Fibroadenoma Surgery in Pune: Removing a Benign Breast Lump

What is a fibroadenoma?

A fibroadenoma is a benign (non-cancerous) breast lump made of glandular and fibrous tissue. It is one of the most common breast lumps in young women, most often found between the teenage years and the mid-thirties. It usually feels smooth, firm and rubbery, and moves easily under the fingers, which is why it is sometimes called a “breast mouse”.

Fibroadenomas are sensitive to hormones. They may grow in pregnancy and often shrink after menopause. Over time, many stay the same size, some shrink and some grow.

There are a few types:

• Simple fibroadenoma: the usual type.
• Complex fibroadenoma: contains other benign changes under the microscope.
• Giant fibroadenoma: larger than about 5 cm.
• Juvenile fibroadenoma: occurs in teenagers and can grow quickly.

A phyllodes tumour can look like a fibroadenoma on a scan but behaves differently and needs wider removal, which is one reason a growing lump is assessed carefully.

Who may need surgery, and how is a lump assessed?

Every new breast lump should be checked, even though most are harmless. Assessment usually includes three parts:

1. Clinical examination of both breasts and armpits.
2. Imaging: ultrasound for most women, and a mammogram as well when age or findings call for it.
3. Needle biopsy: a small sample of the lump taken under local anaesthetic to confirm the diagnosis.

Removal is usually advised when the fibroadenoma:

• is large or keeps growing;
• causes pain or changes the shape of the breast;
• has uncertain or unusual features on imaging or biopsy;
• is a giant or juvenile fibroadenoma;
• causes you ongoing worry, after the facts have been discussed.

What are the treatment options?

Option	Suits	Limitations
Observation with ultrasound	Small, biopsy-confirmed lumps, especially in younger women	Repeated scans; the lump stays
Surgical excision	Large, growing, painful or uncertain lumps; patient preference	A scar; small risk of contour change
Vacuum-assisted excision (image-guided)	Some smaller lumps, in centres that offer it	Not suitable for large lumps; may leave fragments
Removal with breast reshaping	Giant fibroadenomas that have stretched the breast	Longer operation and scars

For a very large lump that has stretched the breast, techniques from breast reduction surgery can help to restore shape after removal.

How is fibroadenoma surgery performed?

1. Marking: the lump is marked, sometimes with ultrasound guidance.
2. Anaesthesia: local anaesthesia for small, easily felt lumps; general anaesthesia for larger or deeper ones.
3. Incision: a cut is made where the scar will be least visible, often around the edge of the areola, in a natural crease, or in the fold under the breast.
4. Removal: the lump is removed whole, preserving the surrounding breast tissue.
5. Closure: the breast tissue is closed in layers to avoid a dent, and the skin is closed with fine stitches.
6. Histopathology: the lump is sent to the laboratory to confirm the diagnosis.

How should you prepare, and what should you ask?

• Bring all previous scan reports, images and biopsy results.
• Tell the surgeon about medicines that increase bleeding.
• Bring a soft, supportive bra to wear after surgery.

Questions to ask:

• Does my fibroadenoma need removing, or can it be watched?
• Where will the scar be?
• Will my breast shape change after removal?
• When will the laboratory report be ready, and who will explain it?

What is recovery like?

Time	What to expect for most patients
Days 1-3	Mild soreness and bruising; wear a supportive bra day and night
Days 2-5	Many return to desk work
About 1-2 weeks	Laboratory report discussed; stitches removed if not dissolvable
Weeks 2-4	Return to exercise and lifting as advised
12-18 months	Scar fades and softens

What are the risks of fibroadenoma surgery?

• Bruising or haematoma (a collection of blood), which occasionally needs draining.
• Infection, usually treated with antibiotics.
• Scarring, sometimes thick or dark.
• A dent or change in breast shape, more likely with large lumps.
• Change in nipple sensation if the lump was near the areola.
• New fibroadenomas forming elsewhere in the breast.

Contact your surgeon if the breast becomes very swollen, red or hot, if you develop fever, or if the wound discharges.

What results can you expect?

Most women go home the same day, recover within a few days and are reassured by the laboratory report. The scar is usually small and placed to be discreet. Continue to be breast aware after surgery and report any new lump.

What affects the cost of fibroadenoma surgery in Pune?

• Size, number and position of lumps.
• Anaesthesia: local or general.
• Imaging and biopsy before surgery, and the laboratory examination after.
• Facility, medicines and follow-up visits.

Removal of a breast lump is often a medical rather than cosmetic procedure, so some health insurance policies may cover it. Check with your insurer.