Clinical Application Of Ultrasound-guided Laser Ablation In The Treatment Of Breast Fibroadenoma

1.BackgroundBreast fibroadenoma is the most common benign breast tumor with a peak age of 20-25 years.Regular follow-up,surgical therapy,and minimally invasive treatment were the main treatment methods.Mammotome(MMT)is the most widely used minimally invasive treatment,but it has the disadvantages of large internal trauma and easy residual tumor.Laser ablation(LA)has the characteristic of small scope of action,high energy controllability,high safety,small damage and low expense and has achieved good results in the treatment of other diseases.However,there are still few studies on laser ablation for breast fibroadenoma,and more research data are needed.2.Objective(1)To investigate the effectiveness and influencing factors of ultrasound-guided laser ablation in the treatment of breast fibroadenoma,and to provide evidence and experience for clinical application.(2)To compare the efficacy of LA and MMT in the treatment of breast fibroadenoma and analyze the advantages of LA to provide a safer and more minimally invasive surgical method.3.Methods(1)A total of 49 patients with breast fibroadenoma from October 2021 to October 2022 who were treated in the hospital were conveniently selected and treated with LA.subsequently,they were followed up regularly at 1 week,1 month,3 months,6 months,and 12 months after ablation.The preoperative data,ablation energy,postoperative volume change,postoperative complications,breast cosmetic effect,and patient satisfaction were collected to analyze the efficacy and influencing factors of laser ablation.(2)A total of 38 patients with breast fibroadenoma who were treated in the hospital at the same time were conveniently selected as the control group and treated with MMT.The operation time,intraoperative blood loss,hospitalization days,hospitalization expenses,postoperative complications,breast cosmetic effect,and patient satisfaction were compared between the LA group and MMT group.4.Results(1)The nodule volumes of all 49 patients decreased after ablation.At 1 year follow-up,the nodule volumes were decreased from 164.34 ± 153.50 mm3 to 15.36±42.83 mm3,The mean of VRRs was 95.98%,the effective ablation rate was 92.86%,The proportion of lesions with complete regression was 57.14%.All nodules were divided into three groups according to the maximum diameter of 10 and 20 mm.The group with diameters ≤10 mm was the first to achieve complete absorption.Only 3 cases of patients occurred mild skin pain with VAS scores of 3 points and 2 cases occurred skin pigmentation,which all disappeared within 1 month of follow-up.The excellent and good rate of breast cosmetic effect was 97.96%and the proportion of patient satisfaction was 100%.Comparing the general data and treatment parameters of the complete absorption group and the incomplete absorption group,Univariate analysis showed that age,marriage,ablation energy,maximum diameter,and initial volume were statistically significant(P<0.05),and multivariate analysis showed no statistical significance(P<0.05).(2)The operation time,intraoperative blood loss,hospitalization days,hospitalization expenses and incidence of postoperative complications in the LA group were significantly lower than those in the MMT group(P<0.05),and the excellent and good rate of breast aesthetics was also significantly higher than MMT group(P<0.05).While there was no significant difference in patient satisfaction between the two groups.5.Conclusion(1)LA in the treatment of breast fibroadenoma has good efficacy and safety and is expected to become a novel method for the treatment of breast fibroadenoma.(2)Compared with MMT,LA in the treatment of breast fibroadenoma has shorter operation time,less bleeding,faster postoperative recovery,lower cost,fewer postoperative complications,and better breast minimally invasive,which is worthy of clinical promotion.