Not all fibroadenomas cause symptoms. In fact, most don't.
Hence, most of them do not require treatment.
These are the symptoms which warrant intervention like VABB (non surgical treatment).
1. Pain- Sometimes the patient has excess focal pain. And patient doesn't need to tolerate it.
2. Dysmorphic Appearance - large fibroadenomas can cause asymmetry of breast and cause appearance to be dysmorphic
3. Large size. For fibroadenomas more than 2-3 cm, it maybe a good threshold to remove them. As above 4 cm lesions, VABB may get difficult.
4. Interval growth - If serial scans (ultrasound usually) reveals significant growth in size then better to treat then wait for further growth.
5. Non resolution upto 35 years of age- Most fibroadenomas should start disappearing by 30s as natural cycle. If they don't, better to do VABB and remove them. As they might get calcified or bear a cancerous potential.
6. Anxiety/apprehension -
All these symptoms maybe absent but patient is super anxious because of the lesion sometimes. Fearing it to be malignant. Better to treat than continue living with anxiety.
