Fibroadenomas & Phyllodes Tumours
What Are Fibroepithelial Lesions?
Fibroepithelial lesions are a group of breast conditions that involve both the fibrous (connective) tissue and epithelial (glandular) tissue of the breast.
The two most common types are fibroadenomas and phyllodes tumours. These are typically benign (non-cancerous) but may require monitoring or treatment depending on their appearance and behaviour.
What is a Fibroadenoma?
A fibroadenoma is a benign, solid breast lump made up of glandular and fibrous tissue. It is the most common type of breast lump found in young women, typically between the ages of 15 and 35, although it can occur at any age.
Fibroadenomas are usually painless and feel smooth, firm and mobile beneath the skin.
Types of Fibroadenomas
Simple Fibroadenomas
Small, uniform fibroadenomas that are typically not associated with an increased risk of breast cancer.
Complex Fibroadenomas
Contain additional features such as calcifications or cysts and may slightly increase the risk of breast cancer.
What is a Phyllodes Tumour?
Phyllodes tumours are rare fibroepithelial lesions that may be benign, borderline or malignant. They tend to grow more quickly than fibroadenomas and can recur after surgical removal.
Although phyllodes tumours can occur at any age, they are most commonly diagnosed in women in their 40s to 70s.
Types of Phyllodes Tumours
Benign
Non-cancerous and typically do not spread beyond the breast.
Borderline
Have features that suggest an increased risk of recurrence.
Malignant
Cancerous and have the potential to spread to other parts of the body, although this is uncommon.
Symptoms
Both fibroadenomas and phyllodes tumours commonly present as a painless breast lump.
Symptoms may include:
A round, firm or rubbery breast lump
A lump that moves easily beneath the skin
Enlargement of the lump over time
Breast discomfort or pain
Stretching or tightening of the skin over larger phyllodes tumours
Phyllodes tumours generally enlarge more rapidly than fibroadenomas.
Diagnosis
Both conditions are assessed using a combination of:
Clinical breast examination
Breast ultrasound or mammogram
Core needle biopsy or excisional biopsy to distinguish a fibroadenoma from a phyllodes tumour
Because fibroadenomas and phyllodes tumours often appear similar on examination and imaging, a biopsy is frequently required to accurately diagnose the lesion.
Treatment
Fibroadenomas
Fibroadenomas are benign and do not always require treatment.
Removal may be recommended if:
The biopsy suggests the lesion could be a phyllodes tumour.
The fibroadenoma is growing rapidly.
It increases in size on follow-up imaging.
It is causing pain or discomfort.
The patient prefers to have the lump removed.
Otherwise, observation with regular follow-up may be appropriate.
Phyllodes Tumours
Because phyllodes tumours have the potential to recur and, in some cases, spread, they are typically treated with surgery.
Removal usually involves excising the tumour along with a margin of normal breast tissue to reduce the risk of recurrence.
What is Involved in Surgery?
Most fibroadenomas and phyllodes tumours can be removed as a day procedure under a general anaesthetic. If a phyllodes tumour is suspected, an overnight stay may occasionally be recommended.
For fibroadenomas, the incision is planned to minimise visible scarring and is often placed around the nipple (areola).
For phyllodes tumours, a larger incision may be required to allow removal of both the tumour and a margin of normal breast tissue. Whenever possible, the incision is placed within the bra line or a natural skin crease.
All wounds are closed with dissolving sutures and covered with a waterproof dressing.
Most patients are able to return to work within a few days of surgery.
Possible Risks & Side Effects
As with any surgical procedure, there are potential risks.
Common (up to 10%)
Bruising
Long-term pain or discomfort
Prominent scarring
Need for a second operation to achieve clear margins if a phyllodes tumour is present
Uncommon (up to 5%)
Wound infection
Bleeding requiring further surgery
Breast contour changes or poor cosmetic outcome
Reduction in breast size following phyllodes tumour surgery
Keloid (raised) scarring
Rare (less than 1%)
Anaesthetic complications
Deep vein thrombosis (DVT) or pulmonary embolism (PE)
Heart attack
Allergic reaction
Prognosis
Most fibroadenomas are benign and have an excellent prognosis.
Benign phyllodes tumours also have excellent outcomes following surgery, although recurrence remains possible.
Borderline and malignant phyllodes tumours carry a greater risk of recurrence and, in some cases, may spread. Early diagnosis and appropriate treatment offer the best outcomes.
Frequently Asked Questions
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Breast pain alone is rarely a sign of breast cancer. However, it's important to have any new, persistent or unusual breast symptoms assessed by your doctor to ensure an accurate diagnosis.
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Yes. This is particularly common with cyclic mastalgia, where breast pain is linked to hormonal changes throughout the menstrual cycle. Symptoms often improve once menstruation begins.
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Yes. Although less common, men can also experience breast pain. This may be caused by hormonal imbalances, infections or injury, and should be assessed if symptoms persist.
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Yes. Because of their potential for rapid growth and recurrence, phyllodes tumours are generally treated with surgical removal, even when they are benign.
Need Further Advice?
The team at Brisbane Breast and Surgical Care can provide specialist assessment and personalised advice.