Synopsis
Distinguish a concordant fibroadenoma from cellular fibroepithelial lesions and phyllodes tumour, then select observation, further sampling or excision according to diagnostic certainty, growth and patient priorities.
- A fibroadenoma is a benign biphasic lesion containing epithelial and stromal elements; it commonly presents as a well-defined mobile mass in a younger patient.
- Rapid enlargement, large size, older age at presentation or imaging-pathology discordance raises concern for a phyllodes tumour or another diagnosis, even when a previous core suggested fibroadenoma.
- Triple assessment must be concordant: the clinical mass, radiological target and sampled tissue should describe the same lesion and support the same benign explanation.
Investigation priorities
Characterise a palpable fibroepithelial lesion and provide a route for representative needle sampling.
Management branches
A 24-year-old presents with a 2 cm mobile breast mass that has not changed over four months and has no skin, nipple or nodal abnormality.
- Map the lump clinically and ask about growth, pregnancy, hormone exposure, previous masses and family history, while avoiding a definitive benign label from mobility alone.
- Arrange targeted imaging; if ultrasound shows a classic benign mass, decide with the breast team whether age, appearance and local protocol require core confirmation.