Large benign breast tumors cause significant asymmetry and are unique reconstructive challenges after removal. These giant fibroadenomas are relatively rare, accounting for less than 1% of all fibroadenomas.
Giant juvenile fibroadenomas are benign neoplasms that usually appear between the ages of 15 and 25 years. They are classified as “giant” when they exceed 5 centimeters.
Partial breast reconstruction, without the need for additional tissue donation or the implantation of additional breast prostheses, is achieved by applying and combining the Goldilocks mastectomy technique.
The breast reconstruction in the images is of a 21-year-old woman with late presentation of a giant fibroadenoma in the right breast. The mass was very large and caused her emotional distress. She had no history of trauma, previous breast surgery, or other disorders.
Once the right breast was operated on, we observed a well-circumscribed, firm and mobile mass. She had no skin changes, no axillary lymphadenopathy (swollen lymph nodes) and no nipple discharge. Previous ultrasound study showed a hypoechoic, lobulated, septate lesion more than 15 cm in diameter. Core needle biopsy reported a fibroadenoma without atypia (alterations affecting cell shape, size and cell division process).
Giant fibroadenoma is an unusual presentation of benign breast disease requiring skin envelope reduction, extensive glandular resection, lower pole reconstruction and nipple grafting to achieve symmetry with the opposite breast.
The most important recommendation is that the patient should always contact certified professionals, with great experience and recognized prestige. Do not hesitate to ask me any questions you may have.
Adapting the Goldilocks mastectomy technique provides autologous vascularized tissue (from the patient herself) suitable for partial breast reconstruction. Using the lower flap of breast skin to compensate for volume loss after tumor removal and glandular excision.
The fibroadenoma was resected. It was well demarcated and encapsulated, did not invade the underlying skin or chest wall. The tumor weight was 1.1 kg. And the effect created by excision of fibroadenoma was localized in the lower pole of the breast.
Metal clips were left on the tumor margins to allow postoperative radiographic observation.