What Is Fibroadenoma Surgery?

When fibroadenomas are clinically detected—especially if they are relatively large, multiple, or discovered prior to pregnancy and cause patient concern—surgical intervention is typically recommended. Surgical management generally falls into two categories: open surgery and minimally invasive vacuum-assisted excision.

Since the introduction of the minimally invasive vacuum-assisted excision system in China, small fibroadenomas are commonly removed using this technique. However, for lesions larger than 2.5–3 cm, open surgery is usually required. To minimize visible scarring, concealed incisions—such as periareolar, axillary, or inframammary fold incisions—are often employed, resulting in minimal postoperative scarring.

Minimally invasive surgery involves making a 3-mm incision adjacent to the areola or along the anterior axillary line, through which a vacuum-assisted biopsy device (rotational cutting probe) is inserted. The probe’s cutting chamber is positioned beneath the tumor, enabling automatic, repetitive “in-and-out” rotational excision to gradually remove the lesion. Importantly, the tumor is not excised en bloc but rather fragmented into thin tissue strips and removed incrementally. This approach avoids conventional surgical incisions and significantly reduces visible scarring. Nevertheless, it has both advantages and limitations: for larger tumors, those located in anatomically challenging areas, or cases requiring specific oncologic considerations—including mastectomy—the minimally invasive approach may not be optimal. Therefore, concealed incisions remain a preferred option for excising benign breast lesions such as fibroadenomas, particularly when cosmetic outcomes are prioritized, as they leave minimal or no visible scars on the skin surface.