Removal of breast fibroadenoma

A benign tumor localized in a woman's breast may be called fibroadenoma. This tumor rarely transforms into a malignant tumor. However, removal of fibroadenoma of the mammary gland is inevitable. It cannot be left in the breast.

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Indications for removal

After a suspicion of a neoplasm arises, the woman undergoes an examination (ultrasound or mammography) to confirm or refute the diagnosis. If a woman has crossed the forty-year mark, then she is mainly prescribed a mammogram, before this age - an ultrasound examination.

Fibroadenomas respond quite well to treatment, but surgery is prescribed in most cases, but not all.

There are indications for performing surgery to remove fibroadenoma of the mammary gland, which are confirmed by the results of the examination. Each clinical picture is considered by the doctor individually, after which the most optimal method is selected. Indications for surgery:

• Fibroadenoma phylloides type.
• Leaf-type fibroadenoma.

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

• Another indication is its large size (more than two centimeters), leading to deformation of the female breast.
• If further growth of the tumor size parameters is observed.
• The patient's own wish.
• Planning of pregnancy by a woman of childbearing age, since such a problem will interfere with lactation, and there is also a risk of progression of purulent mastitis.

There is a common belief that a benign neoplasm can resolve itself, but it is absolutely groundless. A cystic formation can disappear under certain circumstances, but not a fibroadenoma.

Preparing for surgery

Before proceeding with the excision of the neoplasm, the doctor must clearly understand the entire picture of the disease. Preparation for surgery to remove fibroadenoma of the mammary gland begins with determining the size of the tumor, its location and the patient's wishes. Based on this and the woman's health, the surgeon decides on one of three methods of performing the operation:

• Enucleation, which involves excision of the formation itself. Usually, the tissues of the body itself remain untouched. The operation is the least traumatic and is mainly performed under local anesthesia as an outpatient procedure. The incision is usually made directly above the neoplasm itself, in the armpit area or along the areola of the nipple.
• Sectoral resection is performed if the tumor size characteristics are large enough. During this operation, both the tumor itself and the part of the breast that is in contact with the tumor are removed. The surgeon makes an incision directly above the tumor. In this case, the woman's breast may change shape and become smaller in size.
• Total resection is prescribed when several fibroadenomas are diagnosed, creating conglomerates, as well as when the tumor growth rate is quite high or there is a suspicion of its malignant nature. Relatively often, this excision technique is used for phyllodes fibroadenoma.

During the preparatory period, the woman must undergo a number of additional examinations. For example, a blood clotting test and determination of the blood formula (hemoglobin level, red and white blood cells, and others) are prescribed.

If necessary, a test may be ordered to check for an allergic reaction to medications (for example, to the drug that will be used for anesthesia).

It would be useful to know that the nature of the formation can be determined with a high degree of probability even at the palpation stage. A malignant neoplasm is difficult to “move from its place”, while a benign adenoma is distinguished by noticeable mobility in the breast tissue.

Surgery to remove fibroadenoma of the mammary gland

Do you know what a breast fibroadenoma removal surgery is? It should be noted that there are two options for tumor removal. But in this case, everything depends on the specific situation. So, fibroadenoma can only be removed 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 enucleation. This procedure is prescribed only if there is no suspicion of cancer. This is done by local anesthesia using a tiny incision. In this case, everything is removed quickly.

The second method is a bit more complicated, it is a sectoral resection. Such a procedure is performed only if there is a suspicion of cancer. In this case, in addition to the tumor itself, it is necessary to remove the area around it, literally a couple of centimeters. Just understand that such an intervention can slightly disrupt the shape of the breast. But there is a good side to this issue, you can do plastic surgery at the same time. As a rule, the stitches are removed literally on the fifth day. The person is discharged on the same day. In general, removing fibroadenoma of the mammary gland is not particularly difficult.

Technique of operation

After the doctor has decided on the method of tumor excision and the patient has undergone a full examination, the day of the operation arrives. But before going under the surgeon's knife, many women want to know how the operation to remove fibroadenoma of the mammary gland is performed and what consequences can be expected?

If enucleation, or as it is also called enucleation, has been prescribed, the patient is given local anesthesia, which will numb the area of intervention. After the anesthesia has taken effect, the doctor makes a small incision directly above the neoplasm and through the resulting opening excises the fibroadenoma.

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

When performing an operation using the sector resection method, the surgeon makes a small incision, but removes not only the tumor itself, but also from a centimeter to three centimeters of surrounding breast tissue. This type of surgery is considered more traumatic than the previous one, but it provides a greater guarantee against relapse. And it is especially relevant if there is a suspicion of a malignant nature of the tumor.

