A 30-year-old woman presents with a well-defined, firm, mobile breast lump measuring 2 cm with characteristic ultrasound features of a fibroadenoma. Core biopsy confirms fibroadenoma without atypia. What is the most appropriate management?
- A Conservative management with clinical and imaging surveillance; excision for giant (>5cm), increasing size, atypia, or patient anxiety ✓
- B Immediate surgical excision for all fibroadenomas
- C Fine needle aspiration and drainage
- D Mammography and MRI breast for further characterization
Explanation
Fibroadenoma is the most common benign breast tumor in young women; most are managed conservatively as they tend to remain stable or involute spontaneously, particularly those under 3 cm confirmed on triple assessment (clinical, imaging, cytology/histology). Indications for excision include: giant fibroadenoma (>5 cm), increasing size, histological atypia, patient preference or anxiety, or diagnostic uncertainty. Vacuum-assisted excision (Mammotome) is an alternative to open surgery for smaller lesions. Annual clinical review is appropriate for conservatively managed fibroadenomas.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.