Minimally Invasive Surgery for Breast Fibroadenomas: What You Need to Know

Q: Minimally Invasive Surgery for Breast Fibroadenomas: What You Need to Know

Dear Ms. <br>Li： Is minimally invasive surgery the same as "Mammotome"? This procedure is not covered by health insurance and is primarily used for 1. <br>the removal of benign tumors and 2. <br>biopsies of suspected malignant tumors. <br>It is not recommended for the excision of

Minimally Invasive Surgery for Breast Fibroadenoma

I am 47 years old, unmarried, and have never given birth.
I discovered a fibroadenoma in my right breast when I was 18, and in my 30s, I found another fibroadenoma in my left breast.
I have been undergoing follow-up with a breast specialist approximately every six months to a year since I was 35.
In late November 2015, my doctor found a shadow in a hard lump in my left breast (the fibroadenoma is about 1 cm) and recommended minimally invasive surgery to remove it for confirmation.

I would like to know if there are any other considerations besides the out-of-pocket expenses for the minimally invasive procedure.
If this lump turns out to be malignant, could the minimally invasive process leave behind any cancerous cells in my body and cause metastasis? Additionally, about two years ago, I had regular follow-ups and also underwent a mammogram (including a 3D localized magnification once).
The doctor mentioned there were calcifications, but they appeared to be fine, and regular follow-ups were sufficient.
Recently, a friend informed me that calcifications are usually precursors to cancer and advised me to have them removed quickly.

I would like to know if removing the calcifications will prevent any future calcifications from occurring.
Given that I have recently consulted two different doctors at two hospitals who both recommended continued monitoring, should I still be concerned about the calcifications and consider having them treated? Thank you, Dr.
Zhou, for your response!

Ms. Li, 40~49 year old female. Ask Date: 2016/01/06

Dr. Zhou Jiazhen reply Breast and Thyroid

Dear Ms.
Li: Is minimally invasive surgery the same as "Mammotome"? This procedure is not covered by health insurance and is primarily used for 1.
the removal of benign tumors and 2.
biopsies of suspected malignant tumors.
It is not recommended for the excision of suspected malignant tumors.
If your physician suggests using Mammotome for tumor removal, it should be for a benign tumor, which does not raise concerns about metastasis.
If the size and number of calcifications have not changed or increased, monitoring is sufficient; however, if there are changes, targeted excision is necessary.

Reply Date: 2016/01/06

More Info

Minimally invasive surgery for breast fibroadenomas is an important topic, especially for individuals like yourself who have a long history of monitoring these benign tumors. Given your age and medical history, it’s understandable to have concerns about the procedure, potential risks, and the implications of findings such as calcifications in breast tissue.

Understanding Minimally Invasive Surgery
Minimally invasive surgery, particularly techniques like vacuum-assisted biopsy or minimally invasive excisional biopsy, allows for the removal of fibroadenomas with smaller incisions and less trauma to surrounding tissue compared to traditional surgical methods. This approach can lead to quicker recovery times, reduced scarring, and less postoperative pain.

Costs and Considerations
You mentioned the cost of the procedure, which is an important factor. In the U.S., costs can vary significantly based on the facility, the specific procedure, and whether you have insurance coverage. It’s crucial to discuss with your healthcare provider about the total costs involved, including any potential follow-up treatments or additional imaging that may be necessary.

Concerns About Malignancy
Your concern about the possibility of the fibroadenoma being malignant is valid. While fibroadenomas are typically benign, there is always a small risk that a lesion could harbor atypical cells. The minimally invasive techniques are designed to remove the entire lesion, which helps in confirming the diagnosis through pathology. If the biopsy reveals malignancy, further treatment options can be discussed, including more extensive surgery if necessary. The risk of leaving malignant cells behind is generally low, especially if the procedure is performed by an experienced surgeon.

Calcifications and Their Implications
Regarding the calcifications you mentioned, it’s important to understand that not all calcifications are indicative of cancer. They can be benign, especially if they are classified as "macrocalcifications." However, "microcalcifications" can sometimes be associated with precancerous changes or early-stage breast cancer. The fact that your doctors have recommended regular monitoring suggests that they do not currently see any cause for alarm.
If calcifications are removed, it does not guarantee that new calcifications will not develop in the future. Breast tissue can change over time due to various factors, including hormonal changes, aging, and other health conditions. Regular follow-ups and imaging are essential to monitor any changes in your breast tissue.

Follow-Up and Monitoring
Given your history of fibroadenomas and the presence of calcifications, it’s crucial to maintain regular follow-ups with your healthcare provider. If you have concerns about the calcifications or any new symptoms, do not hesitate to seek a second opinion or further evaluation. It’s your right to be proactive about your health.

Conclusion
In summary, minimally invasive surgery for fibroadenomas can be a safe and effective option for you. While there are costs and potential risks involved, the benefits often outweigh these concerns, especially when it comes to confirming the nature of the lesion. Regular monitoring of calcifications is also important, and you should feel empowered to discuss any concerns with your healthcare provider. Your health and peace of mind are paramount, so don’t hesitate to ask questions and seek clarity on your treatment options.

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