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Abstract: The patient came to the clinic 1 week ago after unintentionally finding multiple masses in the left breast. After mammography and mammography, a breast nodule was considered to have occurred in the left breast. With the patient’s consent, a left mastectomy was performed, and the postoperative pathology suggested a benign lesion of breast nodules due to breast fibroadenoma. The larger breast nodule was successfully removed intraoperatively, and the patient’s nervousness and anxiety were significantly relieved.
Basic information】Female, 28 years old
Type of disease】Mammary nodules
Hospital】The First Hospital of Harbin Medical University
Date of consultation】April 2022
Treatment plan】Surgical treatment (left mammary mass excision)
Treatment Period】4 days of hospitalization and review after 2 months
Results】The large breast nodule was successfully removed, and the patient’s nervousness and anxiety were significantly relieved.
I. Initial consultation
The patient unintentionally found multiple lumps in the left breast one week ago and came to the clinic for a definitive diagnosis. Multiple “bean” sized masses were palpable in the patient’s left breast, with no pain or discomfort and no nipple discharge. CDFI: no abnormal blood flow signal in the gland, BI-RADS: class 2. Mammography showed that the left lateral breast had a circular isointense nodule of about 22 mm × 19 mm with clear borders, and the left upper quadrant of the left breast had an isointense nodule of about 23 mm × 19 mm with clear borders, and multiple small nodules were seen in the left breast, BI-RADS: category 3. Combined with the patient’s medical history and relevant examinations, a breast nodule was considered to have occurred in the left breast.
II. Treatment history
Breast ultrasound and mammography showed that the patient had a large number of breast nodules and some of them were large in size, so surgery was considered for her. After thorough communication with the patient and her family and weighing the thoroughness of the surgery against the integrity of the gland, it was decided that this surgery would mainly target the larger breast nodules and the smaller nodules would be closely observed. After completing the preoperative examination with no contraindications, the patient underwent excision of the left breast mass and the larger breast nodule was removed. The pathological results showed a breast fibroadenoma, that is, a breast nodule caused by a benign lesion like a breast fibroadenoma. A postoperative lap band was required to fix the breast incision for 2 weeks to avoid fluid accumulation in the incision.
III. Treatment results
After the patient underwent left mastectomy, the bulky breast nodule was successfully removed. Pathological examinations were performed both during and after surgery, and the results showed benign. The patient was informed that it was a benign lesion, and her preoperative tension and anxiety were significantly relieved. After 4 days of hospitalization, the incision was free of redness, swelling and exudate, and the patient was generally in good condition and given discharge.
IV. Notes
We are glad that the patient’s disease has improved after treatment, but we still need to remind the patient to pay attention to the following matters in daily life.
1. Care of the incision and medication: The patient underwent mastectomy, and the chest incision was closed with absorbable sutures, which did not need to be removed after surgery. However, the patient’s breast needs to be fixed with a lap band under pressure to avoid fluid accumulation in the incision.
2. Moderate activity: Patients should avoid bed rest after surgery and actively go down to the ground for activities. Prolonged bed rest can lead to thrombosis, which can increase the chance of adverse events such as pulmonary embolism.
3. Review: Patients should have their first review 2 months after surgery. The review should include mammography ultrasound to observe whether breast nodules recur and to observe other small breast nodules that have not undergone surgery.
V. Personal insight
Young women need to be alert for breast nodules when a large breast lump is found. In this case, it is reassuring that the patient’s self-examination revealed a breast lump, which was surgically treated in the hospital and confirmed to be benign postoperatively. However, a significant proportion of breast nodules are malignant and have a better prognosis with early diagnosis and treatment. In the case of breast nodules, when they are smaller and have no malignant tendency, they can be reviewed regularly under the guidance of a doctor. If the breast nodules increase in size or if the examination shows a malignant tendency, surgery is required as soon as possible.