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Background: Fibroadenomas are the most common benign breast lesions in women. They present as a unilateral mass and can rapidly enlarge in size through hormonal changes. Fibroadenomas could be classified as small or giant, and as simple or complex. They are classified as 'giant' when the size exceeds 5 cm and/or weight 500 gram; and as 'complex' if one of the following characteristics is present: cysts with a size >3 mm, epithelial calcifications, sclerosing adenosis and papillary apocrine metaplasia. Giant fibroadenomas can cause compression of surrounding breast tissue or breast asymmetry, requiring surgical excision in order to preserve a normal breast shape., Case: A 26-year-old pregnant woman was referred with a palpable mass of her right breast. The mass rapidly increased in size to a diameter of 13 cm during the second trimester of her pregnancy. A tru-cut biopsy confirmed a fibroadenoma. The rapid growth and compression of normal breast tissues indicated a lumpectomy during her pregnancy. The mass was easily excised without any consequences for the pregnancy. Pathological examination showed a complex giant fibroadenoma., Conclusion: A unique case of a pregnant woman with rapid progression of a fibroadenoma that met the criteria of a complex and giant fibroadenoma, was presented. This case emphasizes the importance of timely surgical intervention, even during pregnancy, to prevent permanent breast tissue damage.

Background: Fibroadenomas are common among young females. The size of the lesion used to be an indication for further assessment or excision. With arising of the watch and see proponents, criteria for selecting patients are important to establish., Methods: This is a retrospective study of a prospectively maintained database where all patients having the clinical/radiological provisional diagnosis of fibroadenoma and attending our center - from January 2008 to March 2020 - were enrolled. The primary outcome was the incidence of malignancy and the secondary outcomes were the correlation of malignancy-risk with epidemiologic and radiologic criteria., Results: The study enrolled 1392 patients. The mean age of the patients was 35.7 + ∕- 13.1 years. The median of the longest diameter of the detected breast lesions was 25 mm. The incidence of malignancy was 188 (13.5%). The size of the lesion measured by largest diameter was insignificant (p = 0.99), while the patients' age, marital status, and imaging criteria as measured by BIRADS score were significant (<0.001)., Conclusion: Approaching patients with the age above 35 or with BIRADS 4 provisionally diagnosed with fibroadenomas should be cautious with biopsy and short-term follow-ups The size of the tumor alone should not be used as an indication for surgical intervention.

Pseudoangiomatous stromal hyperplasia (PASH) is a breast stromal change, histologically characterized by anastomosing, slit-like spaces lined by slender myofibroblasts and surrounded by dense collagenous stroma. Mass forming cases clinically and radiologically simulate fibroadenoma. A middle aged women presented with unpalpable breast nodule discovered on ultrasound examination. The ultrasound characteristics were typical for fibroadenoma, while fine-needle aspiration cytology was inconclusive. The histological examination of the lumpectomy specimen showed fibroadenoma with peculiar stromal alteration consistent with pseudoangiomatous stromal hyperplasia. The presented case of fibroadenoma with pseudoangiomatous hyperplasia within its stroma demonstrates the relationship between these two entities not only clinically and radiologically, but also histologically.

Juvenile fibroadenoma is the most common breast mass in adolescents accounting for 0.5-4% of all cases of fibroadenomas. Giant fibroadenomas are well-circumscribed, firm breast masses characterized by proliferation of epithelial and connective tissue. They are defined as being larger than 5 cm or weighing more than 500 g. The peak age has been reported between the ages of 17 and 20, with less than 5% of these in patients less than 18-years-old.We present a 9-year-old, pre-menstrual, Nigerian female with no known family history of breast masses or cancers who developed spontaneous giant fibroadenoma measuring approximately 13  cm × 13 cm. Rapid growth of a breast mass can be of great concern to such young patients whose breasts are in the early formative stages. It is important to promptly rule out malignant processes or phyllodes tumor, and educate young patients and their families on treatment options that fit their unique concerns and circumstances.

Fibroadenomas with a predominant cystic change are called cystic fibroadenomas. These are extremely rare forms of fibroadenomas and only one case has been reported so far. They are classified under the category of complex fibroadenomas. Complex fibroadenomas are a rare variant of fibroadenomas occurring in elderly females. They are characterized by presence of one of the complex features along with the usual patterns of fibroadenoma such as cysts more than 3 mm, papillary apocrine metaplasia, or sclerosing adenosis. Patients with these lesions have higher chances of developing carcinoma of breast. We present a case of 35 years old lady with a freely mobile mass in the left breast diagnosed as cystic fibroadenoma after thorough histopathological examination of the lesion.

A giant juvenile fibroadenoma is defined as a fibroadenoma greater than 5 centimeters in size occurring in the pediatric population. It frequently affects adolescents. Rapid growth of the mass may result in breast asymmetry and deformity. Varying techniques in surgical extirpation have been described in order to optimize aesthetics and minimize distortion. The advent of new methods to remove benign breast disease is in its infancy stages. Many practitioners are unaware of the novel options that are emerging in the treatment of fibroadenoma. We describe an excision of a 12 centimeter giant juvenile fibroadenoma and adjacent juvenile fibroadenoma using a strategically atypical incision that resulted in excellent cosmesis and contour of the breast without subsequent reconstruction. Multiple modalities of removing a fibroadenoma are described with a review of the associated risks, benefits, and long term implications as well as a discussion on the indication for reconstructive surgery in patients with giant juvenile fibroadenoma.

Giant juvenile fibroadenomas in patients with hemihypertrophy are exceptionally rare. We present a very interesting case of a 13 year old girl with hemihypertrophy of the left side presenting with recurrent giant juvenile fibroadenomas of the left breast. The giant fibroadenomas occurred twice in the left breast over two years. The first had a diameter of 12 cm and was excised through an inframammary incision. The second occurred a year later, had a diameter of 11 cm, and was associated with three smaller fibroadenomas. These lesions were removed through a single periareolar incision. The procedures were complicated by keloid scarring but the results were improved with steroid impregnated tape dressing and local methylprednisolone injection. This report adds to our experience in managing patients with recurrent giant juvenile fibroadenomas complicated by hemihypertrophy and raises awareness to anticipate keloid scarring.

Giant fibroadenomas are a rare form of fibroadenoma that present as rapidly enlarging breast masses. They are typically greater than 5 cm or 500 grams in size and most frequently are seen in premenopausal Afro-Caribbean or East Asian females. This unique case report presents a 22-year-old female who presented with an enlarging breast mass measuring 23 × 28 cm. After core needle biopsy, the mass was diagnosed as a giant fibroadenoma and treated surgically with mastectomy. After a 5 year follow up she has not reported any signs of recurrence of the mass.