In general, all benign breast tumors that I see in my clinic require surgery as an outpatient and do not require hospitalization.
The following cases require hospitalization.
1. The mass is more than 5 cm
2. The patient is over 65 years old or has serious cardiovascular disease
3.The examination suggests the possibility of malignant tumor
4.Patients strongly request hospitalization for surgery
5.Patients with public medical expenses, considering the reimbursement factor, hospitalization is more economical than outpatient.
Selection of surgery for benign tumor.
1.B ultrasound report of our hospital shows that the breast mass is cystic mass, so surgery is not required.
2. If the ultrasound report of our hospital shows that the mass is “fat necrosis”, surgery is not required for the time being and will be reviewed after 6 months.
3.If the ultrasound report of our hospital shows “lipoma” or “malignant tumor”, surgery is not required unless the mass is large and affects life.
4.If the ultrasound report of our hospital shows “papilloma”, outpatient surgery for grade 3 and inpatient surgery for grade 4
5.If our ultrasound report shows “benign nodules” or “hyperplastic nodules”, review after 4-6 months, about 10 days after menstruation
6.If the ultrasound report of our hospital shows “breast adenofibroma”, then we need to discuss whether surgery is needed, or whether we should observe, how to observe, and how to operate if surgery is needed.
7.If you are not sure, you can see my clinic and decide.
Should I see the doctor first or do ultrasound first?
The smartest way to find a breast lump is to first register at the registration desk at 7:30 a.m. for a “Breast Clinic No. 1” and a “Specialist No. Zhang Bin, Deputy Chief Physician”, and then get a “Breast Clinic” number on the first floor of the B building. At the “Breast Clinic” on the 1st floor of the B building, you can apply for an ultrasound of both breasts, go to the “Breast Ultrasound Room” of the “Breast Diagnostic Imaging Department” on the 2nd floor of the B building, and then Take the ultrasound results to my clinic and make an appointment for surgery. In this way, although the registration fee is 4 yuan more, you can save at least one day of consultation time.
The purpose of benign tumor consultation
1. To decide whether surgery is needed or whether observation can be done first.
Tumors smaller than 0 or 5 cm are usually not operated first, and then the ultrasound will be reviewed after 3 months, if there is enlargement, surgery will be removed, if there is no change, ultrasound will be reviewed once every 6 months, if there is no enlargement, observation can be continued, if there is enlargement, surgery should be performed. If there is no change, the ultrasound will be repeated every 6 months. The review should be done about 10 days after menstruation.
Most cases larger than 1 cm require surgery.
2. Decide how to operate.
All benign breast tumors can be operated either by traditional open-ended surgery or minimally invasive surgery with McMurdo.
Generally, single tumors over 2 or 5 cm or those that are more superficial and in the superficial layer of the gland are more likely to prefer traditional surgery.
Open-heart surgery is always indicated for those whose diagnosis is suspected to be malignant.
Those with greater diagnostic certainty, multiple occurrences, those that are deeper and not clearly palpable, or those where the patient is younger and particularly concerned about the surgical scar, tend to prefer McMurdo minimally invasive surgery.
3. Take my business card, get contact information and make an appointment for surgery.
Benign swelling consultation and surgery process.
1. All outpatient surgery is Saturday, Monday clinic about Tuesday surgery, if it is Monday is the next day surgery.
2. You don’t need to register for a specialist number, you can register on the registration terminal to avoid the pain of queuing.
3. Make a request for ultrasound examination and make an appointment at the registration room of the Breast Diagnostic Imaging Department on the 2nd floor of the B building to have ultrasound done, or have ultrasound done before the consultation and come to the clinic with the ultrasound examination results – the latter is encouraged and most efficient.
3. Confirm benign tumor by ultrasound, and determine the number of tumors (single, multiple), and tumor size
4.Come to me to confirm the surgery method and agree on the surgery time (every Tuesday morning).
5. On the surgery day, you can have breakfast and come to me on the 7th floor of the B building at 8:00 am for registration, usually the surgery will start around 10:00 am and finish before noon.
