American Society of Plastic Surgeons
Member Log In For Medical Professionals
 

What is giant juvenile fibroadenoma and how is it treated?


Fibroadenomas are common benign breast tumors. They are found in younger women and will typically present as firm, mobile, painless masses. Initial physical examination coupled with mammography and/or ultrasound can help differentiate it from more suspicious lesions. These masses can grow rapidly which can lead to heightened patient anxiety and discomfort.

A rare subtype of fibroadenoma is termed a "giant juvenile fibroadenoma" and these masses can grow larger than 5cm in diameter. Significant presenting asymmetry of the breasts may occur and subsequent removal of these fibroadenomas can result in concomitant deformity.

Dr. Nahabedian's team describe a novel modification of a "Goldilocks mastectomy" for breast reconstruction of giant fibroadenoma. Their PRS-Global Open article details the pre-operative markings used in this procedure with a schematic outline of the lower pole de-epithelialized flap that is folded superiorly to supplement volume. With this creative approach, the reconstructive surgeon is able to utilize the expanded affected breast skin shape the skin envelope. Concurrently, some of the remaining bulk of the lowermost breast tissue is able to provide volume and projection to the lower pole and retroareolar space. Figure 3 provides an intraoperative view of the lower flap being mobilized and Figure 4 shows a very nice symmetrical outcome at five weeks.

As Dr. Nahabedian notes, the indications for this procedure will vary with the patient's anatomy—both in terms of the affected fibroadenoma side and the contralateral side. However, in the appropriately selected patient, this technique allows for a cost-effective way to reconstruct a large breast defect without engaging the risk of prosthetic devices and without subjecting the patient to a separate donor site surgery.

Partial Breast Reconstruction with Goldilocks Technique After Excision of Giant Fibroadenoma: A Case Report

Logo

Surgeons In Your Area

Wendy Gottlieb Headshot

Wendy Gottlieb MD

1800 Town Center Drive Suite 418
Reston, VA 20190

(703) 668-9499

Michael Brown Headshot

Michael Brown MD

45155 Research Place Suite 125
Ashburn, VA 20147

(703) 726-1175

Craig Dufresne Headshot

Craig Dufresne MD

5530 Wisconsin Avenue Suite 1208
Chevy Chase, MD 20815

(301) 654-9151

Roberta Gartside Headshot

Roberta Gartside MD

1300 Chain Bridge Road The Magassey Building
McLean, VA 22101

(703) 204-2706

Behzad Parva Headshot

Behzad Parva MD

224-D Cornwall Street, NW Suite 300
Leesburg, VA 20176

(703) 777-7477

David Berman Headshot

David Berman MD

14 Pidgeon Hill Drive Berman Cosmetic Surgery & S...
Sterling, VA 20165
Morad Tavallali Headshot

Morad Tavallali MD

#1150 5530 Wisconsin Avenue
Chevy Chase, MD 20815
Phillip Chang Headshot

Phillip Chang MD

19500 Sandridge Way Suite 350
Lansdowne, VA 20176

(703) 729-5553

Logo

Patient Care Center