Breast adenoma: how to treat, symptoms,operation, diagnosis, classification

Update: October 2018 When something is wrong with the body –
this leads to confusion when the mammary glands are not in order –
causes panic in any woman. But before you despair and
mentally say goodbye to life, should be examined and
necessary treatment, because not all diseases, including
adenoma of the mammary glands, threaten with rebirth in cancer. Breast adenoma
more often diagnosed in women of reproductive age (20 – 35
years), but can occur in adolescent girls between 14 and 16, and in
premenopausal and menopausal tumors independently
absorbs.

Breast adenoma disease

The mammary gland consists of glandular tissue (organ parenchyma),
the main function of which is the secretion of milk and stroma
(supporting the parenchyma of the skeleton), represented by fat and
connective tissue, as well as Cooper ligaments. Adenoma can
occur in any organ containing glandular tissue, for example,
adenoma of the thyroid gland or prostate.

All adenomas, including mammary glands, belong to
benign tumors and rarely malignant. Disease
occurs as a result of proliferation (proliferation) of glandular
epithelium and is observed quite rarely. This tumor
education is a form of mastopathy, that is
hormone-dependent tumor and changes from hormone levels in
body (change phases of the menstrual cycle, pregnancy and
lactation).

After 40 years a breast adenoma is not formed, and by 45 – 50 years
existing tumors reduce, because by this age period
the composition of the mammary glands changes, the glandular tissue is replaced
fatty and connective.

Many women, and even doctors believe that adenoma and fibrous
breast adenoma is the same disease. In terms of
clinical picture of these diseases are similar, but differ
histological structure. If the adenoma consists of glandular
tissue, the composition of the fibroadenoma is glandular and connective
the cloth. In the case of the predominance of connective tissue talk about fibroma
chest

Causes of breast adenoma

Proliferation of glandular epithelial cells occurs more often in
women of childbearing age, which is associated with active growth and
development of lobules, dairy and intralobular ducts of the breast and
maximum functional load of the mammary glands (pregnancy
and breastfeeding). At the heart of the development of breast adenoma
there is a hormonal imbalance, in particular, a violation of products
sex hormones and their ratios. For the formation and growth
glandular tissue “responds” to progesterone, which is produced during
second phase of the cycle and during gestation.

Under the action of estrogen proliferate ducts and connective
the cloth. If progesterone production is insufficient and decreases
content in the tissues of the mammary glands – adenoma develops. also in
the formation of a tumor plays a role and prolactin, the level of which
increases in the second phase of the cycle, during pregnancy and especially in
lactation period. It is prolactin that contributes to the emergence of such
symptoms like engorgement and sore glands. Boost
prolactin and progesterone reduction – the main cause of
adenomas.

Also the cause of the disease may be pathology.
thyroid gland (in 30% of women with breast adenoma), in particular,
lack of production of thyroid hormones and pancreas
(diabetes). Matters in the development of the disease and pathology
liver, which, along with bile removes excess from the body
hormones. In liver diseases, it cannot cope with its
functions that lead to the development of hormonal imbalance.

Predisposing factors

The emergence of a tumor can contribute to a number of factors:

  • heredity (cases of mastitis along the female line);
  • ovarian tumors;
  • inflammatory diseases of the internal genital organs;
  • long-term use of birth control pills;
  • non-breastfeeding;
  • forced suppression of lactation;
  • overweight (fatty tissue produces estrogens);
  • bad habits;
  • spontaneous and artificial termination of pregnancy;
  • parity (number of births and pregnancies);
  • dissatisfaction with family and social situation
    chronic stress;
  • lack of sex or irregularity;
  • sexual dissatisfaction.

Classification

According to the WHO classification, adenoma can be located in the nipple.
or okolososkovoy region and in the thickness of the breast. In his
queue, breast adenomas are subdivided (by localization) into:

  • nodal points that are clearly distinguished from nearby
    fabrics;
  • leafy, composed of many layers and rapidly
    growing;
  • pericanalicular growing around the milky ducts;
  • intracanalicular, tumor proliferation occurs inside
    milk ducts.

On the histological structure of the nipple adenoma can be simple and
syringomatous. Simple adenomas are characterized by proliferation.
cylindrical and muscular epithelium in ducts. Syringomatous
adenomas arise in the areola of the nipple from developing from the sweat epithelium
glands. It is characteristic that such tumors have no clear boundaries,
although their growth is non-invasive (they do not germinate in the surrounding tissues).

Breast adenomas are divided into:

  • tubular adenomas arise only from the glandular epithelium in
    young women of child-bearing age and are presented as a single and
    finely delimited seal not associated with skin or
    nipple;
  • lactating adenomas develop in pregnant and lactating women
    women self-disappear after normalization of hormonal
    level;
  • pleomorphic adenoma, growing from glandular, fibrous, adipose
    tissue (mixed tumor) and is similar to adenoma salivary and sweat
    glands;
  • apocrine adenomas, growing from glandular epithelium and
    undergoing pronounced apocrine changes (proliferation
    epithelium of sweat glands);
  • ductal adenomas – growing inside the milk duct in the form of
    glandular polyp.