6.You can go home immediately after the outpatient surgery without hospitalization; you need to press the wound by yourself for 1 day after the open surgery, and you can uncover the gauze by yourself after 7 days; you can lift the bandage by yourself after 48 hours of minimally invasive surgery; all outpatient surgeries do not need to change the medicine and remove the stitches; you can take oral antibiotics by yourself for 3 days after the surgery, choose cephalosporin or penicillin, you do not need to take the medicine in our hospital, generally you can have it at home; you do not need infusion treatment.
7, 7-9 days after surgery to my clinic to see the pathology, see the wound; before to the clinic guide desk to get on the pathology report.
The treatment is over.
Pre-surgical examination process
1. Outpatient surgery must have our ultrasound, and those who are over 45 years old need to have additional mammogram. ultrasound application form must be issued before 8:30 a.m.
2. Registration: 1st floor registration office of E building (crowded, starts at 7:30), 1st floor registration office of B building (crowded, starts at 7:30), 2nd floor registration office of B building (less crowded, starts at 8:00), radiotherapy area can also be registered (less crowded, starts at 8:00). You must come early before 7:30 to register. You can “register for Zhang Bin’s specialist number” or “mammography convenient number”.
3. Application form
(1) Monday all day or Saturday morning, register for “Zhang Bin’s specialist number” or “mammography convenient number”, go to the 1st floor of the B building, Zhang director’s office (Saturday, room 1, Monday, room 4) and ask Zhang director directly for an ultrasound application form.
(2) Monday to Friday, all day or Saturday morning, go to the Breast Clinic to obtain an ultrasound application form by registering for the “Breast Clinic Private Number”.
(3) Monday to Thursday morning, register for the “Mammography Clinic” and go to Dr. Liu Yu or Dr. Huang Yi on the 7th floor of the B building to get an ultrasound prescription.
4. Payment: Pay the fee first and then make an appointment. Payment is made at the fee counter on the 2nd floor (less crowded) and 1st floor (more crowded) of the B building.
5.Appointment for ultrasound/mammogram: Breast ultrasound and mammogram are both located in the “Breast Imaging and Diagnostic Department Registration Room” on the 2nd floor of the B building, and the appointment must be made before 9:00 a.m. in order to be able to do it on the same day. If the application form is opened late, it is recommended to pay the fee first and then go to the appointment at 7:30 am the next day.
Procedure for surgery appointments.
All outpatient surgeries are Saturday or Monday appointments for Tuesday’s surgery. Monday appointments on the following day, Saturday appointments three days later
The director will issue a surgery appointment form, a blood test application form, and an ultrasound positioning application form if necessary. For open surgery, a prescription of “Lan Ling Tissue Glue” is required, but for minimally invasive surgery, no prescription is required.
1.Surgery appointment form –> Go to the outpatient surgery room on the fourth floor of Block E to make an appointment for surgery and fill in the informed consent form. Surgery without appointment will not be accepted.
2.Blood test before surgery –> After paying the fee at B1 or 2nd floor, go to the laboratory on the 1st floor of Block B to have blood drawn. The blood drawing time is during working hours, starting at 7 o’clock in the morning with a sign at the entrance, and the result will be issued in about two hours. If you have your blood drawn on the day of surgery, be sure to pay in advance and come to the blood draw at 7:30 a.m. on Tuesday to be in time for the surgery that day.
3. Ultrasound positioning –> same as pre-operative ultrasound.
Surgery time.
Both open-heart surgery and minimally invasive surgery are done on Tuesday mornings. You need to make an appointment for surgery at the clinic on the previous Saturday or Monday and have two tests done: routine blood tests and flow disease (hepatitis, tuberculosis, syphilis, AIDS) tests. Out-of-town patients can come directly to the surgery appointment with the results after the tests are done locally.
Please pay special attention to out-of-town patients!
Pre-surgery preparation.
1. You need to bring: ultrasound results, blood test report form, outpatient surgery appointment form at the time of surgery. Tissue glue (required for open-heart surgery, not for minimally invasive surgery). The test report form will be shown to the operating room window teacher during the surgery. It is not necessary to look for the blood test results in advance with Director Zhang.
2. Patients with hypertension, please take relevant medications to control blood pressure in advance. For patients with chronic diseases, please take your regular medication before surgery.
