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

Area of Science:

• Breast Health
• Benign Breast Conditions
• Fibroadenoma Research

Background:

• Multiple fibroadenomas (MFAs) represent a distinct subset of benign breast disease.
• Understanding their clinical presentation, diagnosis, and management is crucial for patient care.

Purpose of the Study:

• To systematically review the literature on multiple fibroadenomas (MFAs).
• To evaluate clinical presentation, diagnostic challenges, and treatment strategies for MFAs.
• To identify gaps in current knowledge and propose future research directions.

Main Methods:

• Systematic literature search of PubMed, Medline, Scopus, and Embase (1948-2025).
• Adherence to PRISMA 2020 guidelines for study selection and data extraction.
• Evidence level assessment using Oxford Centre for Evidence-Based Medicine guidelines.

Main Results:

• MFAs predominantly affect adolescents, with bilateral involvement in 64.6% and >10 lesions in 52%.
• Risk factors include hormonal contraceptive use, family history, and cyclosporine therapy.
• Ultrasonography is the primary diagnostic tool; surgical treatment has a 15.4% recurrence rate. No increased cancer risk compared to solitary fibroadenomas was found.

Conclusions:

• Inconsistencies in MFA definitions necessitate a consensus on diagnostic criteria.
• Standardized treatment algorithms and prospective research are needed for improved outcomes.
• MFAs, while distressing, do not appear to carry an increased risk of malignancy.