Removal of fibroadenoma of the mammary gland

A benign neoplasm, localized in a woman's breast, can be called fibroadenoma. This new formation is rarely transformed into a malignant tumor. But, nevertheless, the removal of fibroadenoma of the breast is inevitable. You can not leave it in your chest.

[1], [2], [3], [4], [5], [6]

Indications for removal

After the appearance of a suspicion of a neoplasm, a woman undergoes an examination (ultrasound or mammogram) to confirm or deny the diagnosis. If a woman has overcome a forty-year boundary, then she is mainly assigned a mammogram, before this age - an ultrasound examination.

Fibroadenomas are quite good at treating, but surgical intervention is prescribed in most cases, but not in all.

There are indications for an operation to remove the fibroadenoma of the breast, which is confirmed by the results of the survey. Each clinical picture is examined by the doctor individually, after which the most optimal method is selected. Indication for the operation:

• Fibroidadoma of the phyloid type.
• Fibroadenoma leaf type.

Both these types have a small but risk of degeneration into sarcoma. Therefore, it is better to excise a tumor in order to prevent degeneration.

• Another indication to it is its large size (more than two centimeters), leading to deformation of the female breast.
• If there is a further increase in the size parameters of the tumor.
• Wishes the patient herself.
• Planning a woman of childbearing age of pregnancy, since such a problem will prevent lactation, as well as there is a risk of progression of purulent mastitis.

There is a common opinion that a benign neoplasm can dissolve on its own, but it is absolutely groundless. Disappear in certain circumstances is capable of cystic formation, but not fibroadenoma.

Preparing for an operation

Before proceeding to excise the tumor, the doctor should clearly represent the whole picture of the disease. Preparation for surgery to remove breast fibroadenoma begins with determining the size of the tumor, its location and the desire of the patient herself. Based on this and the state of health of women, the surgeon decides on the choice of one of the three methods of conducting the operation:

• Enucleation, in which there is excision of immediate education itself. Usually the tissues of the body remain untouched. The operation is the least traumatic and, mainly, conducted under local anesthesia within the outpatient treatment. The incision is usually made directly above the neoplasm, in the armpit or in the areola of the nipple.
• Sectoral resection is performed if the size characteristics of the tumor are sufficiently large. In carrying out this operation, both the neoplasm and the part of the breast that comes into contact with the tumor are removed. The surgeon applies a cut directly over the formation. In this case, the woman's breast can change shape and become smaller in size.
• Total resection is prescribed for the diagnosis of several fibroadenomas, creating conglomerates, as well as for a sufficiently high rate of tumor growth or a suspicion of its malignancy. Relatively often this technique of excision is used in phylloid fibroadenoma.

In the preparatory period, a woman must undergo a number of additional studies. For example, a blood test for coagulability and determination of the blood formula (hemoglobin level, red and white blood cells, and others) is prescribed.

If necessary, a test analysis for an allergic reaction to the drugs (for example, the agent that will be used for anesthesia) can be assigned.

It is not superfluous to learn that the nature of education can be determined with a high degree of probability and even at the stage of palpation. Malignant neoplasm is problematic "to move from the place", whereas benign adenoma differs appreciable mobility in the tissues of the breast.

Operation to remove fibroadenoma of the breast

Do you know what an operation is to remove the fibroadenoma of the breast? It should be noted that there are two options for tumor removal. But in this case everything depends on the specific situation. So, you can get rid of fibroadenoma only surgically. If the tumor size does not exceed 2 centimeters and does not pose any danger to the woman's body, then it is simply observed.

In general, there are two types of fibroadenoma removal. The first method is vyluschivanie or enucleation. This procedure is assigned only if there is no suspicion of cancer. This is done by local anesthesia with the help of a tiny incision. In this case, everything is removed quickly.

The second method is a little more complicated, it is a sectoral resection. This procedure is done only if there is a suspicion of cancer. In this case, in addition to the tumor itself, it is necessary to remove and place around it, literally a couple of centimeters. Only it should be understood that such an intervention can somewhat disrupt the shape of the breast. But there is a good side in this matter, at the same time you can make plastic. As a rule, the seams are removed already literally on the fifth day. The person is discharged the same day. In general, the removal of fibroadenoma of the breast is not particularly difficult.

