What is a breast nodule?
The term “breast nodule” is not a single disease name, but a general term for a group of diseases. In this case, it refers to a mass in the breast less than 3 cm, which can be a benign lesion such as breast enlargement, fibroadenoma, malignant tumor such as breast cancer, or a malignant tumor such as breast cancer. Generally, benign breast lesions grow slowly and without obvious discomfort, but most of them will not shrink and disappear on their own; they usually grow gradually without realizing it, and some of them may become malignant. The incidence of breast tumors in women is very high, with fibroadenomas accounting for about 10% of benign tumors and cysts, which are abnormalities in the development and degeneration of the breast, also having a higher prevalence of about 7%. Due to their small size, nodules have relatively more treatment strategies available; however, with the gradual increase in health awareness, the need for treatment of some benign breast nodules (such as those with associated symptoms, clinical consideration of malignant tendency, combined with high risk factors for breast cancer, and those whose normal life is affected by excessive appearance or ideological anxiety) has also increased.
Do breast nodules go away on their own?
The regression of breast nodules is closely related to the type of lesion (hyperplastic nodule, fibroadenoma, malignant tumor, cyst, breast cancer, etc.); some breast nodules may increase or decrease in size with the menstrual cycle, but they do not decrease or disappear on their own throughout the course of the disease; some breast nodules may remain the same size for several years after detection, and a few may gradually decrease in size; most benign nodules continue to grow, especially Most benign nodules continue to grow, especially solid nodules; the fate of most nodules is not known, but some may become malignant.
What tests are needed for breast nodules?
Ultrasound of the breast to determine the number, location, and size of the nodules and to identify the malignancy of the nodules; mammography (routine for women over 35 years of age, contraindicated in pregnant women) to identify the malignancy of the nodules; and fine needle aspiration or hollow needle biopsy to identify the malignancy of the nodules if necessary.
What are the treatment options for breast nodules and their advantages and disadvantages?
(a) Drug treatment and follow-up observation: drug treatment often has no significant effect, and there is no significant difference between follow-up observation and drug treatment; the advantage is that the risk and cost of related treatment are low; the disadvantage is that most breast nodules will not disappear on their own, most nodules will continue to increase in size and a small number of nodules have the risk of malignant change, patients have anxiety, most patients eventually choose open surgery or minimally invasive treatment.
(2) Traditional surgery: The advantage is that radical resection of malignant nodules is feasible; the disadvantage is that there is a high risk of postoperative bleeding, hematoma, and difficult healing of wound liquefaction, and the surgical scar is large and affects the aesthetics, and it is difficult to completely remove nodules that are not obvious on palpation.
(iii) Minimally invasive treatment: ① Vacuum-assisted minimally invasive rotary excision: the advantage is accurate positioning, less trauma than open surgery, no obvious scar, fast recovery; the disadvantage is that it is only applicable to nodules smaller than 2.5 cm; ② Microwave thermal ablation coagulation therapy: the advantage is accurate positioning, less trauma than vacuum-assisted minimally invasive rotary excision, no scar, fast recovery, precise efficacy, easy for young women to accept; the disadvantage is that it is only applicable to nodules smaller than 3 cm. nodules smaller than 3 cm.
What is the principle of vacuum-assisted minimally invasive rotary incision treatment?
The ultrasound probe is used to determine the location of the lesion, and under ultrasound guidance, the rotary cutter tip is inserted under the mass (the groove is directly under the mass) and repeatedly rotated under vacuum suction. The mass disappears completely from the screen, the blood is aspirated from the wound cavity, and pressure is applied to bandage it.
What is the principle of microwave thermal ablation coagulation therapy?
The microwave ablation needle is punctured into the lesion under ultrasound guidance, causing coagulative necrosis of the lesion tissue through high temperature heating effect, and finally the necrotic tissue is absorbed by the body, thus achieving the purpose of minimally invasive local inactivation of the lesion.
Which breast nodules are suitable for minimally invasive treatment? Which ones are not suitable?
The following are suitable for vacuum-assisted minimally invasive rotary excision or microwave thermal ablation coagulation of breast nodules: (1) lesions visible by ultrasound or suspected microcalcifications; (2) benign lesions such as breast fibroadenoma and breast cyst, which require a diameter of less than 2.5 cm for rotary excision and less than 3 cm for ablation; (3) for severe hyperplastic lesions, rotary excision can achieve both diagnostic and therapeutic purposes.
Contraindications include: ① those with hematopoietic system diseases such as bleeding tendency and coagulation mechanism disorders; ② those with pregnancy and lactation; ③ those with infectious diseases; ④ those with serious primary diseases such as cardiovascular, cerebrovascular, liver and kidney; ⑤ those suspected of breast hemangioma; ⑥ those with prosthesis in the breast.
What are the complications of minimally invasive treatment of breast nodules and their management?
1. Burning sensation and pain in the chest: the more common complications of microwave ablation, usually occurring during the procedure, are relieved immediately by reducing the power or discontinuing the treatment, and do not require painkillers; no burning sensation in the chest with rotary cut treatment, and occasional pain, which can be relieved by adding a small amount of anesthetic.
2, fever: rare, symptomatic treatment can subside.
3, breast hematoma formation: low incidence, mostly seen in rotary incision, disappears within 1 month, strict compliance with pressure bandaging 72h, often can be avoided.
What is the effect of minimally invasive treatment of breast nodules? How many days of hospitalization are required?
Ultrasound-guided minimally invasive treatment of breast nodules is a safe and effective method for precise and complete removal or ablation of breast nodules. The hospital stay is usually 3 to 5 days.