Such an event is carried out only in a specialized oncology clinic and under general anesthesia. The shape of the female breast loses its former outline and size, which may subsequently raise the question of plastic surgery.

The surgical intervention 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 medical history of the patient.

Before the excision, a woman should clarify what kind of suture the doctor plans to apply. Of course, it is desirable that it be a cosmetic suture performed according to 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 answered that it will not be possible to make a cosmetic suture, perhaps it is worth contacting another medical institution.

After such excision, on the fifth day, doctors remove the stitches. In this case, if the patient feels normal, she can be discharged home on the same day after the operation and recovery from anesthesia. But usually she stays in the hospital for two or three days.

Fibroadenoma is the most frequently diagnosed disease, mainly affecting women of childbearing age (i.e. between 15 and 40 years old), as a result of hormonal fluctuations. About 95% of cases are noted for the benign nature of the tumor, but the probability of degeneration still remains.

There are only two methods to solve the problem. If the neoplasm does not exceed two centimeters, the mammologist may suggest that the woman not resort to radical measures for now, but observe the tumor. In case of its further growth, or if the neoplasm already has dimensions of more than 2 cm, an operation to remove the fibroadenoma of the mammary gland is prescribed.

During the operation, a small amount of neoplasm material is taken for biopsy, the results of which will be ready in a week or ten days. Histological examination allows determining the presence (or absence) of atypical cells, which malignant tumors consist of.

Therapy for this disease shows greater effectiveness with a comprehensive approach to treatment. That is, in addition to surgery, drug treatment is also required. Anti-inflammatory drugs, antibiotics, and, if necessary, hormonal drugs are usually administered.

Usually, if a sectoral resection is prescribed and it is performed in a hospital, with a normal course of the operation and postoperative period, the woman stays in the hospital for two to three days, after which she is discharged home. Mostly, the period after the resection is painless.

Tumor removal under local anesthesia

As studies show, removal of fibroadenoma of the mammary gland under local anesthesia is a less stressful method for the body. But in the territory of the countries of the former Soviet Union, it was customary to strictly regulate all activities related to a particular procedure. Therefore, if the treatment protocol prescribed local anesthesia, then it was carried out.

Abroad (especially in Israel and European countries) it is customary to discuss this issue with the patient, explaining the method of action and giving her the right to choose. If a woman is afraid to hear and feel everything during surgery, then she will be given general anesthesia.

Not all of our clinics agree to such cooperation with the patient. And it is the doctor - anesthesiologist, together with the mammologist - oncologist who decides on the advisability of using one or another anesthesia.

Tumor removal under general anesthesia

In most cases, especially advanced ones, fibroadenoma of the mammary gland is removed under general anesthesia. Such anesthesia has both its pros and cons.

The advantages of this type of anesthesia include the fact that the woman will not have to psychologically experience the operation. She will fall asleep before the procedure and wake up after it is completed.

The disadvantages include the fact that general anesthesia drugs act directly on a specific area of brain cells, which cannot remain without consequences one way or another. Especially if the patient had to endure more than one general anesthesia. And any administration of a general-action drug is stress for the entire human body.

But if the tumor is large enough, or there is a suspicion of the cancerous nature of the cells, then the scales tip in favor of general anesthesia drugs.

Sectoral resection of the mammary gland

If a woman herself or a specialist, during a routine professional examination, has identified a pathological neoplasm in the mammary glands, a more thorough examination is carried out in the future. It allows determining the size and location of the tumor. Such diagnostic methods include ultrasound examination (usually prescribed to women under 40) or mammography (for women over 40).

After receiving the results of the study, the doctor decides whether surgery is necessary.

Sectoral resection of the mammary gland is prescribed:

• If the tumor size exceeds 2 cm and there is a tendency for it to grow further.
• If there is a suspicion of a malignant nature of the neoplasm or there is a high probability of such degeneration.
• Fibroadenoma phylloides type.
• Leaf-type fibroadenoma.

The essence of this organ-preserving surgical intervention is that not only the tumor is excised, but also the surrounding tissues. From 1 to 3 cm of tissue of the female body can be excised. The procedure is performed under general anesthesia. Very rarely, the surgeon may decide to use local anesthesia.

After such an operation, a cosmetic defect is possible, which will require subsequent plastic surgery.

After its removal, the woman remains under the supervision of a mammologist. She is recommended to undergo regular check-ups, undergo ultrasound, and see a specialist for consultation.