Technique of operation

After the doctor has determined the method of excision of the tumor and the patient has undergone a complete examination, the day of the operation comes. But before falling under the surgeon's knife, many women want to know how the operation to remove the fibroadenoma of the breast is done and what consequences can be expected?

If an enucleation has been prescribed, or as it is also called a hatching, the patient is given a local anesthetic, which anesthetizes the site of the intervention. After anesthesia has worked, the doctor applies a small incision directly above the neoplasm and through the resulting aperture excising fibroadenoma.

After this, an internal (self-absorbing) and external, subsequently removed, seam is applied. If necessary, drainage is installed. This procedure, mainly, is carried out in outpatient walls outpatiently.

When performing surgery using the method of sectoral resection, the surgeon makes a small incision, but removes not only the neoplasm itself, but also from a centimeter to three surrounding breast tissue. This surgery is considered more traumatic than the previous one, but it gives more guarantees against relapses. And it is especially important if there is a suspicion of the malignant nature of the tumor.

Such an event is only held in the conditions of a specialized oncological clinic and under general anesthesia. The shape of the female breast at the same time loses the former outline and dimensions, which subsequently may raise the issue of plastic.

Surgery can last from 20 minutes to an hour. Such a time gap is associated with the characteristics of the clinical picture of the disease, the individuality of the human body and the accompanying history of the patient.

A woman before excision is to clarify what kind of seam plans to impose a doctor. Of course, it is desirable that it was a cosmetic suture complied with all the rules. It is more accurate and less noticeable, which is important for the aesthetic appearance of the breast and the psychological state of the woman. If the clinic replied that it was not possible to produce a cosmetic suture, it might be worthwhile to contact another medical institution.

After carrying out such excision on the fifth day, doctors remove the seams. At the same time, if the patient feels well, she can be discharged home on the same day after the operation and withdrawal after anesthesia. But mostly she is in the hospital two - three days.

Fibroadenoma is the most often diagnosed disease, mainly affecting women of childbearing age (that is, in the period from 15 to 40 years), as a result of fluctuations in the hormonal background. About 95% of cases are noted benign character of the tumor, but the probability of degeneration still remains.

There are only two methods to solve the problem. If the tumor does not exceed two centimeters, the mammologist may suggest that a woman should not resort to radical measures while observing the tumor. In case of its further growth, or if the neoplasm already has a size of more than 2 cm, an operation is performed to remove the fibroadenoma of the breast.

When carrying out the operation, a little material of the tumor is taken for a biopsy, the result of which will be ready in a week or ten days. Histological examination allows to determine the presence (or absence) of atypical cells, of which malignant formations are composed.

Therapy of this disease shows greater effectiveness in the integrated approach to treatment. That is, in addition to surgery, it is necessary and medication. Usually, anti-inflammatory drugs, antibiotics, and, if necessary, hormonal drugs are administered.

Usually, if a sectoral resection is prescribed, and it is carried out within the hospital, during the normal course of the operation and the postoperative period, the woman is in the hospital for two to three days, after which she is discharged home. Predominantly the period after resection is painless.

Removal of tumor under local anesthesia

As studies show, the removal of fibroadenoma of the breast under local anesthesia is less stressful for the body way. But on the territory of the countries of the former Union, it was decided to clearly regulate all activities related to a particular procedure. Therefore, if an anesthesia of local action was prescribed according to the protocol of treatment, then it was carried out.

Abroad, especially in Israel and European countries, it is customary to discuss this issue with the patient, explaining to her the method of action and giving her the right to choose. If a woman has a fear of hearing and experiencing during an operation, she will be given general anesthesia.

Far from all of our clinics go to such cooperation with the patient. And it is the doctor - the anaesthesiologist, together with the mammalogist - the oncologist who decides the expediency of using an anesthetic.

Removal of tumor under general anesthesia

Most, especially neglected cases, remove the fibroadenoma of the breast under general anesthesia. Such anesthesia has its pluses and minuses.

The pluses of this narcosis can be attributed to the fact that a woman does not have to psychologically experience the operation time. She falls asleep before the procedure and wakes up after her.

