van Fossen K. PMID 30570966. Missing or empty |title= (help)
  5. 5.0 5.1 Fibroadenoma. Radiopaedia (2015) http://radiopaedia.org/articles/fibroadenoma-of-the-breast-1 Accessed on January, 29 2016
  6. 6.0 6.1 Cerrato F, Labow BI (February 2013). "Diagnosis and management of fibroadenomas in the adolescent breast". Semin Plast Surg. 27 (1): 23–5. doi:10.1055/s-0033-1343992. PMC 3706050. PMID 24872735.
  7. Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer WD, Rados MS, Schuyler PA (July 1994). "Long-term risk of breast cancer in women with fibroadenoma". N. Engl. J. Med. 331 (1): 10–5. doi:10.1056/NEJM199407073310103. PMID 8202095.



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