There are several types of adenomas but fibroadenomas are the most commonly detected in the breasts of women. While these can occur at any stage of a woman’s life, they are more often found among pre-menopausal women. This type of adenoma is mostly smooth and round, clearly outlined and palpable. Although they are usually found in isolation, some women may detect more than one at a time. These adenomas are generally painless, and they may expand or shrink over time. Fibroadenomas occur naturally, and their causes remain unclear, although it has been found that elevated progesterone levels owing to a pregnancy or hormonal therapy treatments can enlarge the lumps, while menopause often results in a decrease in their size.
Fibroadenomas generally require no special treatment where no other indicators are present. Indeed, screening every 6 months or on an annual basis is generally considered sufficient risk management due to the chances of them developing into cancer being less than 1%.
How do fibroadenomas differ from cysts?
Breast adenomas are a lump of hardened tissue, whereas cysts in the breasts are sacs that contain fluid. An ultrasound scan or breast aspiration procedure can usually adequately distinguish the difference between the two conditions.
What are the indicators that surgery may be required?
Surgery indicators are classified into the following 4 main types:
- An enlargement of the adenoma owing to certain risk factors, such as hormone changes, a pregnancy, breastfeeding, or hormone therapy
- Pain from the adenoma that begins to affect the daily life of the patient, such as increased pain during her period
- The lump enlarging to beyond 3cm in length or increasing to over 2cm before the age of 30
- Patient anxiety. Some patients may not want to leave the adenoma untreated, or it could be inconvenient for them to attend regular screening. Therefore, should those patients have multiple adenomas, they may wish to remove one or more of them, especially in cases where the aforementioned indicators are present.
What treatment options are there?
Bumrungrad Hospital currently offers two main forms of procedures to remove benign adenomas, as follows:
- Traditional surgery: Surgeons will remove the adenoma in its entirety as well as some of the surrounding tissue, which means patients will be left with scarring following the procedure.
- Cryoablation: This process involves injecting an extremely cooled liquid into the adenoma, destroying that tissue immediately. The liquid and destroyed cells are then broken down by the body and absorbed within 6 months of the procedure taking place. Cryoablation treatment is a minimally invasive form of treatment that only requires a few, tiny injections to be made.
What complications are associated with these procedures?
- Infection: The chances of infection are significantly reduced due to sterile techniques being employed during the procedure itself, as well as through the prescription of antibacterial medication post-surgery.
- Pain: Some patients may experience pain following their procedure. For traditional forms of surgery, medical staff will administer NSAID drugs to combat the pain. However, cryoablation results in only minimal discomfort that can usually be managed with paracetamol.
- Frostbite: This condition can be caused by cryoablation, where the adenoma being treated is in close proximity to the patient’s skin. However, surgeons manage the risk of frostbite using a saline solution that acts as a barrier between the extremely cool fluid and the skin.
The Breast Care Clinic at Bumrungrad Hospital offers diagnosis and treatment for all forms of breast adenoma. Indeed, our experienced team of specialists work alongside a multidisciplinary team with high levels of knowledge and expertise, enabling effective treatment for all types of breast condition.
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