How long before a fibroadenoma would shrink

[Cowgirl37]

In July 2003 I had a 5-6 mm "suspected deteriorating fibroadenoma".  I was 41 years old at the time.  My mammogram and ultrasound from 4 months prior to this was clear.  Four months later it showed up on an ultra sound, but NOT on an MRI that was done at that time.  It is immediately adjacent to the implant capsule in the left breast @ 1:00 o'clock.  I had an open excisional biopsy done on it in 2003 and the pathology report reads like this, "1.3 x 1.3 x 0.5 cm benign female mammary gland with a slight increase in the amount of fibrous tissue.  There are benign lobules and few ducts within fibrous tissue with a scant amount of fatty tissue present.  Malignant tumor is not present".

In March 2008 this same lump is still there and NOW it lit up on the MRI and can still be seen on the ultrasound.  It still says it's 5-6 mm.  I don't think they removed it in 2003.  The incision was 1/4 inch wide.

1.  Is this a typical pathology report from a fibroadenoma?    

2.  The tissue sample was 1.3 x 1.3 x 0.5, does this sound like they took out the whole 5-6 mm lump in 2003?  

3.  If they missed the lump in 2003, would it have grown in 4 years or shrunk or changed?  Do some cancers grow this slowly or not at all?  

They attempted an ultrasound guided needle biopsy in 2003, but it was too small and too close to the implant, so that is out of the question.  I'm having an open excisional biopsy on the right breast and I'm wondering if they should biopsy this or not.  I should mention that I have several other "suspected fibroadenomas" that have shown up over the last few years that did NOT light up on the MRI.

Thank you    

[Cowgirl37]

Thank you for answering me, I appreciate what you do for all of us out here in this situation and I value your opinion.  

I was able to talk to my radiologist yesterday, after I posted these questions to you.  This is the plan that he came up with.  Of course this is "if" the right breast microcalcifications end up being benign on May 12th.

1.  Bilateral MRI in 3 months (August) to check on the fibroadenoma in the left breast (the one that lit up) and ALL the other fibroadenomas in both breasts.  I have 6 in each breast according to the recent ultrasound.

2.  Followed by a Bilateral Ultrasound (to check on anything that lights up from the new MRI)

3.  Bilateral Mammogram in November (6 months after surgery on right calcifications)

He explained to me that I have 3 "suspected fibroadenomas" in the 1:00 area and one in the 2:00 o'clock area of the left breast (same general area as the previous biopsy).  I didn't know this.  There are so many and they can't really tell which is which.  The reason he is waiting 3 months is so he can now "watch" each one and if any one of them changes ever so slightly, they can pinpoint it and take it out at that time.  I guess you could call that a baseline MRI.  Now I understand why they can't just take "IT" out during this up coming surgery.

I just started going to this Women's Breast Center at a large hospital in February of this year and now I can have some consistency in having the same radiologist review all of my reports every time.  In the past they were scattered all around different imaging centers, different radiologists and different surgeons.  Does this plan sound reasonable to you?  

Again, thank you for your time.  And God bless you too.    

[PaulMD]

Hi there.

It will be very hard to tell if they were able to capture the whole lump during the procedure in 2003, however the pathology report sounds assuring.  MRI evaluations on a breast with implants can offer difficulties or sometimes inconsistencies in interpretations.  It would also be very hard to distinguish between a benign and malignant lesion at this point since the only definitive way of ascertaining this is to do another biopsy.  This time, I suggest that you make sure that they take out the entire lump through imaging studies like ultrasound after the biopsy procedure.

Regards and God bless.