الفهرس 
Anatomy of the Female Breast
Physiopathological Lesions of the BreastOnly 14 pages are availabe for public view
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Abstract
Fibroadenomas of the breast are common, accounting for 50%
of all breast biopsies performed. Physical examination, sonography
and fine needle aspiration cytology (FNAC) are effective in diagnosis
of fibroadenoma. Transformation of fibroadenoma to cancer is rare.
Endoscopic procedures have spread rapidly in various fields
of surgery since the 1980s, and several procedures have already been
widely established as standard operations in plastic surgery.
The present study was conducted on 10 female patients who
were admitted into the Surgical Oncology Unit, at General Surgery
Department, in Tanta University hospital during the period from
June, 2016 to August, 2017 with our aim to assess feasibility, safety,
cosmetic result and complications of endoscopic resection of breast
fibroadenoma.
Preoperatively, all studied cases were subjected to full clinical
history, general examination, breast & axilla examination, routine
laboratory investigations, breast ultrasound with or without
mammography, fine needle aspiration cytology (FNAC) and
informed consent was obtained from all patients before participation
in the study.
Endoscopic procedures generally have a learning period. The
mean operative time per resected tumor was shortened by almost one
hour (90 minutes in the first operation and 32 minutes in the last one).
In addition to technical skill, the critical factors of the operation were site and size of the fibroadenoma. When a mass is less than 3 cm in
diameter, it can usually be pulled through a 10 mm incision, but a
mass exceeding 3 cm has to be cut in pieces in the subcutaneous
space and is then taken out of the breast piecemeal
Subcutaneous emphysema has been occurred in 3 cases, and it
was reversible in the second post-operative day, and no further
complications were experienced. Carbon dioxide inflation is better to
see a tumor, especially when the tumor is located far from the
incisions, than using a retractor, and it has no adverse effects from the
pressure, which is maintained at approximately 6 mm Hg. No patient
had discomfort or adhesion on the operated breast.
All the 8 followed up cases were evaluated for cosmetic
outcome by Harvard scale; excellent outcome resulted in 87.5%.
Good outcome was in 12.5%.
Conclusion:
Endoscopic trans-axillary excision of fibroadenoma of the
breast is an easy, safe and feasible technique; it has excellent
cosmetic outcomes with high patient’s satisfaction as scars on the
breast were avoided. The operative time is comparable to
conventional technique without increasing risk of complication. We
now believe endoscopic extirpation is one of the best options to treat
a benign breast mass. We recommend performing further studies with
larger population scale and longer follow-up to confirm and support
the results.