As technology advances and people become more aware of self-care, more and more breast masses are detected by ultrasound or mammogram, and the traditional treatment is surgical removal. Surgery is not only traumatic, but also leaves permanent scars on the breast skin and causes psychological damage to the patient.
I. Definition
Mammotome (MMT) is a new treatment system for breast lump disease through minimally invasive surgery. The system can remove the lesions of benign breast diseases such as fibroadenoma (≤2.4cm in diameter) with minimal damage, leaving no scars after surgery and excellent cosmetic results.
The use of Mammotome minimally invasive rotary biopsy for suspicious breast lesions can provide a definite diagnosis and reduce the rate of surgery for benign breast lesions.
Principle
The Mammotome was first developed in the 1990s.
The Mammotome minimally invasive rotary biopsy system was developed based on the technique of hollow-core needle biopsy, which consists of two devices: a rotary cutter and a vacuum suction pump. The rotary cutter is composed of a trocar needle, supplemented by a vacuum suction, and has a special transfer device to deliver the resected specimen out of the body through the inner trocar needle movement without withdrawing the outer trocar needle. The whole procedure is monitored by ultrasound in real time and can be performed several times until the lesion is completely excised and finally terminated by ultrasound in real time. Vacuum suction can be used to remove the local blood accumulation during the process of rotary incision and before setting out the rotary cutter.
Three, the use of methods and processes
1.Positioning: The patient is placed in a flat position, sterile towel is laid, and the site and number of breast masses are detected by ultrasound to guide the selection of the puncture site.
2.Anesthesia: Local anesthetic is injected into the base of the lesion and the puncture needle tract with a 22 G long needle.
3.Puncture spinotomy: An incision of about 3 mm in length is made at the pre-puncture site with a sharp knife blade.
Under the guidance of ultrasound, the rotary cutter was inserted into the base of the swelling, and the swelling was adsorbed into the groove of the rotary cutter by negative pressure attraction, and the rotary cut was started. For multiple lesions of the same breast, the swelling can be removed by changing the direction of the rotary cutter without further skin incision without pulling out the rotary cutter.
4.The whole procedure of rotary incision is carried out under the real-time guidance of B ultrasound, and after complete excision, the blood in the residual cavity is aspirated and the rotary knife is removed. The residual cavity is compressed with gauze and wrapped with a chest strap, and the incision does not need to be sutured.
IV. Advantages and features of Mammotome
1. Minimally invasive surgery: Ultrasound-guided Mammotome reduces the underestimation rate of the disease. It eliminates the need for multiple punctures, reduces the possibility of epithelial metastasis, minimizes bleeding and interference of local anesthetics with ultrasound images.
2. Qualitative and accurate: it can improve the rate of breast-conserving surgery for breast cancer and improve the prognosis and quality of life.
3. Hidden incision: the skin incision is about 2~3mm long.
4. No suture: direct pressure is applied to the incision site by both hands for at least 10 minutes to achieve good hemostasis.
5. Quick recovery: The small skin incision is taped with 3M sterile no-sew tape, and the chest elastic bandage is wrapped with pressure for 48 hours.
V. Indications for Mammotome
Benign tumors less than 2.4cm in length and diameter can be excised at once to avoid scars caused by traditional open surgery; those who cannot be clearly diagnosed by clinical and imaging examinations and have no sufficient basis to exclude breast cancer and need to undergo excisional biopsy; breast lumps suspected to be malignant tumors, preoperative biopsy with Mammotome to clarify the diagnosis and determine the biological characteristics of cancerous tissue and neoadjuvant treatment. The main ones are.
1.Fibroadenoma
2.Nodules
3.Microcalcifications
4, asymmetric density: (1) breast biopsy; (2) excision of benign lesions