Treatment of benign breast tumors

Breast cancer is common in young women and most of them are painless lumps that are often discovered inadvertently. In the early stage, it is smaller, but grows and develops rapidly. It is round or oval in shape, with clear boundaries. Most of them are protruding, and flat ones are rare. The surface is not very smooth. It feels like small nodules when touched carefully. Some of them are obviously divided. They are mildly to moderately hard, mostly non-tender, and can be pushed or pulled at will.

It can be mainly divided into breast fibroadenoma, breast intraductal papilloma, breast lipoma, breast leiomyoma, breast hamartoma, breast neurofibroma and breast hemangioma, etc.

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1. Surgery

Confirmed common fibroadenomas can not be treated surgically, but require close observation and regular follow-up. Improving the accuracy of diagnosis of breast fibroadenomas is the key to reducing the surgical treatment rate.

Surgery is the most effective treatment for breast fibroadenoma. Whether it is common fibroadenoma or special types of fibroadenoma such as juvenile fibroadenoma and giant fibroadenoma, it can be cured as long as it is completely removed. The surgical treatment of transverse breast fibroadenomas is very easy, but the surgical treatment of multiple breast fibroadenomas is more difficult. For scattered multiple breast fibroadenomas, if all of them are removed, the breast will be covered with wounds, which is obviously unacceptable. Consideration may be given to selecting large tumors or suspected lumps for removal, while those typical fibroadenoma lumps may be observed. During the observation process, if the lump is found to be enlarged or cannot be transformed into a malignant tumor, surgery can be performed immediately.

Some patients still develop new tumors in the original surgical site, other parts of the breast, or even the other breast after complete excision. This is not a true recurrence of the original tumor, but the cause of a second primary tumor. To be frank, the claim that "removing breast fibroadenoma will cause the occurrence of other tumors" is completely unfounded.

(1) Opportunity for surgery: For single women, those who are basically diagnosed can be considered for elective surgery before or after marriage according to the patient's wishes under strict follow-up; for patients who are planning to get pregnant after marriage, it is often recommended to have surgery during the pregnancy preparation to avoid surgery during pregnancy and breastfeeding, because both pregnancy and breastfeeding can accelerate the growth of the tumor; if the tumor is discovered during pregnancy, it is advisable to have surgery between the 4th and 6th months of pregnancy; if there are no conditions such as pregnancy, breastfeeding, trauma, etc. that promote tumor growth, and the tumor suddenly grows rapidly in a short period of time, surgical treatment should be performed immediately. The best time for full-term surgery is to avoid the premenstrual period and menstrual period.

(2) Surgical treatment method: Traditional surgical removal is based on aesthetics and the convenience of complete surgical removal. The arc-shaped incision along the edge of the nipple will leave a small scar after healing and is not so obvious visually. For multiple cases, an incision in the outer edge of the breast fold can be considered. During surgery, the principle of layered incision should be implemented. The skin and subcutaneous layer can be incised along the lines of the grain, while the mammary duct layer needs to be incised radially with the nipple as the center to reduce damage to the mammary duct. Surgery requires complete removal of the entire tumor. The disadvantage of traditional surgical treatment is that it will leave skin wounds and scars, affecting the beauty of the breasts. For patients whose breast cosmetic effect is greatly affected by the large tumor resection area, breast reconstruction surgery can be combined with breast resection as appropriate. Minimally invasive surgical removal of breast fibroadenomas is generally performed in patients with confirmed breast fibroadenomas. A hole (about 3mm) is punctured in hidden areas such as under the armpit or nipple, and under the guidance of ultrasound or molybdenum target, the tumor is removed by using Mammotome or Eco breast tumor vacuum pump-assisted peeling system. The needle is inserted once and multiple cuts are made. There is little pain, and only a hole scar of about 3mm is left after the operation. The wound heals quickly, and no stitches are needed, so there is no need for surgical removal of stitches. It is possible to remove multiple tumors at the same time through a single incision. This type of surgery is particularly suitable for tiny tumors that are clinically intangible. The disadvantages are that it is expensive, prone to local bleeding and subcutaneous tissue ecchymosis, and sometimes cannot be guaranteed to be completely removed.

Due to the possibility of clinical misdiagnosis, specimens removed during surgery should generally be subjected to pathological examination. Give relatively appropriate solutions based on the results of pathological examination. For specimens removed by traditional surgical treatment, priority can be given to intraoperative freezing and rapid cutting into slices for pathological examination.

After breast fibroadenoma surgery, there is still a similar chance of fibroadenoma growing again in other parts of the breast, so regular physical examinations and imaging examinations should still be taken seriously after surgery.

2. Medication

It is generally not possible to regress existing breast fibroadenomas, but it can inhibit the growth of tumors and the formation of new tumors. You can consider traditional Chinese medicine treatment. The principle of traditional Chinese medicine treatment is to soothe the liver and regulate qi, relieve cough, resolve phlegm and eliminate knots. It can be used for patients with small basic diagnosis or patients with multiple breast fibroadenomas after selective removal. Endocrine medication is generally not recommended.