27.01.2022 | Review Article
Management of Multiple Breast Fibroadenomas, Literature Review
verfasst von:
Michael Faheem, Sunreet Randhawa, MDZaker Ullah
Erschienen in:
Indian Journal of Surgery
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Ausgabe 6/2022
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Abstract
Multiple fibroadenomas (MFAs) account for 20% of breast fibroadenoma cases, and their management poses a particular challenge for two reasons; firstly, the controversy of whether they need any active management, and secondly the potential risks and complications of different management plans. We aimed to provide an overview of different management protocols for MFAs, to help in subsequent decision making and to provide a guide towards best practices. An electronic search of Medline and Embase database for English literature reporting on MFA management was performed in June 2021. Forty-eight articles reported on MFA management approaches with their cons and pros. In non-operative approach, MFA resolved spontaneously in many cases, therefore avoiding unnecessary intervention, but the true pathology of these MFA-like lesions remains uncertain. Conventional surgical excision may represent an overtreatment of likely benign disease, with potential surgery complications and cosmetic concerns. Vacuum-assisted excision is a less invasive approach with better cosmetic results but still entails risks of haematomas and incomplete lesion removal. The experience with ablative procedures for MFA management is very limited. A balanced approach tailored to patient wishes and risks, and considering the available expertise and facilities should therefore be followed.