We agree with Sperber et al1 that ultrasound-guided minimally invasive surgery provides a definitive option for treatment of fibroadenomas. This series adds to the growing body of evidence in the literature that benign breast disorders can be treated in a minimally invasive fashion without any significant scarring. Indeed, we have extended the use of this modality by treating not only fibroadenomas but also gynecomastia by using the 8-gauge rather than the 11-gauge probe. Using this technique, we have excised fibroadenomas as large as 4.5 cm in diameter, as well as successfully treating many men with gynecomastia by combining the Mammotome (Ethicon Endo-Surgery Inc, Cincinnati, Ohio) excision of the glandular tissue with sculpturing with liposuction. Therefore, we have had to use local anesthetic and sedation rather than just local anesthetic, but we believe the authors are correct in promoting the use of local anesthetic alone in smaller lesions.
Iwuagwu OC, Drew PJ. Ultrasound-Guided Minimally Invasive Surgery for Fibroadenomas. Arch Surg. 2004;139(5):564. doi:10.1001/archsurg.139.5.564