The minuses include the fact that preparations of general anesthesia affect directly a certain area of the brain cells, which in one way or another can not remain without consequences. Especially if the patient had to suffer more than one general anesthesia. And any input of a medicinal product of general action is a stress for the entire human body.

But if the tumor has a large enough volume, or there are suspicions of the cancerous character of the cells, then the scale tends to favor preparations of general anesthesia.

Sectoral resection of the mammary gland

If the most woman or specialist, with the next professional examination, the pathological neoplasm in the area of the mammary glands was recognized, then a more thorough examination will be carried out later. It allows you to determine the size and localization of the tumor. These diagnostic methods include ultrasound examination (usually prescribed for women under 40) or mammograms (women over 40).

After receiving the results of the study, the doctor decides on the need for surgery.

Sectoral resection of the breast is prescribed:

• If the tumor size exceeds 2 cm and there is a tendency to its further growth.
• If there is a suspicion of a malignant neoplasm or a high probability of such a degeneration.
• Fibroidadoma of the phyloid type.
• Fibroadenoma leaf type.

The essence of this organ-preserving surgical intervention is that excision is performed not only of the tumor, but also of nearby tissues. Examination can be subjected to 1 to 3 cm tissue of the female body. The procedure proceeds under general anesthesia. It is very rare for a surgeon to decide on a local anesthetic.

After such an operation, a cosmetic defect is possible, which subsequently requires plastics.

After its removal the woman remains under supervision at the mammologist. She is recommended to be checked regularly, undergoing ultrasound, and to show up for a consultation with a specialist.

If the surgical procedure is carried out correctly and without special complications, after it pregnancy and feeding of the newborn baby with breast milk is quite permissible.

Possible complications. It may well develop a hematoma, a change in the outline of the mammary gland, the formation of an abscess.

Complications of sectoral resection may include hematoma, suppuration of the wound, deformity of the breast.

Removal of fibroadenoma of the breast by laser

Science does not stand still. Modern developments and technologies make it possible to get rid of the pathology in question more sparing for the organism. To date, you can call technology such as vacuum aspiration biopsy. In her case, a small puncture is made on the woman's breast, through which, with the help of special equipment, and excision is performed. Such an exercise is carried out on an outpatient basis. It allows you to achieve maximum cosmetology efficiency.

But the equipment, suitable for their conduct, today can not be found with every specialized oncological clinic.

This method can also be attributed to innovative technologies. This procedure is also called laser ablation. Despite the fact that it appeared not long ago in the arsenal of physicians, it already managed to gain recognition and wide application.

Such an evaluation of this method was due to the fact that it is low-traumatic for the female body and shows really high efficiency.

The essence of the method is that the ray is directed to the tumor localization zone. By point heating, the cell growth is destroyed. Due to the small radius of action, it is possible to leave the modified and newly formed cells, leaving healthy healthy.

The mechanism of the "operation" is quite simple. A special light-emitting diode is fed to the cellular conglomerate, along which a strong laser light beam passes.

It is generally accepted that laser removal allows full-scale destruction of "negative" cells, in the place of which quickly renewed (for several months) new healthy cell tissues will begin to form.

Another advantage of this method is:

• This procedure usually takes no more than an hour.
• Does not require mandatory hospitalization of a woman.
• Short-term postoperative period.
• Painless operating and postoperative period.
• The treatment of fibroadenoma with this technology is safer.
• This technique of pathology removal shows a minimal percentage of postoperative complications (especially of an infectious nature).
• Do not forget about the aesthetic side of the operation, which ends up leaving no unattractive scars behind, which can not but be left without attention and not please the women.

To date, the only negative aspect of this excision technology is its high enough price, which not everyone will have to afford and the fact that the necessary apparatus is not available in any clinic.

Due to the high cost of the necessary medical equipment, not every clinic is ready to purchase and at full capacity to use it. Although all physicians agree on one thing, that behind the laser method of removing fibroadenoma of the breast is the future.

Effects

The excision of fibroadenoma is, perhaps, one of the easiest operations among those that are produced on the mammary gland.