3. Please avoid menstruation as much as possible to prevent bleeding.
4. Take a bath the night before surgery and make sure to clean the local skin of the surgical site.
5. You can have a small breakfast on the day of surgery, but you should not be too full.
6. For open-heart surgery, you need to buy tissue glue from Zhenhua Pharmacy on the 1st floor of C building with the prescription of “Lan Ling Tissue Glue”.
7. Before the surgery, you can register at the registration desk on the 2nd and 3rd floor of the E building and get the number of “outpatient operating room”.
8. The operation needs to be accompanied by family members (payment, specimen delivery, accompanying), those without family members will not be given.
9. Outpatient surgery will be performed in the outpatient operating room on the 4th floor of the E building.
10. Come as early as possible for surgery, first come first done.
11. Do not bring valuables into the operating room to avoid loss.
12. Bring enough fees, outpatient clinics cannot take credit for fees.
13. If preoperative ultrasound positioning is required during the visit, you need to position and body mark the tumor location before surgery on the day of surgery.
14. The outpatient operating room stipulates that you must bring the results of routine blood and flow disease tests for surgery (field results are recognized, but must be recent).
Post-surgery matters.
1. Go home directly after outpatient surgery. Be careful not to sweat too much.
2.The surface dressing can be removed one week after the opening surgery. If there is no special instruction, there is no need to change the medicine and remove the stitches.
3.Surgical excision specimens will be sent by family members to the Breast Pathology Department on the 3rd floor of the B building, and pathology results will be taken one week later.
4.For those who have drainage tubes, drain the fluid in the syringe by yourself every day, less than 5ml and come to the hospital every morning to remove the tubes, foreign patients can return to the local area to remove the tubes.
5.Minimally invasive surgery chest bandage needs to be brought for 48 hours, and then removed on its own, the surface wound is covered with a band-aid, surface bruising is a natural phenomenon, no need for special treatment. After a week, you can apply hot compresses to promote healing inside the wound.
6, after surgery can eat 3 days of antibiotics (Pioneer IV, cotrimoxazole, etc. are available)
7.Pathology results can contact Dr. Zhang by WeChat or SMS, or come to the clinic on clinic days to have a look (no need to register), or come to the ward on the 7th floor of the B building every Monday to Saturday morning to have a look at Dr. Zhang’s group.
8.If the surgery is postponed after the appointment due to menstruation or other reasons, please call the contact number: 23340123 ext. 5001 (contact every Monday to Friday).
9.After one year, the clinic will prescribe “ultrasound examination of both breasts” to review the ultrasound (the same principle as above). Then go to Director Zhang’s clinic for consultation. Review if necessary.
Cost.
(Outpatient surgery: 900 RMB per incision, plus 400 RMB for one more tumor in each incision, and two for larger tumors (more than 3 cm), subject to ultrasound, which are covered by general outpatient medical insurance).
Outpatient minimally invasive surgery: RMB 5300, plus RMB 500 for each additional tumor (self-pay)
Inpatient treatment: about 8000 (medical insurance), but I haven’t seen any reimbursement ratio over 83% so far.
Ask the window nurse teacher about the specific algorithm, the surgeon doctor is not a pricer, he just knows the approximate range.
Regarding pathology.
The excised tissue specimens are personally delivered by the patient’s family to the breast pathology department on the 3rd floor of the B building.
The pathology results will be available in a week, and the results will be picked up in the “File 2” room of the Breast Pathology Department on the third floor of the B building.
In principle, patients should come to pick up the results in person; if they cannot come, they can ask their relatives and friends in Tianjin to pick up the results; if not, they can scan the QR code below and add Dr. Zhang as a WeChat friend, so that they can send photos of the pathology results through WeChat, but I am sorry that I cannot send paper copies of the reports for them.
What if I’m out of town and I’m not sure if I need surgery?
1. See your local doctor and have a breast ultrasound examination. Take a picture of the report with your cell phone.
2. You can scan the QR code below, add a WeChat friend, and send the photo to see if you need to come to Tsu first, if you don’t need surgery, you don’t have to run, if you need to set up an outpatient appointment.