Surgical Excision Versus Conservative Management in Fibroadenoma in a Tertiary Care Hospital

Background: Fibroadenomas are benign breast tumors that commonly affect young women. The management of fibroadenomas remains controversial, with surgical excision traditionally being the gold standard. Objective: To compare the recurrence rates, cosmetic outcomes, patient satisfaction, complications, and overall effectiveness of surgical excision versus conservative management in patients with fibroadenomas. Methods: This is a prospective, comparative study conducted at tertiary care hospital in western Maharashtra from September 2023-march 2025 A total of 155 patients diagnosed with fibroadenomas were enrolled and randomly assigned to either the surgical excision group (n = 77) or the conservative management group (n = 78). Patients were followed for 12 months, during which recurrence rates, complications, cosmetic outcomes, and patient satisfaction were assessed. Results: The recurrence rate was significantly lower in the surgical excision group (3.9%) compared to the conservative management group (7.7%) (p = 0.01). Cosmetic outcomes were significantly better in the conservative management group, with 91.0% of patients satisfied with the appearance of their breast, compared to 75.3% in the surgical excision group (p = 0.02). Patient satisfaction was also higher in the conservative management group (81.2% vs. 68.8%, p = 0.04). Complications were more frequent in the surgical excision group (15.6% vs. 5.1%, p = 0.02), with common issues including infection, hematoma, and scarring. Conclusion: Both surgical excision and conservative management are effective for the treatment of fibroadenomas, but they offer different benefits. Surgical excision provides a lower recurrence rate but is associated with higher complication rates and less favorable cosmetic outcomes.