Removing a Fibroadenoma with Laser Therapy

Information and Insights About a Minimally Invasive Procedure

Novilase Laser Ablation for Breast Fibroadenomas
Novilase Laser Ablation for Breast Fibroadenomas. Art © Pam Stephan

Laser therapy is a minimally invasive alternative treatment for breast fibroadenomas that are usually removed surgically. Though its use is currently limited to fibroadenomas that are 2 centimeters or less in diameter (roughly 50 percent of fibroadenomas), it may have the advantage of a smaller incision (and subsequently scar), a faster procedure, and more rapid recovery. It is also less painful. Since the procedure is relatively new, however, the long term benefits or risks aren't yet known.

Breast Fibroadenomas

Fibroadenomas are benign breast tumors that are usually not bothersome unless they are large or near the breast skin. They may be felt on a breast exam or instead show up on mammography as a cyst or well-defined tumor.

Treatment may be recommended for fibroadenomas, especially in women over the age of 40 if they are painful or increasing in size.

Understanding Laser Ablation Therapy

Novilase is the first breast procedure to use laser ablation therapy to remove fibroadenomas—it uses an ultrasound-guided laser device to destroy the fibroadenoma, leaving behind only a tiny scar, no sutures, and no change in breast shape. 

In terms of the actual Novilase procedure, a hollow probe is inserted into the center of your fibroadenoma, and then a laser fiber is threaded into the probe. A temperature probe will be inserted nearby to monitor the laser's heat. The laser heats your benign tumor while your surgeon watches the temperature on a nearby monitor. When the fibroadenoma has been destroyed, the probes are removed, and a small bandage is placed over the skin.

Laser therapy is an outpatient procedure that is done with local anesthesia and takes only around 30 minutes to complete. Relative to surgery, the recovery tends to be more rapid as well.

A Surgeon's Perspective

Dr. Colleen Hagen, a general surgeon with Midwest Surgical Associations, was interviewed in 2009 regarding laser ablation. She stated, "some women have multiple fibroadenomas, and when they want them surgically removed, it's like doing a mastectomy in bits and pieces." Novilase is much easier on women than a lumpectomy, particularly if there is more than one fibroadenoma. "I want to get the word out to my referring primary care physicians, gynecologists, and radiologists that this is an option," said Dr. Hagen.

A Patient's Perspective

Judy G. had the Novilase procedure and said that it exceeded her expectations. She had already been through two painful surgical biopsies with general anesthesia and slow recovery. Following her laser ablation procedure, she said, "I felt good enough after having the procedure done to walk back to my hotel and (later) take a mile-long walk! I was not able to do this after having my biopsy done." J.G. remarked that in contrast to a lumpectomy, the laser ablation did not change her breast shape and caused very little pain. "I also am very pleased with the fact that there is basically no scar at all!" 

Advantages and Disadvantages

When compared with lumpectomy, laser ablation appears to win out with many patients. Since there is only a small nick in the skin, there's less risk of infection. It doesn't require general anesthesia, sutures, surgical drains, or more than a day for recovery. Instead of a two- or three-inch scar, there will be a tiny scratch on the breast. The shape of the breast won't change, as healthy tissue overtakes the lasered fibroadenoma tissue. 

Novilase is FDA-cleared for fibroadenomas up to 2 cm, but such benign tumors can grow up to 15 cm (5.9 inches); and it is not yet known whether laser ablation will be effective on larger fibroadenomas. That said, roughly 50 percent of people will meet this qualification.

Research

There is currently a study going on that is monitoring the long-term safety and effectiveness of the Novilase laser therapy for benign breast conditions, like fibroadenomas and papillomas. It's called the American Breast Laser Albation Therapy Evaluation (ABLATE) study.

This is helpful because it will tease out the pluses and minuses of the procedure and help surgeons determine which patients are best suited for this therapy. 

Laser ablation therapy is now also being studied in the treatment of small breast cancers.

A Word From Verywell

If you have a fibroadenoma that needs to be removed, be sure to discuss the different options available. While laser ablation is a less invasive therapy, it may or may not be the right choice for you. It's important to be your own advocate in your care, learn about the different procedures, and weigh the risks and benefits of each for you personally.

In addition to laser ablation, methods such as high intensity focused ultrasound, radiofrequency ablation, cryoablation (freezing), and microwave ablation are also being evaluated as an alternative to lumpectomy for fibroadenomas, though laser ablation has the advantage of being both minimally invasive and time efficient.

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