Breast adenoma is a neoplasm consisting of glandular epithelium cells, and characterized by a benign flow pattern.
This is one of the varieties of mastopathy, which most affected women 15 - 35 years. Quite often, the development of pathology is noted during pregnancy and breastfeeding. It is noteworthy that in premenopause and menopause, the neoplasm is reduced, and a new one does not appear. This is directly related to the fact that breast adenoma is a hormone-dependent tumor.
This disease is detected less frequently than fibroadenoma, a tumor-like growth that forms from glandular fibrous tissues. In addition, adenoma, as already noted, has a benign character, and is not prone to malignancy.
Causes of development
The risk group includes, first of all, young women over 20 years old.
Reproductive age is associated with a high probability of pregnancy, followed by breastfeeding. These are periods when hormonal background undergoes serious changes, which can later lead to the appearance of cysts in the mammary gland - one or both at once.
Women over 40 are much less likely to suffer from adenoma.
A little physiology
The process of development and subsequent work of the mammary gland depends on the balance of female sex hormones. For example, progesterone, a biologically active substance produced by the cells of the ovaries and adrenal glands, is responsible for the lobules and alveoli of the breast. In turn, the lobules and alveoli provide the process of secretion of breast milk, and support it during the entire lactation period.
The milky ducts and fibrous tissue can fully function only if the level of estrogen is maintained. It is a hormone that the ovaries are responsible for producing.
The ratio of progesterone and estrogen (each of these groups has its own components) can change throughout life. Pregnancy, lactation, menopause - all these periods are accompanied by hormonal changes. And if at this time the ratio of hormones is disturbed, various diseases develop.
Causes of breast cancer
Adenoma in the breast tissue can develop:
- after abortion;
- when a woman refuses to breastfeed;
- against the background of the absence of a full sexual life at the female age of 30 - 35 years.
In addition, the formation of breast cancer can occur under the influence of:
- hepatic abnormalities;
- chronic diseases of the reproductive system;
Some acute infectious diseases affecting the reproductive system can also cause the formation of adenoma in the tissues of the breast.
Breast adenoma can be:
- Nodal. This adenoma is characterized by the appearance of small neoplasms in the breast. During an MRI, CT scan or WG, the tumor has clear boundaries with healthy tissues.
- Sheet-shaped. Such a neoplasm increases rapidly, and consists of several layers. This adenoma requires more serious treatment than nodal.
- Tubular Such adenoma has a round, dense and mobile tumor. Its structure is based on cylindrical epithelial cells. During pregnancy and breastfeeding, such a tumor becomes lactating.
- Fibrous It consists of glandular and fibrous tissues. The main feature of such a neoplasm is its size - it usually exceeds 5 cm.
- Lactating. It develops during the period of HS, and is localized in the tissues of the milky lobes.
- Syringomatous. The tumor is localized in the area of the spike, and has no clear contours.
- Ductal (ductal). In this case, a polyp is formed, which falls into the lumen of the dilated duct. The tumor has a benign character.
In addition, AMZh can be fatty and pleomorphic. The latter, like ductal, is extremely rare.
Another type is the adenoma of the nipple and its surrounding area. With this disease, adjacent tissues are not affected. The main symptom of this disease is a clear discharge from the nipple.
Particular attention should be paid to fibrocystic adenoma of the breast. This tumor also has a benign nature, but can sometimes become malignant. It has its own classification, according to which it is single or multiple, as well as diffuse or one-sided.
The pronounced clinical picture of AMZh appears only when the tumor reaches 5 cm or more in diameter. In other cases, the disease is asymptomatic, and can be detected either by palpation at home or by examining the mammary glands at the doctor for another reason. Palpation can detect a neoplasm only when it has a diameter of 1-2 cm.
At palpation, a soft, elastic, less often - hilly structure of adenoma is noted. However, it is not soldered to the surrounding tissues. Usually the tumor is shallow, and under the influence of hormones in the premenstrual period tends to increase. At the end of the month it acquires the original size.
As a rule, adenoma is localized in the tissues of only one breast. But sometimes it can be two-sided, besides, multiple.
Breast adenoma is characterized by slow progression, but under the influence of certain factors, this process can be significantly accelerated. It is noteworthy that during pregnancy, the neoplasm increases dramatically, and after giving birth either decreases, or disappears altogether.
When the adenoma reaches a large size (7-15 cm), it begins to put pressure on the nerve endings. As a consequence, there is pain and a burning sensation of the affected breast. Axillary lymph nodes do not increase.
Adenoma of the nipple is accompanied by redness, swelling, the occurrence of serous or serous discharge. The skin of the nipple itself and the skin around it begins to flake and ulcerate, which indicates its inflammation. It occurs due to irritation of the epidermis with secretions.
