Yesterday, we performed a marathon fibroadenoma surgery, where we removed 39 fibroadenomas from both the breasts (19 from the right breast and 20 from the left) just by making one incision in each breast. We used a crescent incision in both the breasts and comfortably removed fibroadenomas measuring as big as 5-6 cms through that incision. The entire procedure lasted 2 hours and the patient was discharged the same day.
Although the smaller fibroadenomas could have been left behind (because they are not malignant) but the patient was very apprehensive about them and wanted all of them removed. The importance of the single incision (periareolar crescent) is that it makes the end cosmetic result quite good. I am sharing some intra-operative pictures in this post. Will update the post-operative and follow-up pictures soon.
Marking of the crescent incision.
Fibroadenomas marked along with the incision. Smaller lesions were not marked.
6×7 cm fibroadenoma removed through the incision
5×5 cm lesion removed through the left breast
Starting the closure. Will share the post-op and follow up pictures soon
Random Reflections of a Breast Cancer Surgeon 
I appreciate what you did in surgery for the patient and she is now free from all the lumps she had. My question for you is .Was it worth it removing all the lumps from both breast.i belive you did not put in a drain as well with a lot of dissection happening in both the breast that itself increases the chances of having seroma. Please guide me for my queries as I ask them as a trainee surgeon at Pakistan.
Dear Wahid,
Thank you for your comments and you have raised couple of very pertinent points. We would not have removed all the lesions but the patient was paranoid about these lesions being malignant and despite counselling her, she insisted that all lesions be removed.
For patients who undergo lumpectomies, BCS or extensive dissection like in this case, we do not put drains but we apply compression dressing for 5 days. Some amount of seroma is inevitable and the books on breast surgery have a divided opinion regarding this.
Hope I have answered your queries.
sir,
In this case is simple mastectomy is preferred surgery?. keeping in mind that recurrence of fibroadenoma.
Dear Pavan,
Mastectomy is usually not performed for benign conditions. There is certainly no indication of mastectomy in fibroadenomas as well.
Thanks.I would like to see the compression dressing next time you put it.Good luck
Hi there, I would like your opinion on a situation. I have a Fibroadenoma that has been biopsied on over 9yrs ago. Now another 2 lumps came up that radiologist and breast surgeon want to leave with no biopsy as the two look identical. Is this okay to do so? I’m 30 with no family history.
Also, I have what feels like a fibroadenoma in the opposite breast but its right at the top underarm area. Mobile and firm. I didnt know it was there at my last surgeon visit and cant go back for 6months. Is it possible to be fibroadenoma that far up?
Thanks T
Dear Tia,
Thank you for asking your query. Fibroadenomas are benign lesions and if they are small, they can be left as it is. They have a typical appearance on an ultrasound and each and every lesion does not require a biopsy. Please share your ultrasound report with me on breastcareindia@gmail.com or rohankhandelwal@gmail.com and I will be able to give you a better opinion.
It is possible to have a fibroadenoma in the underarm area as well, as some ladies have accessory breast tissue in that area.
Hope I have answered your query.
I don’t have a copy of my ultrasound report. Where can I get this? All I was told was first the dr (radiolagist) did a scan. He found my old fibroadenoma (biopsied one) and then found the new one and very excitedly told me 10 out of 10 thy both look like fibroadenomas and at age 30 no more needs doing. Saw breast surgeon shortly afterwards who offered surg but said no medical reason to have done so I said if thy are b9 then leave them.
This other one I am trying to convince myself its nothing to do with a Lymph node. My GP said its not a lymph node it moves well darts away from my finger and is firm to me it feels like a fibroadenoma. I’m always making myself sick with worry. I will try and get my report and mail it you.
Thank you for your reply 🙂
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