Minimally invasive percutaneous surgical methods (laser ablation and sclerotherapy) in the treatment of benign breast disease with a prevailing cystic component: short-term and long-term outcomes

Background. Benign breast disease (BBD) is the most common multidisciplinary problem in women globally. Surgery enables complete removal of the pathological tissue and its morphological assessment. However, breast sectoral resection causes excessive injury, increases the risk of postoperative complications, and might result in aesthetic defects. The capacity of minimally invasive surgeries, such as laser ablation and sclerotherapy, for treating breast cysts should be thoroughly analyzed since these methods might provide a highly effective alternative to conventional surgical strategies.
Aim. To evaluate treatment efficacy and quality of life in BBD patients with a prevailing cystic component who underwent minimally invasive percutaneous surgeries and sectoral breast resection.
Materials and methods. This retrospective study included 471 BBD patients with a prevailing cystic component. Women were divided into three groups depending on the surgery type: 1) sectoral resection (n = 155 (32.9 %)); 2) ultrasoundguided percutaneous laser ablation (n = 152 (32.3 %)); 3) ultrasound-guided percutaneous sclerotherapy with 1 % solution of sodium tetradecyl sulfate (n = 164 (34.8 %)). In each group, we evaluated short-term surgery outcomes, surgery duration, length of hospital stay, incidence and severity of early postoperative complications, pain intensity in the early postoperative period, and aesthetic results and quality of life 24 months postoperatively.
Results. We observed a significant advantage of minimally invasive percutaneous surgeries over sectoral resection as they were faster and required shorter in-hospital stay (p <0.01). Better aesthetic results and stable results (no recurrent cysts) 24 months postoperatively were observed in patients after laser ablation and sclerotherapy rather than after sectoral resection (p <0.01). Minimally invasive percutaneous surgeries caused less pain than sectoral resection and, therefore, these patients didn’t need nonsteroidal anti-inflammatory drugs (p <0.01). BBD with a prevailing cystic component resulted in a reduced quality of life in all patients before treatment. All types of surgery (both minimally invasive and conventional) had a positive effect on the quality of life in the long-term perspective. The improvement of the quality of life was more pronounced in patients after laser ablation and sclerotherapy than in those after sectoral resection (p <0.01).
Conclusion. Minimally invasive percutaneous surgical methods (laser ablation and sclerotherapy) were highly effective in BBD patients with a prevailing cystic component. They reduced injury, ensured good aesthetic results, and increased patients’ quality of life.

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