painful fibroadenoma

Hi, I’m new to this forum. I found a lump last year fall 2007. I work at an OB/GYN clinic and had one of the nurse practitioners do a breast exam. She said it felt like a cyst and that we should just watch it. I had her check it again a few months later. She called one our docs in the room and had him examine it. He said the same thing, a cyst but to watch it and leave it alone otherwise. He said he wasn’t worried. So by summer 2008 it was still there and a little more tender. I asked our NP to exam it again and she said this time maybe we should have an ultrasound done since I was worried and it was still there. I had an ultrasound and a mammogram. They didn’t see anything. As in, they only saw normal breast tissue, and didn’t even see the lump. The radiologist suggested a consult with a general surgeon because they felt the palpable lump could not see it on either mammogram or ultrasound.

I went to see a general surgeon and he finally said it was a fibroadenoma. He suggested to remove it or watch it. He said he really didn’t want to do a biopsy because if it came back normal, there would be the chance that they hadn’t gotten the biopsy in the right spot, since it is so movable. I opted for observation. I went back 3 months later and he said the same thing, he’d rather remove it. It doesn’t "seem " to have gotten bigger but I can’t tell for sure. It is definately more tender.

I am 27 and on birth control pills. I have noticed that my breasts are very tender on my pills, when I am off them for the pill free week, my breasts go back to normal and arent’ tender anymore. But usually the lump is still painful. It has gotten more tender in the last 3 months . This worries me , as does the fact that they never did see the lump on mammogram or ultrasound. Everything I’ve read said that a fibroadenoma should show up on a mammogram. How can I be sure its really a benign tumor when they couldn’t see it, and they won’t do a biopsy? I am leaning toward removing it. They never have said how big it is. It feels like it could be an 2 or 2.5 cm by my guess. but thats just a guess.

Is it usually adviced to go off birth control when you have a fibroadenoma? They never mentioned this to me, but I read online that they are sensitive to estrogen and sometimes grow more in response to it. Also I am hoping to try to get pregnant in the next year, and I wondered what affect this would have on a fibroadenoma if I left it? If I get it removed , do they ever grow back, especially with birth control pills?
Thanks!!

Hi Muddygrl,

Welcome to the Breast Cancer Care chat forums, I’m sure there’ll be other users along shortly to help answer your questions.

In the meantime I have posted below for you the link to BCC’s publication on Fibroadenoma’s for you to read. You can download this directly from your computer. I hope this helps.

breastcancercare.org.uk/content.php?page_id=637

Kind regards,
Jo, Facilitator

Dear Muddygrl,

Women with palpable lumps should be referred urgently (seen within 2 weeks) because the small number of referred women who do turn out to have breast cancer need to be treated quickly. Referral guidelines are as follows:

NICE guidelines (England & Wales) nice.org.uk/nicemedia/pdf/Improving_outcomes_breastcancer_manual.pdf
SIGN guidelines (Scotland) sign.ac.uk/pdf/sign84.pdf

Where lumps are palpable then diagnosis is carried out by Triple Assessment.

The Triple Assessment consists of clinical examination (the consultant examines the woman’s breasts), imaging (a mammogram or ultrasound is carried out) and histology (a few cells are taken from the lump by fine needle aspiration or core biopsy and are examined under a microscope by a pathologist). These three tests are the recommended way of diagnosing breast cancer in both the above guidelines and together have an accuracy of 96.4%. (Mammography alone in younger women can have an accuracy of 60 %). From your previous message it seems that you have not had a fine needle aspiration or biopsy.

Please go back and insist on having a fine needle aspiration or biopsy. I say this with some feeling. I successfully sued the NHS because back in 2002 I was referred to a breast clinic and didn’t receive the Triple Assessment. I saw a senior house officer who carried out a clinical examination and (reluctantly) a mammogram but failed to carry out a fine needle aspiration or biopsy. He told me that I had two fibroadenomas. Nothing showed up on the mammogram (this often happens in younger women with dense breast tissue). It wasn’t until a follow-up appointment with a consultant who did a fine needle aspiration that I was correctly diagnosed with two malignant tumours.

Having said please don’t panic. Most lumps are benign. However, get a fine needle aspiration/biopsy done. Be firm with the medics. If they won’t cooperate ask them to put their decision not to do a biopsy in your medical records (and check that they have done so) and then go to your GP and get referred elsewhere.

Hope this is helpful. Again don’t panic - most lumps are not cancer!

Good luck,

Sue

Dear Muddygrl,

Women with palpable lumps should be referred urgently (seen within 2 weeks) because the small number of referred women who do turn out to have breast cancer need to be treated quickly. Referral guidelines are as follows:

NICE guidelines (England & Wales) nice.org.uk/nicemedia/pdf/Improving_outcomes_breastcancer_manual.pdf
SIGN guidelines (Scotland) sign.ac.uk/pdf/sign84.pdf

Where lumps are palpable then diagnosis is carried out by Triple Assessment.

The Triple Assessment consists of clinical examination (the consultant examines the woman’s breasts), imaging (a mammogram or ultrasound is carried out) and histology (a few cells are taken from the lump by fine needle aspiration or core biopsy and are examined under a microscope by a pathologist). These three tests are the recommended way of diagnosing breast cancer in both the above guidelines and together have an accuracy of 96.4%. (Mammography alone in younger women can have an accuracy of 60 %). From your previous message it seems that you have not had a fine needle aspiration or biopsy.

Please go back and insist on having a fine needle aspiration or biopsy. I say this with some feeling. I successfully sued the NHS because back in 2002 I was referred to a breast clinic and didn’t receive the Triple Assessment. I saw a senior house officer who carried out a clinical examination and (reluctantly) a mammogram but failed to carry out a fine needle aspiration or biopsy. He told me that I had two fibroadenomas. Nothing showed up on the mammogram (this often happens in younger women with dense breast tissue). It wasn’t until a follow-up appointment with a consultant who did a fine needle aspiration that I was correctly diagnosed with two malignant tumours.

Having said this please don’t panic. Most lumps are benign. However, get a fine needle aspiration/biopsy done. Be firm with the medics. If they won’t cooperate ask them to put their decision not to do a biopsy in your medical records (and check that they have done so) and then go to your GP and get referred elsewhere.

Hope this is helpful. Again don’t panic - most lumps are not cancer!

Good luck,

Sue