When to delay fibroadenoma surgery?

BrooklynWoodpecker

I have a large fibroadenoma that had started 3 years ago during pregnancy: it was shrinking with each ultrasound, but it grew during the pandemic. I stopped nursing my 2 year old last week. I need to decide whether to remove the fibroadenoma next week or in 2 months. I'd rather get it out sooner, but if it would be a better outcome or an easier recovery if I wait, I'd rather wait. The mass might shrink and breast is going to change as it adapts to not nursing. The surgeon is being non-committal about which is better.

The only peer-reviewed information I've found is a single sentence from a 1998 paper, citing a 1996 textbook and 1989 literature review. This paper says that fibroadenomas tend to shrink after cessation of lactation, so excision should be delayed until hormonal levels are normal, so that there will be a smaller incision. More recent papers don't mention the factor of lactation.

I'd appreciate hearing any thoughts or experiences.

kmartin3243

Out of curiosity, why are you needing to remove it? I have multiple ones and a couple of large ones, but it's been advised not to remove them because it would be a bit disfiguring and they are not cancerous. The doctor even said the chances are great that more will pop up and it wouldn't make sense to keep removing them.

Monarchandthemilkweed

Ialso have a history of fibroadenomas and was given the same advice. Don’t remove, you will likely develop more and I did.

kmartin3243

Exactly. I have spoken to multiple radiologists and they said it would be an unnecessary surgery. The chances are great that another one would pop up. I have them in both breasts, and they just keep appearing. I have thought about taking a more permanent approach to getting rid of most of the breast tissue, but apparently that may not do any good and is also unnecessary.

BrooklynWoodpecker

Wow, I'm so glad to hear from so many of you! My grandmother had the same issue and had a lot of invasive biopsies through her life --- I think this must have been before the days of commonly used needle biopsies -- and I remember sometime in the 1990s she mentioned that she had had a lot of chunks taken out of her breasts that were always benign and it was disfiguring. That is why I didn't do anything about the other one which was a little over 1 cm and then disappeared. The concern is that this one started at 3 cm, went down in size but now it is 5 cm, so if it keeps growing it would be disfiguring in itself as well as possibly convert to Phyllodes. I ended up deferring the surgery and will see the surgeon again in 2 months. In the meantime I'm trying to lose baby weight in case that's helpful. My regular doctor did some blood tests and nothing was remarkable, so no biomarker to target with any type of medication.

kmartin3243

I understand. My mom had the exact same issue as your grandmother -with multiples in both breasts and many removals. I think it's smart to recheck again in two months. In my situation, the breast surgeon (I was referred to) was ready to slice me open the next week, but the radiologists said not necessary or beneficial. We've already verified that it's not cancer. They put me on a watch and wait of three months, then 6 months because of the high likelihood others would pop up. They sure did! One of my larger ones eventually shrunk about a centimeter and the other is still the same size. Sorry you're going through this..it's not a fun experience.

LivinLife

I too have had fibroadenomas - there was never any discussion of removing them....

BrooklynWoodpecker

Here's my fibroadenoma update.

As background: 10 years ago, I had my first fibroadenoma, which finally became undetectable after 10 years. Now I have another, confirmed 2 months ago by core needle biopsy. I stopped nursing 2 months ago after a total of 6 years of nursing my 2 children, so I think it may take time for things to go back to normal.

Earlier this week, I saw the breast surgeon and also had an ultrasound. The mass has not gotten smaller. They still want me to remove it. Before the surgery, the radiologist also wanted me to have a full mammography to detect anything else that should be removed at the same time as the fibroadenoma, which I declined because I don't want to go looking for trouble. I don't want to go down the path of my grandmother to have breasts covered in scars from many benign masses removed.

I would consider getting a second opinion, but I am pretty sure that given the size of this fibroadenoma (5 cm at largest dimension --- officially "giant") that there isn't a single doctor in the city that would tell me that I should keep it in.

Even so, it still seems like there's a good chance that it's going to stay the same and gradually get smaller rather than bigger over the next year.

So I'm confused.

LivinLife

So it sounds like the surgeon prefers to remove it though from what I heard the last part of your post you may want to wait another year? It is a large fibroadenoma. As I said I had fibroadenomas too with no discussion, ever, of removing them. I do not remember how large mine were though I'm sure they were not even close to 5 cm..... That's a tricky situation. A second opinion may be a good idea - at least on the removal or not? Then you can decide what you're most comfortable with given information from two surgeons.... Let us know... hopefully others will comment yet too....