① Breast fibroadenoma with a diameter above 1 cm before pregnancy and lactation.
② Single or multiple fibroadenomas larger than 2 cm.
③ The patient is over 35 years old. However, for unmarried women around the age of 20, those with small tumors or multiple breast fibroadenomas can be treated with traditional Chinese medicine first, without surgery for the time being.
(2) TCM treatment of breast fibroadenoma belongs to the category of "breast addiction" and "breast tuberculosis". According to different clinical manifestations, the combination of oral Chinese medicine and external medicine can achieve the effect of treating both the symptoms and root causes. In the treatment of this disease, Dean Li adopted the combination of external application of "Ru Li Kang Tie" and oral administration of "Ru Pi Yu" series of prescriptions, and the combination of local and overall adjustment, which can fundamentally eliminate the inducing factors of this disease, effectively inhibit tumor growth, and eliminate lumps, thus achieving the advantage that it is not easy to recur after cure. Pay attention to diet during taking medicine, and avoid eating cold, greasy and irritating food. What medicine should I take? When pregnant or breastfeeding, the lump will increase significantly.
Talking about Breast Diseases with Young and Middle-aged Women (2002165438+10/3)
Professor Zou Qiang, chief physician, deputy director of surgery in Huashan Hospital affiliated to Fudan University, dean of Shanghai Huashan Oriental Breast Surgery Hospital, director of breast surgery, and member of the surgical professional committee of Shanghai Medical Association, specializes in early diagnosis of breast diseases, minimally invasive surgery for benign breast tumors, comprehensive treatment of breast cancer, treatment of mammary hyperplasia and mastitis, and breast plastic surgery and reconstruction. (Left)
Professor Shen, deputy director of breast surgery in Fudan University Cancer Hospital, deputy director of Fudan University Breast Cancer Research Institute, and member of China Anti-Cancer Association Breast Cancer Professional Committee, has won the first prize of scientific and technological achievements of the Ministry of Health, the first prize of scientific and technological progress in Shanghai, and the third prize of clinical medical achievements of Shanghai Health Bureau. (right)
Hello, audience friends! This is CCTV's live program "The Road to Health". Today we are going to talk about female breast diseases.
Moderator: Ms. Zhang from Xicheng District, Beijing, aged 36. I often have premenstrual breast pain, but it is not serious. I don't pay attention. It's not obvious when I don't touch it. Do I have breast disease?
Shen: Breast pain before menstruation is very common. In fact, it is not a breast disease, but a normal physiological phenomenon. Generally speaking, it doesn't need any special treatment. However, Ms. Zhang is 36 years old. It is recommended to find a specialist examination. If there is no special disease in the breast, please rest assured that it does not need any special treatment. In most cases, the pain can be alleviated. Breast pain is very common in women, but if the pain lasts for more than 6 months and the pain affects daily work and life, some drugs should be used in this case.
Moderator: Ms. Li, 40 years old, Haidian District, Beijing. Recently participated in the physical examination organized by the unit. The doctor said I have lobular hyperplasia, but I don't have breast pain that other lesbians often say. Am I lobular hyperplasia?
Zou Qiang: It is true that the main symptom of lobular hyperplasia is pain, but the pain is not necessarily proportional to the degree of hyperplasia. If lobular hyperplasia is found, it should be further examined and should not be taken lightly.
Moderator: Ms. Liu from Datong, Shanxi, 28 years old. I have lobular hyperplasia for many years. Recently, the doctor said that I have fibroadenoma again. Are these two diseases the same thing?
Shen: Lobular hyperplasia and fibroadenoma are two completely different diseases. Lobular hyperplasia is a proliferative disease of breast, and fibroadenoma is a benign tumor of breast. Lobular hyperplasia is common in normal women. About 50% of women of childbearing age have lobular hyperplasia, which can be combined with fibroadenoma.
Moderator: Ms. Wang from Xingtai, Hebei, 45 years old. My mother once suffered from breast adenoma. Can this disease be inherited? What should I do?
Shen: There are many reasons for breast cancer. Hereditary breast cancer accounts for about 5% of the incidence of breast cancer. Women with genetic factors are more likely to develop breast cancer than normal people.
Who is prone to breast cancer?
1, unilateral breast cancer
2. Family history of breast cancer
3. Atypical hyperplasia of mammary duct epithelium
4. Early menarche and late menopause
5, no fertility, no breastfeeding
6. Postmenopausal weight gain
7, hormone replacement therapy for more than three years.
Moderator: What should high-risk women do?
Shen: For women with high risk factors, we suggest that they go to the hospital for regular check-ups. Those over the age of 35 should take a molybdenum target film every other year and take some drugs to prevent breast cancer.
Moderator: What harm do lobular hyperplasia and fibroadenoma do to women?
Zou Qiang: Lobular hyperplasia is harmful to women in two aspects, 1, which will bring different degrees of pain. 2 can be accompanied by tumors, including benign tumors and malignant tumors. Often, after a woman with lobular hyperplasia gives birth to a tumor, this tumor is not easy to be found, because lobular hyperplasia tissue becomes thicker and it is easy to cover up the tumor. The doctor's job is to screen out tumor patients and perform surgery in time. For patients without tumors, tell her not to worry too much, as long as she receives regular examinations. Fibroadenoma is a benign disease and will not endanger people's lives. Except for a few cases that grow too fast or even become sarcoma, most cases are benign diseases, and the impact on health is not too great.