If the surgery is performed correctly and without any particular complications, pregnancy and breastfeeding of the newborn baby are completely acceptable after it.

Complications are also possible. A hematoma may develop, the outline of the mammary gland may change, and an abscess may form.

Complications of sectoral resection may include hematoma, wound suppuration, and breast deformation.

Laser removal of fibroadenoma of the mammary gland

Science does not stand still. Modern developments and technologies allow to get rid of the pathology in question more sparingly for the body. Today we can call such a technology as vacuum aspiration biopsy. In its case, a small puncture is made on the woman's chest, through which, with the help of special equipment, the excision takes place. Such an event is carried out on an outpatient basis. It allows to achieve maximum cosmetic efficiency.

However, equipment suitable for carrying them out cannot be found in every specialized oncology clinic today.

This method can also be attributed to innovative technologies. This procedure is also called laser ablation. Despite the fact that it has not been used by doctors for very long, it has already gained recognition and wide application.

This method received such an assessment due to the fact that it is low-traumatic for the female body and shows truly high efficiency.

The essence of the method is that the beam is directed to the tumor localization zone. By means of point heating, the cellular neoplasm is destroyed. Due to the small radius of action, it is possible to hit modified and newly formed cells, leaving healthy ones intact.

The mechanism of the "operation" itself is quite simple. A special LED is brought to the cellular conglomerate, through which a fairly strong laser light beam passes.

It is generally accepted that laser removal allows for the full-scale destruction of “negative” cells, in the place of which renewed healthy cellular tissues will begin to form quite quickly (within a few months).

Other advantages of this method include:

• This procedure usually takes no more than an hour.
• Does not require mandatory hospitalization of the woman.
• Short postoperative period.
• Painless surgical and postoperative period.
• Treatment of fibroadenoma with this technology is safer.
• This method of removing pathology shows a minimal percentage of postoperative complications (especially infectious ones).
• We should not forget about the aesthetic side of the operation, which ends without leaving behind unattractive scars, which cannot but go unnoticed and please women.

Today, the only negative aspect of this excision technology is its rather high price, which not everyone can afford, and the fact that not every clinic has the necessary equipment.

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

Consequences

Excision of fibroadenoma is perhaps one of the easiest operations among those performed on the mammary gland.

If enucleation was performed, or as doctors call it - enucleation, and the procedure was performed under local anesthesia, then a short period of time, about two hours (it all depends on the individual characteristics of the female body), is enough for the woman to come to her senses and be sent home. Although she will have to go to the dressings, which are done every other day or daily. When the surgeon makes a cosmetic suture, the scar remains small, slightly noticeable. In the normal course of the postoperative period, the suture should remain dry and clean. In this case, the site of the surgical intervention can simply be fixed with an adhesive plaster with a sterile napkin placed under it.

If the excision method chosen is sectoral resection, performed under general anesthesia, then the operation is performed within the hospital. The consequences of removing fibroadenoma of the mammary gland using this technology require the woman to stay under the supervision of doctors in the hospital for two to three days after the operation. To obtain effective postoperative rehabilitation, it is necessary to follow all the recommendations given by the doctor.

• A good rest is necessary.
• The diet of a postoperative woman should include foods high in vitamin C and protein foods.
• Clothing should be comfortable: not press or rub at the site of the operation.
• A woman should wear a properly fitted bra. In such a situation, a sports bra is perfect, as it supports the breasts well, but is elastic enough not to cause discomfort to its owner. In this case, there is no need to adjust the length of the bra straps.
• The fabric of underwear and clothing must be natural.
• On average, the recovery period lasts from two to eight days.

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Complications

But surgical intervention is still a violation of the integrity of certain tissue layers. Therefore, in some cases, complications may be observed after the removal of fibroadenoma of the mammary gland. What can a woman expect after such an operation?

• Monitoring of postoperative cases has shown that the patient may feel thirsty several hours after the procedure is completed.
• In the first period after the operation, a woman may be bothered by pain in the chest area and the suture area. If the intensity of the 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 suture area, or there is a bruise or abrasion at the incision site, you should inform your doctor. It is quite possible that he will prescribe a vitamin complex. Hemorrhage may be the result of both improper action by the operating team and the characteristics of the patient's body, which is characterized by increased bleeding.
• Gradually, the surgical suture is transformed into scar tissue, which can be reabsorbed by using special modern creams.
• The possibility of relapses cannot be ruled out. Therefore, such patients should undergo examination at least once a year.
• In some cases, deformation of the operated breast can be observed: its shape and size may change.
• Swelling and hyperemia of the affected breast, as well as the adjacent axillary tissues and shoulder area may be observed.
• There may be pain when touched.
• If an infection occurs as a result of a violation of the sterility of the operation, abscesses form.
• Seroma is a complication similar to hemorrhage, with the only difference being that instead of blood, serous fluid and blood plasma are released. Drainage is required to ensure their normal outflow.

