The clinical pathway of breast fibroid outpatient clinic is one of the treatment procedures for various breast diseases developed by our department. I publish it to let patients examine from a paraprofessional perspective: do they have the disease? It gives patients a chance to self-screen; at the same time, it also allows patients or their relatives to understand whether their treatment is reasonable through the following introduction.
Diagnostic criteria.
1.Mammary fibroid tumor occurs in adolescent women, most common at the age of 18 to 25.
2. The tumor mostly occurs in one breast, often solitary, and the outer upper quadrant of the breast is the most common. The lump is usually round or oval, with different sizes, hard texture, smooth surface, clear territory, large mobility, no adhesion with four tissues, no pain and tenderness. It grows slowly and does not septicize and ulcerate. It is not related to the menstrual cycle.
3.Molybdenum X-ray and other imaging examinations can help the diagnosis. If necessary, needle aspiration cytology examination of the mass or biopsy can be done for ultimate and clear diagnosis of breast fibroids.
Treatment pathway.
1. Detailed medical history taking.
Time of finding the lump, presence or absence of pain, time and location of pain, presence or absence of radiating pain, relationship between pain and menstruation, time of last menstruation, previous treatment and effect, presence or absence of relevant imaging data, etc;
2. Careful physical examination + specialist examination.
The appearance of both breasts should be checked for deformities, nipple invagination, overflow, vascular filling or anger; palpation is the key point, whether there are nodules and lumps, their texture, mobility, boundary, etc., and the degree of pressure pain, etc.
3.Perfection of relevant outpatient auxiliary examinations.
(1) Ultrasound examination of breast: (mandatory)
Advantages: convenient, economic, non-invasive and painless advantages.
Features: With the development of ultrasound imaging, the application of high-frequency ultrasound has greatly improved the resolution of ultrasound, which can detect microscopic lesions in the breast, especially for the identification of cystic and solid tumors, which is difficult to replace by other imaging.
(2) Mammography: (optional)
Advantages: mammography is an important tool for detecting early and microscopic cancers.
Features: for microcalcifications the examination is incomparable to other imaging examinations.
Points to note: However, repeated examinations within a short period of time are not necessary; the breast during puberty and pregnancy and lactation is sensitive to X-rays and overexposure increases the incidence of breast cancer
Frequency of examination: mammography should be performed at least once before the age of 30, once every 2-3 years between the ages of 30 and 40, and once every 1-2 years after the age of 40.
4.Propose a preliminary diagnosis.
5.Outpatient management advice.
(1) Surgery: surgical excision, starting with minimally invasive rotational surgery.
(2) Post-operative minimally invasive surgery: (10-day telephone follow-up, 3-month review)