Asked by msam (Female; 39; 78871; htn, asthma; Relevant drugs:norvasc 5 mg, provental inhaler prn ) on Wed 23, Jun 2010 06:28pm for $19.00:
	From the time that I was 36 I began to get mammograms, the first time I thought that I felt a lump in my breast that year nothing was seen on mammogram or ultrasound. The two years following after mammogram a lump found and after having it removed each time it was a fibroadenoma both were about 2mm. This year another lump was found this one larger 1.5cm, all in the same breast. This time the radiologist suggested a core needle biopsy and place a marker to follow it. I have an appt. with the breast specialist but this time I am more concerned this is 3 years of findings and now this one is bigger. In the past I have opted to have the whole lump removed because my mother has a history of breast cancer. In her thirties she was diagnosed with fibrocystic breast disease. At age 56 after a surgery to remove a cyst that grew large in size breast cancer was found. With this in mind, even though I do not have fibrocystic breasts I am still concerned that these fibroadenoma are just a sign of what is to come and after dealing with this for 3 yrs now I just want to have a mastectomy and be done with it and not have to worry any more. Its grueling to go back and year after year have the same thing happen. Is having a mastectomy an unreasonable thought at this point.
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	Answer by Dr.Kokil Mathur (doctor) on Wed 23, Jun 2010 07:09pm: Hi! Your concern is very palpable and naturally so. Yes, it is very grueling to go to the doctor again and again for this especially with a similar close family history. What I can suggest is that it is wiser to do so, then go for mastectomy at this stage. Simple mastectomy never helps. This is usually done along with removal of lymph nodes of draining area. This has its own set of side effects and such a radical surgery is only attempted if there is a need. You can discuss with the breast specialist when you meet A fibroadenoma which is 3cm large is a borderline case for surgery. If it grew painful, or grew in size or showed atypical cells, it needs to be removed, either by lumpectomy or by laser or cryo ablation. Generally fibroadenomas are benign growths. However in cases where they are multiple growths or painful growths (you have been having single growths only, all less than 3cm), treatment is aggressive (surgical removal) as these fibroadenomas have the potential to become cancerous. Also if there is a family history of breast cancer then also an aggressive treatment route should be followed, which you have been doing in the last few years. It is really difficult to say whether mastectomy will help, or whether it will result in other breast getting affected. I have enumerated the points to be considered. Please consult the breast specialist and go as per his advice as it is a difficult decision to take on net. Please let me know if there is any thing else and do keep me posted. Take care!
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	Comments: Comment by Dr. A. Srivastava on Wed 23, Jun 2010 08:31pm: Hello Mam, I completely agree with Dr Kokil's opinion that mastectomy is a more radical resection surgery in which draining lymph nodes involved are also removed along with breast tissue. This procedure is indicated in frank cancerous lesions. As a matter of fact, fibroadenoma is a benign growth composed of glandular and fibrous breast tissue. They slightly raise the risk of cancer. Average size of fibroadenoma is 1-5 cm and they may growth as big as 15cm. They may vanish or re-appear under the influence of estrogen during various stages of menstrual cycle.Therefore the exact treatment depends on symptoms, sign, any change and persistence of the lump. Asymptomatic fibroadenoma with no pain, tenderness, no recent size change with no biopsy findings are just monitored regularly with follow-up ultrasound or mammography. Large symptomatic fibroadenomas can be removed by lumpectomy or cryoablation etc. i would also say that repeated surgery of benign lesion which is actually present in 10-20% of all women between 15 to 30 years seems less rationale approach as every surgery may produce a scar tissue(may be more prone to abnormal changes than normal tissue) and also there is unnecessary cutting of healthy tissue. Best thing is that you should talk to breast specialist about the same and as marker is already prepared so close monitoring of any growth of lump may be considered. This may help avoid repeated surgeries. Take care. Comment by Unregistered on Sun 01, Aug 2010 08:51pm: te