How big should a benign breast tumor be removed?

Breast lumps are divided into benign lumps and malignant lumps. Although benign tumors have a relatively small impact on the health of the body. However, once it occurs, if it is not treated in time, it can lead to malignant changes. Therefore, in order to avoid benign tumors turning into malignant tumors, it is necessary to examine the body and receive timely treatment. How big should a benign breast lump be for removal?

1. Surgical treatment is not necessary for clearly diagnosed common fibroadenomas, but close observation and regular check-ups are required. Improving the diagnostic accuracy of breast fibroadenomas is the key to reducing the surgical 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. Surgical treatment of single breast fibroadenomas is easy, but surgical treatment of multiple breast fibroadenomas is more difficult. For multiple scattered breast fibroadenomas, if all of them are removed, the breast will be covered with incisions, which is obviously unacceptable. Consideration may be given to removing larger tumors or suspicious masses, while typical fibroadenoma masses may be observed. During the observation process, if the mass is found to be enlarged or a malignant tumor cannot be ruled out, surgical treatment may be performed in a timely manner.

Some patients still develop new tumors in the original surgical site, other parts of the breast, or even the contralateral breast after complete resection. This is not a true recurrence of the original tumor, but a second primary tumor. The claim that "removal of breast fibroadenoma will lead to the occurrence of other tumors" is completely unfounded.

(1) Timing of surgery

① For unmarried women, if the diagnosis is basically clear, elective surgical resection can be considered before or after marriage according to the patient's wishes under strict follow-up;

② For patients who plan to get pregnant after marriage, it is often recommended that surgical resection be performed before pregnancy is planned to help avoid surgery during pregnancy and breastfeeding, because both pregnancy and breastfeeding can accelerate tumor growth;

③ If a tumor is found after pregnancy, it is advisable to undergo surgical removal between the 4th and 6th months of pregnancy;

④ If the tumor grows suddenly faster in a short period of time without the conditions that promote tumor growth such as pregnancy, breastfeeding, or trauma, surgery should be performed promptly.

⑤It is best to avoid the premenstrual period and menstrual period when the surgery is performed.

(2) Surgical method

① Traditional surgical excision selects surgical skin incision based on aesthetics and the convenience of complete surgical excision. The arc-shaped incision along the edge of the areola will leave a small scar after healing and is not visually obvious. For those with multiple lesions, an incision at the fold of the lower edge of the breast can be considered. The principle of layered incision should be implemented during the operation. The skin and subcutaneous layer can be incised along the direction of the skin grain, while the mammary gland layer needs to be incised radially with the nipple as the center to reduce damage to the mammary ducts. Surgery involves complete removal of the entire tumor.

The disadvantage of traditional surgery is that it will leave skin incision scars, affecting the appearance of the breasts. For patients whose tumor resection is so extensive that it affects the cosmetic effect of the breast, combined breast reconstruction surgery can be considered as appropriate.

②Minimally invasive surgical resection is generally performed on patients with a clear diagnosis of breast fibroadenoma. A hole (about 3 mm) is pierced in a hidden place such as the armpit or areola, and the tumor is excised using the Mammotome or Eco breast tumor vacuum-assisted excision system under the guidance of ultrasound or molybdenum target. The needle is inserted once and multiple cuts are made. There is little pain, and only a hole of about 3 mm is left after the operation. Recovery is fast, and the incision does not need to be sutured, so there is no need to remove the stitches. Multiple tumors can be removed at the same time through one incision. This surgery is particularly suitable for tiny tumors that cannot be felt clinically. The disadvantages are that it is expensive, prone to local bleeding and subcutaneous ecchymosis, and sometimes cannot guarantee complete removal.

Because of the possibility of clinical misdiagnosis or missed diagnosis, surgically removed specimens should be routinely subjected to pathological examination. Appropriate treatment should be given according to the results of pathological examination. For specimens removed by traditional surgery, intraoperative rapid frozen section pathological examination can also be performed first. After surgery for breast fibroadenomas, there is still a similar probability of fibroadenomas growing again in other parts of the breast, so regular physical examinations and imaging examinations are still important after surgery.