Giant juvenile fibroadenoma: experience from a university hospital

Fibroadenoma is one of the commonest benign breast lesions in our outpatient clinics. Giant Juvenile fibroadenoma (GJF) characterized with their alarming rapid growth and gross disfigurement is less frequently identified.

A 14-year review (1990-2004) of all fibroadenomas presented to the Outpatient Department was undertaken. Demographic data, duration of symptoms, size at presentation, the use of radiological, cytological and histo-pathological modalities, surgical excision and follow up were all noted. Eight-Hundred-Sixty-Four cases were diagnosed as fibroadenoma by both clinical and radiological examinations and confirmed by FNAC. Patients with fibroadenomas <2 cm in size were followed up regularly in the out patients department, while those >2 cm underwent surgical excision. GJF were defined as those with >5 cm in diameter.

The total number of excised fibroadenomas was 202 (23%), while the remaining662 (77%) fell into the follow up category. GJF were diagnosed in 9 patients accounting for 4.5% of all excised fibroadenomas. Age ranged between 14-23 years.

However benign these lesions may appear, in view of the history of a sudden rapid breast enlargement as demonstrated in nearly all the clinical presentations, surgical excision remains the mainstay of treatment of such lesions in order to allow the previously compressed normal surrounding breast tissue to expand and retain its normal function and cosmetic appearance. The use of radiological modalities such as ultrasound and MRI may aid the diagnosis, limiting mammography to the older age group.