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Breast pain

No matter how gentle the operation is, it involves breaking the integrity of a number of layers, so pain in the mammary gland after fibroadenoma removal immediately after surgical treatment is normal. It should disappear over time.

If this does not happen, and the pain symptoms only increase in intensity, you should inform the specialist who is supervising the postoperative period. It is quite possible that pathogenic flora has entered the woman's body, provoking an inflammatory process. In this case, the doctor will prescribe antibiotics and painkillers.

If the process has started and a purulent infiltrate has already formed, cleaning, installing drainage and using the same medications are completely acceptable.

But you should not focus only on the reasons of this kind, as the source of pain can also be other concomitant diseases. For example, osteochondrosis, neuralgia and numerous different pathologies. Over time, the scar may begin to hurt "for any weather".

In order not to suffer and not to guess what is the catalyst for pain, it is necessary to consult a specialist and undergo an examination. This may be a certain diagnostic procedure prescribed by the doctor, for example, an ultrasound examination.

Temperature

Particular attention should be paid in the case of an elevated temperature after removal of a fibroadenoma of the mammary gland. This symptom is dangerous because it indicates the presence of an intense inflammatory process in the patient's body, which threatens to degenerate into purulent and serous formations.

An increase in body temperature should alert a woman and force her to immediately come for a consultation with a doctor - a mammologist.

Scarring

Before deciding on an operation, it would be a good idea to ask the doctor what kind of suture he will make after excision. In order for the scar after removal of a fibroadenoma of the mammary gland to be as unnoticeable as possible, it must be made using a special technique and get the so-called cosmetic suture.

Doctors also know some places on the female breast, the incision on which will subsequently be almost invisible due to the anatomical fold present nearby. Such an incision can be made in the periareolar zone, which is designated by the fold under the areola of the breast, as well as in the submammary region, which is located in the fold under the female breast.

But if the neoplasm is located directly in the subcutaneous layers, the incision is usually made directly above the tumor.

To achieve a small scar size, doctors use special medical equipment and surgical instruments, such as retractors with illumination. Special absorbable threads are also used.

With a periareolar incision, a subcutaneous suture is used, which allows for good results, making the scar virtually invisible.

The appearance of a hematoma

A hematoma is a collection of blood in the body tissues. After the operation, one of the capillaries may be damaged, which became the source of the outpouring. Hematoma after removal of fibroadenoma of the mammary gland is designated as one of the complications of surgical intervention. But, if the recovery period proceeds normally, most likely these structures will gradually resolve on their own and the dark spot will disappear. To speed up this process, you can use special creams, which the doctor will prescribe in this situation.

Only in rare cases is cleaning and drainage of the canal necessary. But only a specialist can make such a decision. Therefore, it is advisable to consult with your doctor.

The appearance of a seal

The neoplasm in question is removed only by surgical intervention, which damages the skin and subcutaneous layers. Therefore, after the removal is complete, the oncologist surgeon must apply internal (self-absorbing threads) and external (subsequently removed by a medical professional) sutures.

Often, the compaction that is felt at first after the removal of fibroadenoma of the mammary gland is precisely the scars that formed during the surgical intervention and the elimination of the surgical cavity. Over time, they should either decrease in size or almost completely disappear. But if doubts remain, it is better to seek help and an examination by a mammologist.

A woman should periodically palpate her breasts (even after surgery). And if after a significant amount of time has passed, during a routine checkup, a woman feels a lump on her breasts, this is a good reason for further diagnostics under the supervision of a specialist. It is quite possible that the disease has relapsed and repeated treatment is necessary.

Postoperative period

The surgical interventions discussed in this article are almost always difficult for women to bear. The severity of the consequences of the operation consists not only in physical damage, but also in psychological and emotional discomfort. Especially if it concerns the removal of fairly large volumes of tumor.

Therefore, the postoperative period after the removal of fibroadenoma of the mammary gland is very important and requires the complex use of rehabilitation measures. At this time, a woman who has undergone surgery needs the support and help of loved ones more than ever. The emotional aspect of the problem should not be thrown off the boards. The more a woman is determined to have a positive result of the operation, the easier the surgical intervention itself is, as practice shows, there are fewer complications and the postoperative recovery period takes a short period of 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 prescribed specifically for each individual case. In order for the result to be most effective, it is necessary to follow all the requirements of the attending specialist as strictly as possible.