If enucleation was performed, or as it is also called a physician-vyshushchivanie, and the procedure was under local anesthesia, then it takes quite a short time, about two hours (all depends on the individual characteristics of the female body), that the woman comes to her senses and is released home. Although she will have to resemble dressings that are done every other day or every day. When the surgeon performs a cosmetic suture, the scar remains small, slightly noticeable. In the normal course of the postoperative period, the joint should remain dry and clean. In this case, the place of surgical intervention can simply be fixed with adhesive tape with the sterile tissue put under it.

If the excision technique is a sectoral resection performed under general anesthesia, the operation is performed in the hospital. The consequences of removing the fibroadenoma of the breast with the use of this technology causes the presence of a woman under the supervision of doctors, after surgery, in the hospital two - three days. To obtain effective post-operative rehabilitation, it is necessary to adhere to all the recommendations given by the doctor.

• A full rest is needed.
• In the diet of a postoperative woman should be present foods with a high content of vitamin C and protein foods.
• Clothes should be comfortable: do not crush or rub at the place of operation.
• A woman should wear a properly selected bra. In such a situation, a sports bra that perfectly supports the breast is perfect, but being flexible enough, does not bring discomfort to its owner. This eliminates the need to adjust the length of the bra straps.
• The fabric of linen and clothes must be natural.
• On average, the duration of the recovery period is from two to eight days.

[7], [8], [9], [10]

Complications

But surgical intervention is still a violation of the integrity of certain tissue layers. Therefore, in a number of cases, complications can occur after removal of the fibroadenoma of the breast. What can a woman expect after such an operation?

• Monitoring of postoperative cases showed that a few hours after the end of the procedure, the patient may feel thirsty.
• In the first time after surgery, a woman may be concerned about pain in the area of the breast and the area of the sutures. If the intensity of pain does not decrease, but, on the contrary, increases, the attending physician usually prescribes painkillers and anti-inflammatory medications.
• If a hematoma appears in the seam area, or there is a bruise or bruise at the incision site, this should be reported to your doctor in charge. It is possible he will manage the appointment of a vitamin complex. Hemorrhage can be the result of both the wrong operation of the operating team, and the peculiarities of the patient's body, which is characterized by increased bleeding.
• Gradually, the surgical suture is transformed into scar tissue, which can be helped by the use of special modern creams.
• The probability of relapse is not excluded. Therefore, such patients should be examined at least once a year.
• In some cases, it is possible to observe a deformation of the operated breast: it is possible to change its shape and size.
• There may be swelling and hyperemia of the affected chest, as well as adjacent axillary tissues and shoulder area.
• Perhaps soreness in the touch.
• When an infection occurs, the result of a sterility disorder is the formation of abscesses.
• Seroma is a complication like a hemorrhage, with the only difference being that, instead of blood, there is a discharge of serous fluid and blood plasma. Drainage is required to ensure their normal outflow.

[11], [12], [13]

Pain in the mammary gland

No matter how sparing the operation is, but it involves breaking the integrity of a number of layers, so the pain in the mammary gland after removal of fibroadenoma immediately after surgical treatment is the norm. Over time, it should disappear.

If this does not happen, and pain symptoms only increase its intensity, it should be informed to the specialist who leads the postoperative period. It is quite possible that a pathogenic flora, provoking the inflammatory process, has got into the woman's body. In this case, the doctor will prescribe antibiotics and painkillers.

If the process is started and a purulent infiltrate has already formed, it is perfectly permissible to clean, establish drainage and apply all the same drugs.

But one should not focus only on the causes of this sense, since the source of pain may be other related diseases. For example, osteochondrosis, neuralgia and numerous diverse pathologies. Over time, the scar can begin to hurt "on the weather."

In order not to suffer and not to guess what is the catalyst for pain, it is necessary to seek the advice of a specialist and undergo a survey. They may become a specific diagnostic procedure prescribed by the doctor, for example, ultrasound.

Temperature

Particular attention should be paid in the case when there is an increased temperature after removal of the fibroadenoma of the breast. This symptom is dangerous because it speaks about the presence in the body of a patient of an intensive inflammatory process, which threatens to degenerate into purulent and serous formations.

The increase in body temperature should alert the woman and force her to immediately consult a doctor - a mammologist.

