This is a 15 year old Asian girl who presented with a rapidly enlarging lump in the left breast, causing social embarrassment. She had attained menarche a few months ago.
On inspection there was a large lump in the left breast which was larger than the right and pendulous.
On palpation there was a firm, mobile, non tender mass with distinct borders occupying all quadrants of the breast. Axilla was normal.
What is your diagnosis? Click
This is likely to be a Juvenile Fibro adenoma
Juvenile fibroadenomas present as rapidly growing, large sized lumps occurring around menarche.
Why? Click
What is the differential diagnosis? Click
The diagnosis of juvenile fibroadenoma is made on clinical grounds. There is no reliable way to differentiate the above alternatives. Histology can confound even experienced Pathologists. Imaging and FNAC are not definitive.
How do you confirm the diagnosis? Click
By local excision. There may be a discrepancy in breast size even after excision.
How do you treat it? Click
Giant fibroadenoma or benign phylloides tumour. If there was no underlying lump, consider asymmetric adolescent hypertrophy of breasts
Juvenile Fibro adenoma