25 year old Malati, a mother of two, had travelled 2000 km, from the eastern corner of the country. She had a lump in her right breast, the size of a marble. She wanted it removed surgically. Clinical examination and an ultrasound showed unequivocally that the lump was a simple fibroadenoma – a very common condition, and the most frequent type of breast lump at her age.

“Why do you want it removed?” I asked. There was silence. “Is it painful?”. A shake of the head. “Is it growing bigger?” No. “Is it troubling you in any way?” No.  Then finally, “Are you worried it will turn into cancer?” A vigorous nod – yes.

As a surgical oncologist, I see many young women with breast lumps, wanting them removed for fear they may transform into cancer.

Fibroadenomas do not go on to become cancer. Simple fibroadenomas do not need to be treated at all, and many of them go away spontaneously.

There are a few rare instances when we would recommend close follow up or an excision of a fibroadenoma. These are:

1. The diagnosis is not certain, and cancer needs to be ruled out.
2. In an older woman with an atypical or complex fibroadenoma.
3. For very large lumps or when there is pain in the lump (not when there is pain in the entire breast).

Some women understand that a fibroadenoma is harmless, but get it removed for cosmetic reasons, or because they simply choose to – this is understandable. But many others undergo surgery because of a misconception that leaving it alone will lead to cancer or cause more lumps to appear.

The treating surgeon/oncologist often has to patiently explain to the patient and her family that the lump is harmless and can be safely left alone – this sometimes takes more time than actually performing the surgery. But it is worth the effort to convince the woman to avoid an unnecessary surgery.