Scarring

Before deciding on an operation, it is not superfluous to find out from the doctor what seam he will make after excision. To the scar, after the removal of fibroadenoma of the breast, was, as can be less noticeable, it must be done by a special technique and get the so-called cosmetic suture.

Also, physicians know some places on the female breast, the incision on which will subsequently be virtually invisible due to the anatomical folding present nearby. Such an incision can be made in the periareolar zone, which is indicated by a wrinkle under the areola of the breast, as well as in the submammary region, which is located in the crease under the female breast.

But if the neoplasm is located directly in the subcutaneous layers, the incision is usually applied directly over the tumor.

To achieve a small scar size, physicians use special medical equipment and surgical instruments, for example retractors with backlighting. Special absorbable threads are also used.

When periareolar incision is used a subcutaneous suture, which allows you to achieve good results, making the scar almost invisible.

The appearance of a hematoma

Hematoma is the accumulation of blood in the tissues of the body. After the operation, one of the capillaries may be broken, which became the source of the outflow. Hematoma after removal of the fibroadenoma of the breast is designated as one of the complications of surgical intervention. But, if the recovery period proceeds normally, most likely these structures will gradually dissolve independently and the dark spot will disappear. To accelerate this process, you can use special creams, which in this situation, the doctor will appoint.

Only in rare cases is it necessary to clean and drain the channel. But such a decision can only be made by a specialist. Therefore, it is advisable to consult your doctor.

The appearance of a seal

The neoplasm in question is removed only by surgery, which causes damage to the skin, subcutaneous layers. Therefore, after completion of removal, the surgeon - oncologist obligatory imposes internal (self-absorbing threads) and external (subsequently removed by the medical worker) seams.

Often, palpation at the first time, after removal of the fibroadenoma of the breast, is just the scars formed during surgical intervention and elimination of the operating cavity. Over time, they should either decrease in size, or almost completely disappear. But if the doubts remain, it is better to seek help and a checkup for a mammalog.

The woman herself should periodically palpate her breast (even after the surgery). And if after a considerable amount of time on the chest, with the next preventive examination, the woman groped for the compaction, then this is a good reason for further diagnosis under the supervision of a specialist. It is possible that the disease recurred and re-treatment is necessary.

Postoperative period

The surgical interventions considered in this article are almost always difficult for women to tolerate. The severity of the consequences of the operation is not only a physical disorder, but also psychological and emotional discomfort. Especially if it concerns the removal of sufficiently large volumes of tumor.

Therefore, the postoperative period after removal of the fibroadenoma of the breast is very important and requires a comprehensive application of rehabilitation measures. At this time, as much as possible, the woman who underwent the operation needs the support and help of close people. The emotional aspect of the problem should not be thrown off the shields. The more a woman is set up for a positive result of the operation, the practice shows that the surgery itself is easier to undergo, there are fewer complications and the recovery post-operative period takes a short time.

Depending on the severity of the pathology and the operation performed, as well as in connection with the individual characteristics of the woman's body, such measures are appointed specifically for each individual case. For the result to be the most effective, it is necessary to fulfill all the requirements of the treating specialist as clearly as possible.

Rehabilitation period

After any surgical intervention, the patient needs postoperative recovery and psychological rehabilitation. This applies to women who have passed through excision of fibroadenoma. But, as doctors say, the peculiarity of rehabilitation after removal of the fibroadenoma of the breast is that it is not necessary to physically rehabilitate (although it is, of course, necessary) as psychological support.

After all, the breast for a woman is like a symbol of beauty, belonging to the caste of women. This operation undermines the woman's faith in her attractiveness and usefulness. Hence the protracted depression, which can significantly delay the rehabilitation postoperative period.

If the woman is optimistic, then the recovery time is faster, which allows her to return to the usual full life in a short period of time.

However, it should be remembered that the result of a histological examination, to which a tumor sample is necessarily sent, is also important. But in this case too, to expect its result as a verdict, feeling like in an electric chair, should not be. Even if the result showed the presence of cancer cells - this is not a reason for depression and depression. This fact should be the impetus to fight for one's health, but not as a provocateur of a funeral state, when a person psychologically bury himself alive!

Women who are confronted with this problem should not be afraid of the operation, delaying it all at a later time. They should tune in to a positive result, and for example, you can take the women who have already gone through the operation. Many of them live happily ever after, forgetting about the problem for a long time!

