Giant fibroadenoma of one breast: Immediate bilateral reconstruction.

A rare case of giant fibroadenoma of the left breast is presented. We performed a nipple sparing subcutaneous mastectomy of the left breast. Since the patient desired larger breasts, a contralateral augmentation mammaplasty was carried out in a single stage operation. A satisfactory result was achieved.     

乳腺纤维腺瘤手术治疗进展

乳腺纤维腺瘤是女性乳腺最常见的良性肿瘤,多发生在30岁以下的年轻女性,临床以手术切除为主要的治疗手段,手术方法和时机的选择受患者年龄、生育需求、肿瘤大小、位置等诸多因素的影响。考虑到年轻女性爱美之心以及将来哺乳的要求,结合美容医学技术的进展选择更为患者接受的术式显得尤为重要。乳腺纤维腺瘤治疗的手术方法较多,效果不一,适用对象也有差异,本文就乳腺纤维腺瘤的手术进展以及手术时机的选择进行综述。     

Gigantic fibroadenoma of the breast in an adolescent. Description of a clinical case

A case of giant fibroadenoma in a girl of 14 is reported. This case emerged from an examination of about 380 patients observed at the Senology Clinic of the S. Maria di Loreto Hospital (USL 44) in the last 3 years. A statistical contribution is made to the study of breast pathologies in pubertal age and stress is laid on the importance of mass screening among adolescents.     

Juvenile fibroadenoma of the breast: Treatment and literature review

It is uncommon to find palpable breast masses in young patients. Generally, such masses are benign. Juvenile fibroadenoma is the most frequent benign tumour of the breast. The present report describes a case involving a 17-year-old girl with unilateral right breast hypertrophy, for whom resection and breast reduction was effectively achieved.Resection was combined with an aesthetically pleasing outcome through breast reduction, via a wise pattern of reduction with a superior pedicle.While young patients rarely present with breast masses, the consideration of fibroadenoma in these cases is always warranted. The disconcerting appearance of the breasts for adolescents afflicted by such benign masses underscores the importance of achieving aesthetically optimal outcomes and attaining adequate tumour resection for diagnostic purposes through pathological specimens. In the present case, the young patient underwent a procedure that fulfilled both of these valuable goals through careful pre-operative planning, pedicle selection and skin resection patterns.     

巨大乳房纤维腺瘤切除后的乳房成形术

目的：寻求巨大乳房纤维腺瘤切除后合理重塑乳房外形的方法。方法：按缩乳术原则设计乳头、乳晕新位置，标记需切除的表皮区和全层皮肤区。切除部分表皮、皮肤及全部肿瘤，再按隆乳方法重塑因肿瘤的和乳腺切除而空虚的乳房外形。结果：经远期随访本组7例（1例除外）乳房大小，乳头及乳房的挺拔性、对称性，手感及乳头、乳晕的感觉和勃起程度均较满意。结论：该手术方法可以较好地一期解决因切除肿瘤而后遗的乳房缩小畸形。     

经乳房后间隙切除乳腺纤维腺瘤临床观察

目的：探讨经乳房后间隙切除乳腺纤维腺瘤的效果。方法：总结我院甲乳外科137例经乳房后间隙治疗乳腺纤维腺瘤,观察切口瘢痕及对乳房形态、功能的影响。结果：137例病人手术过程顺利,肿瘤均完整切除,切口甲级愈合,切口美观,手术瘢痕不明显,乳房外形改变。36例术后患者产后哺乳正常。结论：经乳房后间隙治疗乳腺纤维腺瘤,手术入路科学,术后瘢痕隐蔽,乳房外形及功能效果满意,达到治病目的,同时符合美容要求,值得推广。     

乳房下皱襞切口治疗青春期乳腺纤维腺瘤

目的：探讨乳房下皱襞切口治疗青春期乳腺纤维腺瘤。方法：均采用全麻,乳房下皱襞弧形切口,沿胸大肌筋膜表面潜行分离乳腺后方间隙组织,自乳腺后方确认瘤体位置,紧贴瘤体钝锐性放射状分离,完整切除肿瘤。腺体不予缝合,可吸收线皮内缝合切口。结果：本组12例术后病理为乳腺青春期纤维腺瘤,均痊愈出院,切口美观、手术切口瘢痕不明显。结论：乳房下皱襞切口设计简单,部位隐蔽,显露充分,易剥离,一个切口可摘除多个瘤体,达到了治疗和美容双重效果。     

A rare case of fibroadenoma in a tubular adenoma of the breast

We report herein a case of a 31 year old housewife who underwent an excisional biopsy for a well-circumscribed lump in her breast. The lump contained 2 histological patterns, namely, fibroadenoma and tubular adenoma. These patterns had no transitional zone, were distinct and changed abruptly. This case was histologically diagnosed as a fibroadenoma in tubular adenoma of the breast, benign, with no other such case ever having been reported in Japan. The histological findings of this case, convinced us that tubular adenoma is closely related to fibroadenoma.     

Diagnosis and treatment of fibroadenoma of the breast: 20 years' experience

The diagnostic differentiation of breast lesions is very important because of the frequency with which they occur. Though fibroadenoma is easy to diagnose, some cases prove really hard to distinguish. Therefore, various methods have been suggested both for diagnosis and therapy, but no common approach has been achieved to date. We report our experience with 1350 cases diagnosed over a twenty-year period. The diagnosis was made on the basis of a diagnostic protocol drawn up over the years where cytology is of primary importance. With regard to therapy, we decide to operate when the cytological findings prompt the need for a histological examination of the lesion. Moreover, we operate on those cases where either an increase in size or a morphological change of the lesion has taken place. Histological examinations were carried out in 420 cases out of 1350 and only one of these cases turned out to be a carcinoma. As a result, the 0.24% error in the diagnosis can be considered irrelevant. In spite of the different therapies suggested (cryoablation, laser hyperthermia, i.a.), we believe that surgical treatment with local anaesthetic is the most suitable solution in those cases requiring treatment. Obviously, the diagnosis has to be accurate and made by surgeons with appropriate expertise. When the diagnosis is certain and the conditions of the lesion are stable, the best policy seems to be periodic follow-up.     

环乳晕切口切除乳腺纤维腺瘤的临床研究

目的：环乳晕切口切除乳腺纤维腺瘤（fibroadenoma ectomy by circum—areola incision,FECAI）因为有突出的美学优势,已经在国内多家医疗单位应用。但是,发表的文献并没有详细阐明FECAI的适应证、禁忌证、注意事项和并发症的预防等问题。因而,本文针对这些问题进行较为详尽的研究和阐述。方法：研究组（35例,40侧乳房）进行了FECAI;同时期同一医疗组所做的肿块表面切口纤维腺瘤切除术设为对照组（28例,32侧乳房）。回顾分析方法比较两组在手术时间、出血量等方面的差别,并且阐述适应证等问题。结果：手术时间：研究组（49±8）min;对照组（38±5）min（P〉0．05）。出血量：研究组（20±5）ml;对照组（31±6）ml（P〈0．05）。适应证：乳晕直径3．5～5．0cm;肿块外缘距离最近乳晕边缘小于5．0cm;肿块直径3．0cm以下;体检、B超、钼靶、细针穿刺或空心针穿刺等所有术前检查均支持纤维腺瘤的诊断。禁忌证：肿块直径大于5．0cm;肿块外缘距离最近乳晕边缘距离≥6．0cm;有恶性可能。结论：此种切口设计的突出优点是瘢痕隐蔽,美容优势明显。为减少并发症的出现,必须掌握好适应证和禁忌证。