Do Fibroadenomas Have to Be Removed Before Breast Augmentation?
Thank you for the question. A lesion that has been worked up and found to be a benign (such as a fibroadenoma) can be removed during the time of breast augmentation surgery. This is especially true if the lesion is close to the planned incision for the breast surgery. Best wishes.
It would be worthwhile having the opinion of an oncologic breast surgeon
Your are asking the right questions. Certainly your youth, family history and stable breast mass favors a benign lesion. Depending on the location of the lesion within the breast, a breast augmentation may alter you ability to follow it over time. Before proceeding further, it would be wise to see an experienced oncologic breast surgeon to have his expert opinion from an oncologic surveillance viewpoint before proceeding with breast augmentation.
Removing a breast mass before breast augmentation
You need to have this mass biopsied before having breast augmentation-you don't know for sure if this is a fibroadenoma yet. This can be done by a general surgeon or by a plastic surgeon at the time of breast implant surgery. The mass can be sent for a frozen section-which is where a pathologist can look at the tissue immediately- and give a diagnosis before the breast implants are inserted. Your plastic surgeon needs to have access to this type of service at his/her surgery center or hospital.
If you are having any symptoms from this mass you should certainly have it removed before your breast augmentation.
You don't have a diagnosis
Although the lump has not changed over the past one year, I still think it should be removed prior to breast augmentation or at least have a needle biopsy. The ultrasound you had showed a possible fibroadenoma. So you do not have a firm diagnosis of what this could be.
Fibroadenomas and breast augmentation
Fibroadenomas are benign (non-cancerous) and most are asymptomatic and painless. They appear as well-circumscribed, rubbery, mobile masses. Most are solitary, but up to 25 percent of patients have multiple tumors.
Adult women with fibroadenomas have a higher risk for developing breast cancer than women of similar age in the general population. Features of the fibroadenoma seen under the microscope influence this risk. There have been no documented reports of malignancy occurring within a preexisting fibroadenoma in an adolescent. Small fibroadenomas typically do not distort the breast, and over half of these lesions will decrease in size over 5 years. For these reasons, most fibroadenomas can be followed with yearly examinations as appears to be your case. If you removed every single fibroadenoma in every patient more than half of those operations would be unnecessary. However, because this conservative approach can be a source of anxiety for the patient and her family, excision rather than observation is frequently the treatment of choice.
Fibroadenomas can be removed by enucleation without removal of any surrounding breast tissue with minimal risk of local recurrence. Mastectomy is not required, and no other treatment is required. In your specific case the questions should be what happens if you get the augmentation and leave the fibroadenoma in place. The answer is most likely nothing but since the surgeon is in there anyways examination of the fibroadenoma or part of it under the microscope would not be a bad idea. If it is easier to remove at the time of breast augmentation vs. afterward should it become problematic that should also be taken into account.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Fibroadenoma and Breast Augmentation
If you were going to have the mass removed, you should have had it removed a year ago. Now you have more information and know that the mass is not changing. That, together with the appearance that says it is benign, should be enough to safely just watch it. If it ever does change, you would need to biopsy it immediately. If you are worried about it, your surgeon could always biopsy it at the time of your augmentation.
Fibroadenomas and breast augmentation
Thickened areas on breast examination may be fibroadenoma, though you may still have a breast augmentation if the evaluation is complete and there is no need for any further treatment. You may have a fibroadenoma, though there are other benign breast thickenings, none of which plastic surgeons remove before breast implants as they don't 'become something' and there is no need to remove them. Before and after breast augmentation, regular examination, and regular mammogram when indicated is key.
Best of luck,
i would have it removed. you never know the diagnosis until it is under the microscope. i guess we are all colored by experience, but i have seen 3 women all under 25 who were watching fibroadenomas which ended up being malignancies. this is probably not the popular answer but it removes the doubt . good luck