When palpation of the chest, the presence of a soft-elastic rolling seal is noted. Areolae do not change their color, wrinkles and "orange peel" are absent. That is what distinguishes AMJ from cancer.
To begin with, a mammologist (or gynecologist) performs palpation and history taking with the study of symptoms disturbing the patient. In order to avoid the development of the disease, a woman is recommended to independently examine the breast after the end of the next menstruation. This will help to identify the first warning signs in time, and to seek qualified assistance.
It is obligatory to conduct laboratory diagnostics - biochemical analysis of blood for steroid hormones and hormone-like substances in blood serum. For the "safety net" is the UAC.
In order to confirm the diagnosis, the mammologist is obliged to refer the patient to the instrumental diagnostic procedures:
- Mammography - X-ray procedure, which in this case is carried out with the use of contrast agents. This manipulation helps to identify adenoma, as well as to assess the permeability and general condition of the channels.
- MRI Magnetic resonance imaging is necessary to study the structure of the neoplasm and determine its type.
- Radioisotope scan. This procedure allows you to determine the nature of the tumor, and assess the risk of its metastasis to other organs.
Also important are the analyzes of venous blood for estradiol and progesterone. When a patient reveals pathological neoplasms in the mammary glands, it is sent for blood donation to tumor markers. This test is necessary in order to understand whether a woman has a tendency towards malignant oncological processes.
Complications in case of breast cancer is rare, but possible. Untreated disease is fraught with:
- Ozlokachestvlenie neoplasms. Fortunately, this is an extremely rare complication of breast cancer.
- Galactophoritis - a pathological lesion of the milky ducts, in which intense inflammation develops. The disease can develop in case of adenoma pressure on the duct, which leads to stagnation of milk in it. Quite often, such a deviation is observed in lactating mothers.
- An abscess is a purulent abscess, which is usually a complication not of the adenoma itself, but of galactophoritis. It occurs against the background of infection of stagnant contents of the milky ducts.
- Deformation of the affected breast. This defect is characteristic of large and multiple breast adenomas.
Breast adenoma can be cured only by surgery. Neither hormone therapy, nor antibiotics - no drugs can help get rid of the tumor.
With a relatively small size of the tumor (10 mm or more), the doctor can take a waiting position. In this case, the patient should undergo an examination every six months with her doctor and do an ultrasound of the mammary glands. In parallel with this, it is important to maintain healthy lifestyles, adhere to a proper diet, take vitamin complexes containing retinol, ascorbic acid, tocopherol, vitamins P and B6. If there are problems with the thyroid gland, then iodine preparations are prescribed in parallel.
If the adenoma is formed during lactation, the patient is prescribed a course of taking bromocriptine. It is a medicine that regulates the production of breast milk and also contributes to the normal termination of HBV.
Adenoma removal is necessary in case of:
- large size neoplasms;
- suspicion of the malignant nature of the tumor;
- intensive, rapid growth of adenomatous node.
There are 2 ways to carry out the operation:
- Enucleation is a procedure in which a tumor is husked without affecting healthy tissue. Such an operation is possible only after a histological examination confirms the benignity of the adenoma. The procedure is performed under local anesthesia.
- Sectoral resection. In this case, the adenoma is removed along with several centimeters of healthy breast tissues. Adenoma is removed in this way if the doctor has doubts about its goodness. After the intervention, the suture remains, but the scar can be removed later.
Adenoma of the nipple is also surgically removed. In this case, an excision or sectoral resection can also be performed. After surgery, the stitches are removed for 8 days.
Of instrumental therapies most often used:
- Cryotherapy The tumor is removed by exposure to frozen liquid nitrogen.
- Laser ablation. The tumor is destroyed by the laser beam.
After such procedures there are no cosmetic defects. The risk of injury to healthy tissue and the opening of bleeding is also minimal.
Amzh has a favorable prognosis. If the tumor is benign, and is not prone to rapid growth, then the woman can quite successfully “live” with her for many years.
But if a malignancy of a neoplasm is suspected, the prognosis will be less favorable. In this case, the operation should be carried out immediately to avoid dangerous consequences.
Prevention of breast cancer includes:
- timely correction of hormonal disorders - gynecological and non-gynecological origin;
- observation by a doctor during the entire gestational and lactation period;
- exclusion of smoking and other bad habits;
- taking COCs only under medical supervision;
- timely detection, treatment and prevention of diseases of the reproductive system;
- avoidance of stress;
- prevention of liver disease, and, if available, timely treatment.
It is also important to remember that healthy lifestyles - the guarantee of health of the whole organism. And he is not limited only to proper nutrition and physical activity, which, of course, is known to every woman.