Oncologist recommendations after surgery

After the operative intervention, the recovery period takes a certain period of time: an average of two to eight days. But in this period of time the patient necessarily receives, after removal of the fibroadenoma of the breast, recommendations for grooming and the rules of the woman's behavior at this time.

• The patient must wear a correctly selected bra during the doctor's recommended time. However, it is not removed even at night. Usually this regime takes from 7 to 10 days, but may be longer - this is decided by the operating mammologist - an oncologist.
• It is necessary to come to the dressing every other day or every day, as the specialist will appoint.
• During this period the woman should rest more, restoring strength.
• In her diet should be enough foods containing a large percentage of vitamin C and protein.
• After he gave permission, a woman can take a shower. But the first time, when carrying out water procedures, it is desirable to hold the mammary gland.
• If there is bruising and swelling, the doctor will prescribe special creams. For example, it can be gel kontrabutubeks.
• If the former patient begins to feel unwell, negative symptoms appear, it is necessary to urgently contact your doctor, maybe an infection has wounded in the wound and the situation requires immediate medical intervention.

What can not be done after the operation?

Various pathological changes in the patient's body require certain limitations. Therefore, it is not superfluous to know what can not be done after removal of fibroadenoma on the mammary gland do?

First of all, there was an operation or not, even if a woman is suspected, the woman should limit her stay in direct sunlight. Especially this issue is relevant in the hot summer period. A similar situation with a visit to the solarium. Even a healthy woman should not get involved in this procedure, and as for patients who have undergone removal of fibroadenoma, they are recommended by doctors to forget about it altogether.

Just for a while after the operation, you should limit physical activity and stabilize the emotional background: soothing teas and positive emotions will benefit the woman.

Cost of surgical intervention

After the question arose about the surgical intervention, the patient has a natural question - the price of removal of the fibroadenoma of the breast and what services for the sounded cost are produced.

What is the cost of removing breast fibroadenoma and is this operation dangerous? The fact is that the removal occurs under local anesthesia, if there is no suspicion of malignant neoplasm. If all the same it is, the removal occurs under general anesthesia.

The cost varies within acceptable limits. Consider this issue is somewhat difficult, because everything depends solely on a particular clinic. In general, much depends both on the operation itself and on the clinic. Therefore, it is difficult to speak in general terms. After all, there are two ways to remove fibroadenoma. The first involves cutting the tumor under local anesthesia, which costs significantly less. The second option of removal is performed if there is a suspicion of a malignant tumor, and all this is done under general anesthesia. Therefore, the cost here is much higher.

Again, in some cases, immediately and plastic adjustment is carried out, which adds a little more to the cost. Therefore, it is pointless to talk about cost.

It is only worth noting that the removal of breast fibroadenoma is a simple operation that does not require large monetary costs.

The cost of the price for the operation, in most cases usually includes staying in the clinic, nutrition, anesthesia, medication, the number of fibroadenomas excised and, accordingly, the necessary histological studies. Some clinics may include additional services. Therefore, before you pay for the procedure, you need to learn more about the list of services offered and their price list.

Some clinics also provide postoperative plastic, which can be included in the total cost, and can be withdrawn as an additional payment.

On average, the cost of these services ranges from 6000 to 8000 hryvnia.

Healthy and beautiful breasts are the pride and health of a woman, which must be protected. Therefore, it will not be superfluous to regularly inspect and probe it. If palpation is felt seal, a single or conglomerate of nodules, it is necessary to consult a doctor - mammologist. It is better if it is a false alarm and with your breast all right, than, ignoring the problem, time was missed and the neoplasm acquired an impressive size. Even worse, when the tumor is reborn and represents a cancerous growth. This metamorphosis is not so common (about 10% of potential cases), but you do not have to test fate, because it is for your case that these terrible percentages can fall out.

Therefore, girls and women are advised not to start the disease, especially the removal of the fibroadenoma of the breast - this is one of the most easy surgical interventions performed on the chest. The faster this problem is solved, the more sparing and organ-preserving will be the operation, and the disease under consideration will be forgotten as a terrible dream.

[14], [15], [16], [17]