Rehabilitation period

After any surgical intervention, the patient needs postoperative recovery and psychological rehabilitation. This also applies to women who have undergone fibroadenoma excision. But, as doctors note, the peculiarity of rehabilitation after the removal of fibroadenoma of the mammary gland is that here it is not so much physical rehabilitation that is needed (although it is, of course, needed), as psychological support.

After all, breasts for a woman are like a symbol of beauty, belonging to the caste of women. This operation undermines a woman's faith in her attractiveness and completeness. Hence the prolonged depressions, which can significantly prolong the rehabilitation period after surgery.

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

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

Women who have encountered this problem should not be afraid of the operation, putting it off until later. They should set themselves up for a positive result, and women who have already undergone the operation can be taken as an example. Many of them live long and happily, having long forgotten about the problem they had!

Oncologist's recommendations after surgery

After the surgical intervention, the recovery period takes a certain period of time: on average from two to eight days. But during this period, the patient necessarily receives, after the removal of the fibroadenoma of the mammary gland, recommendations for suture care and rules of conduct for women during this time.

• The patient must wear a properly fitted bra for the time recommended by the doctor. It is not taken off even at night. Usually, this regimen takes from 7 to 10 days, but it can be longer - this is decided by the operating mammologist - oncologist.
• It is necessary to come for dressing changes every other day or daily, as prescribed by the specialist.
• During this period, a woman should rest more, restoring her strength.
• Her diet should contain enough foods containing a high percentage of vitamin C and protein.
• After he has given permission, the woman can take a shower. But at first, when carrying out water procedures, it is advisable to hold the mammary gland.
• If there is a hematoma and swelling, the doctor will prescribe special creams. For example, this could be Contractubex gel.
• If the former patient begins to feel unwell, negative symptoms appear, it is necessary to urgently contact your attending physician, perhaps an infection has entered the wound and the situation requires immediate medical intervention.

What should not be done after surgery?

Various pathological changes in the patient's body require their own specific restrictions. Therefore, it would be useful to know what should not be done after removing fibroadenoma on the mammary gland?

First of all, whether there was an operation or not, even if there is a suspicion of this disease, a woman should limit her stay in direct sunlight. This issue is especially relevant in the hot summer period. The situation is similar with visiting a solarium. Even a healthy woman should not get carried away with this procedure, and as for patients who have undergone fibroadenoma removal, doctors recommend that they forget about it altogether.

Also, for some time after the operation, physical activity should be limited and the emotional background should be stabilized: soothing teas and positive emotions will benefit the woman.

Cost of surgery

After the question of surgical intervention arose, the patient naturally had a question - the price of removing fibroadenoma of the mammary gland and what services are provided for the stated price.

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

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

Again, in some cases plastic correction is performed immediately, which adds a little extra to the cost. Therefore, it is pointless to talk about the cost in general.

It is worth noting that the removal of fibroadenoma of the mammary gland is a simple operation that does not require large financial costs.

The cost of the operation, in most cases, usually includes the stay in the clinic, food, anesthesia, medication, the number of excised fibroadenomas and, accordingly, the necessary histological studies. Some clinics may also include additional services. Therefore, before paying for the procedure, it is necessary to familiarize yourself in more detail with the list of services offered and their price list.

Some clinics also provide post-operative plastic surgery, which may be included in the total cost, or may be charged as an additional fee.

On average, the cost of such services ranges from 6,000 to 8,000 hryvnia.

Healthy and beautiful breasts are a woman's pride and health, which must be protected. Therefore, it would be a good idea to regularly examine and palpate them. If, upon palpation, you feel a lump, a single or conglomerate of nodules, you should consult a doctor - a mammologist. It is better if this is a false alarm and everything is fine with your breasts than if, by ignoring the problem, time was lost and the neoplasm acquired an impressive size. It is even more frightening when the tumor has degenerated and is a cancerous neoplasm. This metamorphosis is not very common (about 10% of potential cases), but you should not tempt fate, because these terrible percentages may fall on your case.

Therefore, doctors advise girls and women not to neglect the disease, especially since the removal of fibroadenoma of the mammary gland is one of the easiest surgical interventions performed on the chest. The faster this problem is solved, the more gentle and organ-preserving the operation will be, and the disease in question will be forgotten as a bad dream.

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