Principles of Treating Breast Fibroadenoma
The most effective treatment for breast fibroadenoma is surgery. Other treatments include traditional Chinese medicine (TCM), herbal therapy, and hormone therapy. Currently, except for surgery, TCM is primarily used, while hormone therapy is rarely applied.
Although surgery is the most effective method, it does not mean every detected fibroadenoma requires immediate surgery. Instead, surgical timing and indications must be strictly evaluated—not all cases require surgery. For example, unmarried women around 20 years old with small tumors should prioritize clinical observation, possibly supplemented with TCM if needed. Married young women with tumors over 1 cm should consider surgery before pregnancy. If a new fibroadenoma appears during pregnancy or lactation, first observe its growth pattern; if rapid growth occurs, immediate surgery is indicated. For women over 35, especially postmenopausal women newly diagnosed with fibroadenoma, immediate surgical excision with intraoperative frozen section examination is recommended. For recurrent cases, malignancy must be suspected, as each recurrence increases the risk of malignant transformation. Thus, surgery is generally recommended, with slightly wider excision margins, followed by TCM to reduce malignancy risk.
Surgery for breast fibroadenoma should preserve breast function and aesthetic appearance. Since most patients are young women, many of whom are unmarried, when surgery is required, consideration must be given to future breastfeeding needs. A radial incision centered on the nipple should be used to avoid damaging ducts. Incisions should be as small and aesthetically pleasing as possible to minimize scarring after healing. Additionally, routine pathological examination is mandatory during surgery. It is incorrect to assume that since fibroadenomas are benign and rarely malignant, pathology is unnecessary. Routine pathological examination and retention of tissue samples for a period enhance diagnostic capability and contribute to academic advancement.
Treatment of breast fibroadenoma with TCM will be discussed in detail later.
Evaluation criteria for treatment effectiveness are:
(1) Cure: Complete disappearance of the mass.
(2) Improvement: Reduction in mass size.
(3) No change: No alteration in mass size.
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