Defining Multiple Fibroadenomas: A Systematic Review of Clinical Characteristics and Management

This review systematically evaluates the published literature on multiple fibroadenomas (MFAs) of the breast, focusing on clinical presentation, diagnostic challenges, and treatment strategies. A systematic search of PubMed, Medline, Scopus, and Embase from 1948 to June 2025 was conducted using a Boolean search strategy following the PRISMA 2020 guidelines. Of the 409 studies initially screened, 43 met the inclusion criteria. The level of evidence was assessed using the Oxford Centre for Evidence-Based Medicine guidelines, and 72% were found to be of Levels 4 and 5. MFA most commonly affects adolescents. Bilateral involvement was observed in 64.6% of patients, and more than 10 lesions were present in 52% of cases. Risk factors included hormonal contraceptive use, family history, and cyclosporine therapy. Ultrasonography was the most common diagnostic tool, followed by MRI and FNAC. Treatment was mainly surgical, with recurrence noted in 15.4% of patients. There was no evidence to suggest that the risk of cancer in MFA was greater than that of solitary FA. The review highlights inconsistencies in MFA definitions and calls for consensus on diagnostic criteria, prospective research, and the creation of standardized treatment algorithms to improve care and outcomes for this particularly distressing subset of benign breast diseases.