Avoiding Many Operative Scars in Patients with Recurrent Fibroadenomas of the Breast
Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg
April 9, 2012
Fibroadenomas of the breast are quite common among the Filipino females. They are non-cancerous breast mass.
Currently, the most practical way to resolve the problem of an annoying fibroadenoma mass is open excision or operative removal utilizing an incision on the breast skin.
A common challenge among breast surgeons is how to avoid multiple scars on the breast on patients with recurrent fibroadenomas.
Recently, March 2012, I have this patient, RV, a 37-year-old female, with two (2) recurrent fibroadenomas on her left breast, whom I have to do an open excision.
I had operated on her before for fibroadenomas on her two breasts, about 2 to 3 times already. In each operation, I tried to place the incision in an area that will not produce a conspicuous scar, such as along the border of the areola or utilizing old incisional scars.
In this latest operation, I utilized her previous scars on the breast even if the 2 masses were a distance away. I did not create new incisions. Before the operation, I had an informed consent to make an incision over the masses just in case it will be difficult to remove them through the previous scars.
During the operation, however, with the patient under general anesthesia, I was able to remove the 2 masses using her previous incisional scars without creating new incisions. If I did the latter, I will be adding more scars to her breasts. After the operation, the patient was very happy and thank me for what I did.
Below are the pictures of my operation with some annotations.
Above picture showing the locations and sizes of the fibroadenomas and the 3 scars from previous excisions.
If I were to put the incisions over the two new masses, there will be resultant 5 scars after the operation.
CALL IT COMPASSION, I DECIDED NOT TO PUT INCISIONS THAT WOULD RESULT IN MORE SCARS ON THE PATIENT’S BREAST. ALTHOUGH MORE DIFFICULT TO EXCISE THE BREAST MASSES, I USED THE EXISTING SCARS FOR MY INCISIONS.
Above picture shows the locations of the masses, the incisions, and the masses after removal.
How I did it? Tunneling, pushing the masses toward the incision, patience and perseverance for the sake of the patient’s well-being.
The resultant wounds after the operation – NO additional breast scars for the patient.