DMS - Digital Mammography & Women's Imaging
What Is Busy Breast Syndrome A.K.A. Fibroadenoma?
Fibroadenomas, also known as busy breast syndrome or dense breasts, are solid, benign tumors that grow in the breast. These are given importance these days due to increasing public awareness of breast cancer. Also, these are common in women aged between 15 to 35 years and affect most women in their reproductive years. However, in rare cases, men can also develop fibroadenomas. Many women tend to get upset over breast changes. These changes might lead to stress and depression.
Fibroadenomas vary in texture as they might feel either firm, hard or rubbery and they have a distinct shape with well-defined borders. They also vary in size as they can grow larger than a golf ball and shrink on their own and become smaller than a marble.
They feel tender and firm before an individual’s period and even become tender if they are prodded. Fibroadenomas can grow bigger during pregnancy, breastfeeding, and shrink in size after menopause. They feel like a big ball, moving to and fro under your breast's skin when being examined, hence the name busy breast syndrome. Fibroadenomas are made up of an overgrown lump of glandular and supporting tissues.
The causes of fibroadenomas are unknown but it is thought that these develop due to prolonged sensitivity to estrogen hormone.
Fibroadenomas can also be developed by taking oral contraceptives before the age of 20 years. Some women even state that avoiding consumables like chocolate, tea, coffee, and soft drinks have improved fibroadenomas' symptoms however, no such scientific study has been able to establish a link between these foods and improvement of symptoms.
The risk to get busy breast syndrome can be affected by hormone levels and those women who have a family history of breast cancer have a greater risk of developing breast cancer later on in life.
Fibroadenomas can also cause physical deformity due to big size and might result in emotional distress and discomfort in those affected by this disease. However, these fibroadenomas are not usually risky and do not cause any complications for the most part. Studies show that only 0.12 % of fibroadenomas become malignant or cancerous.
Fibroadenomas are known to be found in about 10% of women, with African-American women having double the risk for developing fibroadenomas, as stated by the study of the American Society of Breast Surgeons Foundation. Their potency varies from woman to woman. Some women have a single fibroadenoma and some might have multiple fibroadenomas in either a single breast or both.
Mostly, the syndrome is diagnosed during a physical exam and these benign tumors are observed as a smooth mass in the breast which is painless generally.
Fibroadenomas can also be diagnosed with the help of the ultrasound test, which is considered the best test for their detection. Ultrasound usually shows fibroadenomas as a firm lump in a breast that cannot be labeled as a fibroadenoma unless it is diagnosed with the help of a biopsy.
It is the only accurate way to determine whether a lump is a fibroadenoma or just a lesion. In this procedure, a needle biopsy is used which helps to distinguish between a fibroadenoma and a breast lesion. These lesions can be varied and may include a phyllodes tumor which is a rare breast tumor that resembles fibroadenomas a lot. (Surgeons, 2008)
The lesions are also known as fibroepithelial lesions, that can include both fibroadenomas and phyllodes tumor. However, if a fibroadenoma displays calcification or cysts, it might be called a complex fibroadenoma. Mammography might not be the best to detect fibroadenomas therefore ultrasound and biopsy are preferable.
Young women not displaying any harmful or abnormal features are treated with observation only. Not all fibroadenomas are harmful natured and do not need any removal.
Fibroadenomas should be excised only if they are larger than 2 to 3 cm, according to some studies. However, if fibroadenomas cause discomfort or any growth is observed in imaging, then these should be surgically removed. For the fibroadenomas that are not removed, those must be observed under ultrasound every 6 months for about 2 years. During this time, if they stay benign and unchanged in size, further observations should be stopped as they are labeled as non-harmful.
Apart from surgery, fibroadenomas can be removed by invasive cryoablation. This procedure involves inserting a probe through an incision in the skin, to freeze the fibroadenoma. Not all fibroadenomas can be treated via cryoablation. As they must be previously diagnosed by a biopsy to confirm the diagnosis. Another condition is that it should be smaller than 4 cm in diameter and sonographically visible on ultrasound. Individuals undergoing cryoablation should have a regular follow-up by their physician.
Fibroadenomas are varied in types and comprise of:
This type of fibroadenomas contains rapid changes, caused by the overgrowth of cells, also known as hyperplasia.
This type is quite common as it is mostly found in girls between the ages of 10 and 18 years. They can grow quite larger but most of them shrink with time, and some might even disappear later in life.
These fibroadenomas are quite gigantic and can grow larger than 5 cm. They require removal because they put pressure or replace other breast tissues.
These are usually benign but some phyllodes tumors can become malignant. These cancerous tumors should be removed.
Fibroadenomas tend to be non-harmful in most cases, and do not lead to breast cancer. Sometimes women fear that they might develop breast cancer when they are diagnosed with a complex fibroadenoma but that does not mean that it will lead to developing cancer. Therefore, these fibroadenomas are nothing to worry about as these are quite safe generally, and should be less of a concern. If fibroadenomas are causing anxiety and showing signs of changing, then consultation with a general practitioner should be made.