Comparison of management and treatment options for recurrent breast fibroadenomas in adolescent females
Sherwani, Alisha Magdalena
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Breast fibroadenomas account for approximately 25% of all lesions in asymptomatic women, resulting in large health care costs every year. There are 3 different variations of the disease: simple, juvenile giant and multiple. Patients may have different management and treatment options available to them depending on which variation they have. Of particular interest are female adolescents, who are at most risk for developing these lesions. With this age group not only is it important to pursue options that are minimally invasive and effective, but there are psychosocial implications to consider regarding the cosmetic changes that may occur with the disease, as well as generalized anxiety over having a breast lump. These issues are important to consider for physicians when recommending a treatment or management option. After a systematic review of all options available, it appears the best management method is the conservative treatment as it minimizes invasive intervention and operates on the principle that 10-40% of lesions regress on their own; however, there may be times that adolescents are uncomfortable with this treatment due to anxiety and other uneasiness about having a lesion remain in their breasts, despite the low chance of malignancy associated with breast fibroadenomas. Minimally invasive procedures are being developed in order to minimize possible iatrogenic injury to the developing breasts as well as maintain efficiency and good cosmesis post-procedure. Cryoablation is a minimally invasive technique utilizing extreme cold temperatures for lesion excision that is not currently widely used, however it has great potential to replace traditional open surgical excision.