Causes
The occurrence of breast fibroadenoma is related to endocrine hormone imbalance, especially estrogen. High estrogen levels cause abnormal proliferation of breast ducts and mesenchyme to form tumors. In addition, some patients do not have high estrogen but are highly sensitive to estrogen. There are many causes of high estrogen such as: high fat, high energy diet, obesity, liver dysfunction.
Clinical symptoms
In most cases, breast lumps are the only symptom of the disease. They are not usually painful and do not change with the menstrual cycle. In a small number of cases, breast fibroadenoma is accompanied by breast enlargement, which may cause premenstrual breast pain and discomfort.
Conservative treatment
Many people with fibroadenomas found during physical examinations want to be treated conservatively. The prerequisite for conservative treatment is a detailed examination to rule out the possibility of malignancy, so that your doctor will give you a clear indication that you can follow up regularly on an outpatient basis. Some patients can be treated with herbal medicine. The most important thing about herbal treatment is dialectical evidence. The most important thing in Chinese medicine treatment is dialectic, that is, according to the patient’s different symptom expression, administering different prescription medication. If you prescribe Chinese medicine without evidence, you should say that at least it is not Chinese medicine in practice. This is divided into two main types.
Liver Qi Stagnation Type
Generally, the lump is small, slow to develop, not red, not hot, not painful, and can be moved by pushing. There may be breast discomfort, chest tightness and sighing. The coating is thin and white, and the pulse is string. Treatment is to relieve liver stagnation and dispel lumps and knots.
Blood stasis and phlegm coagulation type
The lump is usually large, firm and hard, with heavy discomfort. There is pain in the chest and hypochondrium, boredom and anxiety, or irregular menstruation and dysmenorrhea. The tongue is dark red, the coating is thin and greasy, and the pulse is thin and stringent. Treatment is to dredge the liver and invigorate blood, resolve phlegm and disperse nodules.
Disease Prevention
In clinical work, we have contact with many patients, basically each patient will ask the details of the patient’s life, including diet and living habits, and found that a large proportion of patients have these characteristics: impatient personality, long-term late night, high work pressure, poor relationship between husband and wife, irregular menstruation, late marriage, single at an advanced age. In general, disease prevention requires: a good attitude, regular work and rest, high-fiber diet, and a return to nature.
Returning to nature is a rather general statement, simply saying that people used to live a simpler life and have a lower disease rate. All suggestions now include for example, using less estrogen-containing cosmetics, no breast enlargement, avoiding prolonged hot water to stimulate the breasts and body, wearing less corsets or tight clothes, exercising more, and consuming less fast food such as chicken, duck, fish and shrimp.
Inpatient surgery procedure (stay in the hospital is 1 day)
(Except for Friday and Saturday) admission on the first day of admission on an empty stomach (doctor prescribes hospitalization: first floor payment – nurse station for admission – doctor prescribes examination and asks for medical history and ultrasound positioning – blood draw) – surgery on the second day (hospitalization that night) – discharge on the third day after medication change. You cannot schedule surgery for a Sunday admission, so those admitted on Sunday need to schedule surgery for Tuesday.
Choice of surgical method
Currently, there are traditional surgical procedures and minimally invasive procedures with the McMurdo surgical system. It is important to understand that the size of the surgery cannot be generalized: minimally invasive means less invasive, while traditional surgery is more invasive. If all benign breast masses smaller than 3 cm are considered to be minimally invasive, at least it can be considered that the choice of surgical approach is not perfect. We have a different pursuit for the same benign breast mass surgery. We pursue a combination of minimal damage and aesthetic appearance: first, to ensure that the mass is cut off, then the principle of surgery is to minimize damage to the breast, and the smallest incision is the most beautiful.
When a mass is superficial and close to the nipple, we consider the traditional surgery. In this case, the areolar incision is concealed, the boundaries of the adenoma are clearly defined, and most of the surgeries are performed with blunt separation, so the surgical trauma is small and the milk ducts can be almost undamaged. In contrast, in this case, the use of minimally invasive is prone to postoperative complications, and it is easy to destroy the milk ducts, and the trauma is not small. In the case of multiple breast masses or masses that cannot be retrieved on examination, minimally invasive has a unique aspect and we choose to use minimally invasive. The other is that if the mass is suspicious of malignancy, we choose to use the traditional approach, which can avoid unnecessary transfer of the puncture needle tract. Therefore, it is worthwhile to listen more to the specific analysis given to you by your doctor in terms of the choice of surgical approach. We will choose the best surgical option for each patient.
Post-operative care
Compression bandages with elastic bandages are routinely required after mastectomy. The dressing has two purposes: to stop bleeding and to promote wound healing. It is important to note here that the degree of tightness of the compression bandage will not be the same for each patient, so if you can try to stick to it, it will also reduce postoperative wound bleeding and bleeding, as well as reduce the stiffness of the wound to the touch after surgery. In addition, the presence of pressure dressing affects the skin suture problem in traditional breast surgery. Convenient and effective “skin glue” in breast wounds is less effective, and many postoperative wounds are “broken” by the elastic bandage pressure. The choice of sutures is made with the choice of ordinary fine thread, ordinary absorbable thread, and protein absorbable thread. Among them, the ordinary silk thread is required to remove the thread, while the ordinary absorbable thread we recommend is better to remove the thread. The protein absorbable thread can be absorbed 7 days after surgery and has some advantages for use in breast wounds. All three types of threads are not much worse for skin healing.