Moderator: Let's look at a patient's medical treatment. Patient: "One of my teachers was diagnosed with breast cancer in June 2006, 5438+0. At that time, she was in her fifties and died in less than half a year. Later, I learned that she had a breast tumor in her twenties and didn't pay attention to it. She didn't go for reexamination or treatment. I found benign breast tumors on both sides after examination. At that time, I made up my mind to remove it. "
Moderator: What kind of inspection do you usually need?
Shen: First of all, we should have a physical examination, and then do some auxiliary examinations according to the patient's specific situation. Among them, molybdenum target X-ray inspection is now widely used. This examination can shoot many breast masses that can't be touched by hands, especially some very early breast cancer that can't be touched by hands, which can save the lives of many patients with early breast cancer. The World Health Organization recommends that women aged 35-40 make molybdenum target films every 1-2 years. Women over 50 years old make molybdenum target films every 1 year.
Zou Qiang: At present, because good molybdenum target equipment is not popular enough, I recommend high-frequency color Doppler ultrasound examination. Advantages of this test include no radiation. We don't encourage women under 35 to take molybdenum target photos, because molybdenum target photos have radiation, and the breast tissue of women under 35 is thicker and the imaging effect is poor. Color Doppler ultrasound does not have these effects, and it can also detect early breast tumors with good results. In addition, you can also do nuclear magnetic resonance vibration inspection. Advantages are clear imaging and no radiation, but the price is about 1000 yuan and the inspection time is about half an hour. Which detection method can be selected according to the conditions of local hospitals.
Moderator: Will lobular hyperplasia become cancerous?
Shen: If you still can't determine whether it is lobular hyperplasia or breast cancer with the three methods mentioned above, you can use the following two methods to identify it: 1, make a puncture and take some tissues for judgment. 2, judging by cutting off a piece of tissue by surgery. The purpose of these two methods is to make a definite diagnosis. Relatively speaking, puncture has less trauma and relatively low cost. I still advocate puncture examination. General lobular hyperplasia does not require special treatment.
Moderator: Will fibroadenoma become cancerous?
Zou Qiang: Most fibroadenomas do not become cancerous. If fibroadenoma is too big or grows too fast, it can be treated by surgery. Drug therapy is ineffective for fibroadenoma. It is suggested to cure fibroadenoma before pregnancy as much as possible, because it is more troublesome to treat it after pregnancy and lactation. Fibroadenoma surgery In addition to conventional fibroadenoma resection, some minimally invasive operations have been carried out in recent years.
Moderator: Let's learn about this minimally invasive surgery through a video.
Shen: This is a minimally invasive operation under the guidance of ultrasound, which requires the cooperation of surgeons and sonographers. The black tumor in the middle is about 1.7cm. Make a small incision of 3mm on the breast surface and insert a specially designed rotary cutter. This rotary cutter can cut the tumor into pieces, and at the same time take out the tumor for pathological examination, which also solves the last diagnosis problem. Let's get to know the whole process of the operation through an animation. First, insert the puncture needle, suck the tumor down by vacuum negative pressure, cut it off and export it through the pipeline, and finally take it out completely under the supervision of ultrasound. Due to the limitation of equipment, it is generally required that the tumor should not be too large, preferably a tumor below 2.5 cm.
Moderator: Let's take a look at the postoperative situation of the patient in front. Patient: "I think minimally invasive surgery can maintain a good appearance, which is ideal." The operation has been going on for two hours, and now there is basically no feeling, no pain or bleeding. I was able to walk immediately after the operation and went to the movies in the evening.
Zou Qiang: The wound after the operation is very small. Let's look at some photos. You can see that the incision is only about 2-3 mm. You don't need to sew needles, just stick tape.
Moderator: Ms. Song, a 48-year-old from Huzhou, Zhejiang Province, suffers from fibroadenoma. The doctor asked me to be hospitalized for surgery, and everyone else was an outpatient. Is my illness serious?
Shen: Age is very important in the diagnosis and treatment of breast diseases. Fibroadenomas are common in young women aged 20-25, and 48-year-old fibroadenomas are rarely encountered clinically. Suggest further examination and follow the doctor's advice.
Moderator: Ms. Chen, 3 1 year old, Hefei, Anhui. I have a lump in my left chest. The doctor asked me to do B-ultrasound and mammography. I heard that molybdenum target photography has radiation. Do I have to do it?
Zou Qiang: 365,438+0 years old, molybdenum target photography is generally not recommended. A color Doppler ultrasound is enough, unless there is something suspicious about the color Doppler ultrasound, you can add a molybdenum target photography as a supplement.
Moderator: Ms. Gu from Xuchang, Henan Province, a 23-year-old doctor said that I have three fibroadenomas of the breast and can be operated on. Can I treat them in a minimally invasive way
Shen: The patient's condition is representative to some extent. One is that he is young and does have a tendency to have multiple fibroadenomas, which can be removed one by one through minimally invasive surgery. It can be done in one operation.
Moderator: Ms. Cao from An, Shaanxi, is 29 years old. I have lobular hyperplasia. What problems should we pay attention to in our daily life?
Shen: Lobular hyperplasia is very common in women, and the real reason is not clear. It may be related to the imbalance of hormone levels in the body or the different sensitivity of breast tissue to sex hormones. Pay attention to eating more vegetables and drinking less caffeinated foods and drinks.