Vacuum-assisted large-bore needle excision of fibro-adenomata of the breast is an established procedure approved by the National Institute for Health and Clinical Excellence. However, despite its perceived advantages over formal surgical excision to both patient and clinician of speed, cost, convenience and cosmesis, it is not commonly used in the UK. As fibroadenomata are diagnosed by triple assessment and do not usually need to be excised for clinical reasons, it becomes a cosmetic procedure. We therefore did a survey of patients to determine their satisfaction with the procedure.
We looked at the case records of 198 patients who had had 211 fibroadenomata removed in our unit between 1999 and 2006. We sent these patients a questionnaire about satisfaction and cosmetic outcome.
The mean age of patients was 30.1 years (range 15 to 64). The mean size of fibroadenoma excised was 17.9 mm (range 6.6 to 36.5). 102 questionnaires were returned (51.5%). The mean score (5 point scale) for anxiety surrounding the procedure was 3.2, the mean pain score was 2.5. Only 21.6% could see a visible scar and of these only two said that it bothered them; 16.7% said that they could still feel a lump; and 83.9% of those who had previously had a surgical excision said that they preferred the mammotome excision.
This is a well tolerated procedure and has advantages for the patient, the surgeon and the health care provider. As it has become a cosmetic procedure, the measure of outcome is patient satisfaction. We feel that this procedure should be the standard of care.