Patient: I: female, 38 years old, unmarried and infertile, with a history of one medical abortion, diagnosed at the age of 26 with lobular hyperplasia, which has not been treated. Her periods are normal, starting late at the age of 13, usually completely clean for 6 to 7 days, with an interval of 40 days. In the last few years, both breasts have been very painful for a week before the menstrual period, but normal after the menstrual period. Reason for visit: On December 19, 2011, the ultrasound of physical examination revealed a 13*8mm hypoechoic area, and the examination result was a possible left breast fibroid. Within a week after my period, I still had a vague tingling sensation in both breasts, and I felt pain in some parts of my breasts when I pressed them, but now I don’t have this phenomenon anymore. 2012.3.9 Results of X-ray examination at a famous tertiary hospital (examined one week before menstruation, pain in both breasts). The skin and areola of both mammary glands are not significantly thickened, and the nipples are not depressed. The margins were elevated and roughly symmetrical. A small calcified shadow was seen on the right breast. A dense long strip-shaped shadow, about 1.9cm*0.9cm in size, with smooth edges, was seen on the left breast. The structure of the lateral left breast gland was slightly disorganized, and the bilateral subcutaneous lymph nodes showed. -2012.3.9 Breast ultrasound results from a famous tertiary care hospital, ultrasound description: right breast tissue thickness: 23mm, left breast tissue thickness: 22mm Bilateral breast gland thickening, smooth and intact borders, internal echogenic enhancement, disorganized structure, uneven distribution, no significant ductal expansion, no significant abnormalities in CFI Blood flow signal. A mass of about 19*8mm in size was seen at about 1 o’clock in the left breast, growing horizontally, oval in shape, with clear borders and well-defined margins, with hypoechoic internal echogenicity, and no obvious calcification foci were seen. The 3D ultrasound did not show any obvious abnormal distribution of glands and Kuhnian ligament. The lymphatic portal structure is visible, and CDFI: a small amount of blood flow signal. The left breast substantial nodular lesion: proposed US-Bi-RADS, class 4A, please combine with the clinical bilateral lobular hyperplasia bilateral axillary lymph nodes show, now the pressure is very high, through the online study, my questions are: 1, “left breast external upper strip dense shadow” in the end what is the evidence of the disease? Is it a substantial nodular lesion in the breast or a fibroid in the left breast? 2. What is the difference between the x-ray and ultrasound results? I learned from the Internet that 4A seems to be recommended for surgery because it is not certain whether it is benign or malignant, while Bi-RADS-3 or 2 may require follow-up. 3.In the x-ray, there is a punctate calcification on the upper right breast, and it seems that there is pain in this area after the period some time ago, what is this evidence and is it benign or malignant? 4. In my current situation, do I need surgery? When is the best time for surgery? If surgery, is the recommended form of surgery mm pass, minimally invasive or normal? Why? If the surgery site, is it the left breast or the right breast, or both? Shenzhen Women’s and Children’s Hospital Breast Department Wang Enli Wang Enli: Surgery on the left side, observation on the right side, do not complicate the problem. Patient: Thank you very much! I am under pressure, so please ask: what form of surgery is used for the left side, mm pass, minimally invasive or normal? Also want to ask, after the surgery, is it no longer recurring? Wang Enli: Minimally invasive, open can be, not that because of the surgery only recurrence, which doctor can not guarantee that you are not growing ah. The attitude is very important! It is wise to listen to the advice of the doctor who has seen you.