The Application Of Mammotome In Excision Of Benign Breast Tumor

Object: Through the retrospective analysis and study of our 220 cases benign breast masses excision with Mammotome, evaluate the application value of Mammtome in benign breast mass excision objectively, so as to better guide clinical work.Methods: This research adopts a retrospective way, through review the 220 cases benign breast masses excision with Mammotome in our hospital,SRRSH, affiliated hospital of zhejiang university, since from June 2006 to September 2009. By phone and out-patient interview, total of 178 (which include 470 lesions) patients' postoperative information was collected. The primary follow-up information point involve:pain, fever, flare, skin bruises, hematoma, residual, satisfaction degree of nick, etc. Average follow-up time was 22 months. Then use SPSS 16.0 statistical analyze the factors of patients age, BI-RADS classification of US, maximum diameter of US, number of mass,and pathologic types.Resultss178 patients which with 470 masses can be classified, according to BI-RADS classification:BI-RADS grade 2 was 166 patients(93.3%), BI-RADS grade 3 was 12 patients (6.7%);According to the tumor size:less than 1cm (including 1cm) have 36 cases (20.2%), tumor size between 1cm and 2cm (including 2cm) have 111 cases (62.4%), tumor size above 2cm have 31 cases (17.4%);According to the postoperative pathologic result:adenosis with fibroadenoma 244 patients (51.9%), simple fibroadenoma 111 patients (23.4%), simple adenopathy 112 patients (23.8%), and other including cyst tubular adenoma, papilloma, benign lobulated tumor each one case; According to the postoperative complications:skin bruises 36 cases (20.2%), postoperative pain 24 patients (mild+midrange)(13.5%=12.4%+1.1%),16 cases of hematoma (9.0%), Without a fever symptoms. According to the postoperative residual (substantial mass was found in situ by US in less than 3 months after excision biopsy): 18 cases (10.1%), and residual only have relation with tumor mass number,mass diameter and the hematoma/skin bruises, p value(multiariate analysis) 0.049,0.021 and 0.036 respectively. And has no obvious statistical correlation with age, BI-RADS classification, pathologic types and pure hematoma or simply skin bruises;According to the beauty satisfaction degree of nick:very satisfied 175 patients (98.3%), the general satisfaction 2 cases (1.1%), not satisfied with 1 (0.6 percent).Conclusion:Mammotome has a good application prospect in breast benign excision, is the specific application of minimally invasive surgery in clinical work. For some breast benign,it has synchronous diagnostic and therapeutic effect. It has good performance in safety, efficacy, especially the satisfaction of shape incision etc. However, Mammotome also has some shortcomings after operations, such as postoperative residual etc. A preliminary analysis point that residual relatived with tumor mass number,mass diameter and the hematoma/skin bruises, and longer diameter it had, more number is increased, more hematoma/bruises formed, residue form more likely happened. And has no obvious statistical correlation with BI-RADS classification, pure hematoma or simply skin bruises. Fully preoperative assessment, proficient and carefully operating in surgery and good symptomatic treatment post operation may reduce the postoperative complications.