Can Deep Fibroadenomas Near the Chest Wall Be Surgically Removed?

The cystic fibrosis location is too deep?

If a fibrocystic lesion is located too deep near the chest wall, is it possible to perform traditional surgery for its removal? When I reviewed the report, the physician mentioned that the lesion's deep location would make it difficult to locate, thus it is not suitable for traditional surgery and minimally invasive surgery is required.
Is this statement correct? Thank you for your clarification.

Yiii, 20~29 year old female. Ask Date: 2024/06/15

Dr. Li Zhonghuai reply Surgery

Hello! All tumors located by ultrasound can be removed through traditional surgery; however, for cosmetic reasons, the incision is usually concealed along the edge of the areola or the breast margin.
This approach can lead to more damage to the milk ducts, making it easier for mastitis to occur during pregnancy and breastfeeding.
Therefore, if private insurance is available, it is recommended to use the Encore minimally invasive excision, which causes less damage to the milk ducts.
The prerequisite is to first perform a core needle biopsy to rule out malignancy before considering traditional or minimally invasive excision.

Reply Date: 2024/06/15

More Info

When it comes to the surgical removal of deep fibroadenomas located near the chest wall, the approach taken can vary based on several factors, including the size, depth, and specific characteristics of the fibroadenoma, as well as the surgeon's expertise and the available surgical techniques.

Fibroadenomas are benign tumors commonly found in breast tissue, particularly in younger women. They are typically well-defined and can vary in size. When a fibroadenoma is located deep within the breast tissue, especially close to the chest wall, it may pose challenges for traditional surgical excision. The surgeon may find it difficult to locate and remove the tumor without causing damage to surrounding tissues, which could lead to complications such as scarring or changes in breast shape.

In cases where the fibroadenoma is deep and difficult to access, minimally invasive techniques, such as ultrasound-guided core needle biopsy or vacuum-assisted biopsy, may be recommended. These methods allow for the precise targeting of the fibroadenoma while minimizing trauma to the surrounding tissue. If the fibroadenoma is confirmed to be benign and not causing any symptoms, some surgeons may suggest monitoring it rather than proceeding with surgical removal.

However, if surgical intervention is deemed necessary—whether due to size, symptoms, or patient preference—surgeons may opt for a more specialized approach. This could involve using imaging guidance during surgery to help locate the fibroadenoma accurately. Techniques such as wire localization or intraoperative ultrasound can assist in identifying the tumor's exact position, which can be particularly beneficial for deep-seated lesions.

It's important to have a thorough discussion with your healthcare provider regarding the best approach for your specific case. Factors such as the fibroadenoma's characteristics, your overall health, and personal preferences should all be considered when deciding on the surgical method. If a surgeon has indicated that traditional surgery may not be suitable due to the depth of the fibroadenoma, it is likely based on their assessment of the risks and benefits involved.

In summary, while traditional surgical removal of deep fibroadenomas near the chest wall can be challenging, it is not impossible. The choice of surgical technique should be tailored to the individual case, and minimally invasive options may be more appropriate in certain situations. Always consult with a qualified surgeon who can provide personalized advice based on your specific circumstances and the characteristics of the fibroadenoma.

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