We welcome patients who come for “minimally invasive biopsy” and “minimally invasive surgery” to treat benign masses, but we hope patients will understand what “minimally invasive” means and its pros and cons. But we hope that patients can understand what “minimally invasive” is and its advantages and disadvantages. However, we hope that patients will understand what “minimally invasive” is and its advantages and disadvantages. We have found that many patients who come to us do not know what “minimally invasive” is and are just following the clouds. Minimally invasive, in a broad sense, means that any surgery in modern medicine should be developed towards minimally invasive. For example, breast cancer breast-conserving surgery, thoracoscopic pneumonectomy, laparoscopic cholecystectomy, laparoscopic oophorectomy ……. With comparable efficacy, smaller incisions, less trauma (meaning overall trauma, not just incisions) and minimal impact on appearance are both the demands of patients and the pursuit of generations of doctors. Everyone has a love of beauty, especially in mammography, which is performed on important female areas (secondary sexual characteristics). Even traditional open surgery has evolved toward smaller and more discreet incisions. In a narrower sense, let’s talk about the role of the Mammotome vacuum-assisted minimally invasive mastectomy system. If you look carefully at the product description, this device should be based on minimally invasive “biopsy”, and only secondly on the part of the appropriate benign lumps (should refer to the lump size, depth, location, etc. is appropriate) can be removed under the guidance of ultrasound. I once read on the Internet that “the only disadvantage of McMerton is that it is expensive”, and I have to say it politely, fallacy! Foolishness! The McMerton system is primarily a biopsy device, and from a biopsy point of view, it can take more specimens than other devices (such as hollow core needles, fine needles), and as we all know, the more specimens, the higher the pathological accuracy. Compared to surgical biopsies (with sufficient volume of specimens), the incision is smaller. Therefore, from a biopsy point of view, the “only disadvantage is that it is expensive” can be justified. In terms of treating the disease (removing the mass), it is important to understand how it works. The device operates only under mammography or ultrasound monitoring, using mammography to guide the biopsy of “calcified spots” and other suspicious lesions, and ultrasound to guide the biopsy or excision of “masses”. The device is operated with a hollow-core bimetallic sheath-like needle with a groove at the front of the outer sheath to facilitate lump insertion, and an inner sheath that moves back and forth to cut off the tissue stuck in the outer sheath (the inner sheath rotates during the process, a concept known as “spinotomy”), and then “strikes” A strip of tissue (the specimen is about 3 mm in diameter and 18 mm in length, similar to a small piece of vermicelli) is “punched” out of the substantial mass by repeatedly moving the endosheath in and out under ultrasound guidance with a needle-like object. As for vacuum-assisted suction, it means the operation can attract blood and tissue fluid at the same time, so as to avoid unclear field of view (mainly refers to the ultrasound monitoring picture), not to “suck off” the tumor as people think, the tumor is not liquid, it cannot be sucked off. Rotational resection refers to the relative activities of the inner and outer sheaths, not the “knife” rotating around the periphery of the tumor to remove it. If the tumor is malignant, the doctor will only use McMurdo to complete the biopsy, not surgery. Why? Because the resection of malignant tumor is about “completeness”, it is not safe to cut into strips; secondly, it is about “residual rate”, the residual of malignant tumor will lead to recurrence. Doctors will not take this risk. What about benign tumors? The operation of this device needs to be monitored by B-ultrasound, so “intraductal papilloma” which cannot be seen by B-ultrasound is not suitable. If you can’t see it, how can you cut it? Cysts or abscesses, which are liquid inside, will be broken once they are hit, and the cyst wall cannot be removed, and recurrence will occur if the cyst wall is not removed. Therefore, it is also not suitable. Inflammation (mastitis or plasmacytoid mastitis), of course, is even more inappropriate. This device can be used to biopsy to diagnose inflammatory disease, but not to treat inflammation. Solid tumors, most commonly fibroadenomas, are a matter of opinion as to what size is appropriate to operate with this device. If the patient is more interested in “complete excision”, of course, it is traditional open surgery at the cost of the incision; if the patient is more interested in the aesthetics of the incision, this device can be used, but of course one needs to be prepared for recurrence. In fact, the size of each specimen (there are coarse and fine needle types, the above is an example of coarse ones) I have written above, so, looking at the size of your tumor, you can estimate how many strokes and how many strips of tissue you need to “hit” in order to Remember that the tumor is three-dimensional, so you need to expand the safety distance around it, and the puncture needle will not turn around, so there will be waste in the corners). For tumors on the edge of the areola, repeatedly “hitting” them multiple times will damage more ducts and is inappropriate if you want to breastfeed in the future. At one point, I was told that a surgeon in XX province had removed the largest fibroadenoma of 50 x 50 x 30 mm with a minimally invasive procedure using McMerton. I could only smile and asked him to calculate the volume of the tumor and the volume of each biopsy specimen and divide it by how many strips of tissue would have to be “beaten” to complete it. He also asked him to explain how to deal with the huge “cavity”. He did the math and stopped talking. If hundreds of thousands of pounds per acre is an extreme example of a “specific period”, then I just hope that history can tell the future.