Clinical picture

Symptoms of breast adenoma appear only when
significant size of the tumor (more than 5 cm). In other cases
the disease is asymptomatic and tumor detection occurs
случайно на профилактическом осмотре или самообследовании chest
Palpation is determined small, with a pea, about 1 – 2 cm,
education with a rounded shape and clear contours. To touch it
elastic, smooth, rarely lumpy, not soldered to the skin and surrounding
tissues. As a rule, the tumor is painless. Tumor usually
localized shallow and tends to increase the day before
menses. After the end of critical days, adenoma again
returns to its size. Commonly diagnosed single
tumors on the one hand, but the appearance of multiple adenomas is possible
and in both mammary glands. Breast adenomas grow very slowly, but
the action of adverse factors can provoke their stormy
growth. It is characteristic that during pregnancy the tumor is significantly
increases in diameter, and after childbirth and cessation of lactation
decreases or disappears altogether.

With a significant amount of education (7 15 cm) occurs
breast deformity, there is its soreness (tumor
squeezes the nerve endings) and burning. Axillary lymphatic
nodes are not enlarged.

Adenoma of the nipple is characterized by swelling, redness, appearance
serous or serous discharge from the nipple. Nipple skin and
okoloskoskovoy area ulcerated and crusted
due to irritation with secretions. To the touch deep in the nipple
determined by a soft-elastic node with preserved mobility. Colour
areola is not changed, there is no symptom of “orange peel” and
выраженная морщинистость, являющиеся признаками рака chest

Diagnostics

To diagnose the disease, you must contact the department
mammology. The doctor will find out the history of the disease, the presence / absence of complaints,
conduct a physical examination of the mammary glands in a standing and lying position.
Palpation of the chest reveals a single mobile formation
(sometimes several) the size of a pea or small ball.
Регионарные лимфоnodes are not enlarged. Required
clinical blood and urine tests, blood biochemistry, genital blood
hormones and prolactin, in suspicious situations, blood on
tumor markers. To confirm the diagnosis, apply the following
instrumental examination methods:

  • Mammography

X-ray examination of the mammary glands in the straight and lateral
projections. The method is highly informative, the accuracy of the definition of cancer
breast reaches 95%. Mammography не проводится женщинам моложе 35
years, lactating and pregnant.

  • Breast ultrasound

Allows you to identify tumor formation, its localization and
quantity, cohesion it with the surrounding tissues, hold
дифференциальную диагностику аденомы с другими заболеваниями chest
Advantages of the study: safety, the possibility of examining the young
women and conducting multiple studies.

  • Biopsy

Under the control of ultrasound is the fence area of ​​education.
The resulting material is sent for histological examination,
confirming the purity of the tumor and determining it
structure (with adenoma revealed glandular tissue).

In the case of concomitant gynecological, somatic and
endocrine pathology to the diagnosis of the disease involved
general practitioner, endocrinologist and gynecologist. Differential diagnostics
аденомы груди проводят с кистами, фиброаденомой и раком chest

In case of suspected nipple adenoma are held:

  • Nipple smear cytogram

For cytological examination, a detachable is taken.
from the nipple. Allows you to determine the presence / absence of atypical
cell

  • Ductography

Introduction to the milky passages radiopaque substance with
further performing x-rays. Allows to reveal
intraductal formations.

  • MRI of the breast

Allows you to study the structure of the breast in layers and determine
swelling of the nipple. Ultrasound and mammography due to the ineffectiveness of adenoma
nipple not shown.

  • Biopsy.

Treatment

How to treat adenoma of the breast? The method of treatment for this
disease, there is only one – surgical. No
hormone therapy, and even more folk remedies will not help cope
with disease and get rid of the tumor. If education does not exceed in
a diameter of 10 mm, the specialist recommends that the patient regularly
наблюдаться (2 раза в год) и ежегодно проходить УЗИ молочных glands.
In parallel, the mammologist advises maintaining a healthy lifestyle,
compliance with proper nutrition, taking vitamins (A, C, E, P, B6),
with problems with the thyroid gland iodine-containing drugs.
In the diagnosis of lactating adenoma, the doctor will prescribe
Bromkriptina (Parlodel), which inhibits the synthesis of prolactin and
milk production.

Removal of breast adenoma is performed as follows.
indications:

  • significant size of education, which leads to deformation
    breasts;
  • suspicion of a malignant tumor;
  • интенсивный рост adenomas.

Surgical intervention is performed in two ways:
enucleation of education and sectoral resection of the gland.

Enucleation consists in expelling a tumor without affecting
healthy tissue. It is carried out only with the confirmation of histological
a study of the good quality of education. Running under
local anesthesia.

Sectoral resection more serious surgery,
which is the excision of adenoma along with several
centimeters of healthy tissue (resection of the gland sector). Held
when in doubt about the good quality of education. As a consequence
interventions – the formation of a rough seam, but getting rid of it in
further it is possible with the help of cosmetic surgery.

Installed nipple adenoma also requires surgical
interventions. Either an excision is performed – excision of the tumor, not
touching healthy tissue or sectoral resection. Stitches after
surgery on the chest is removed for 8 days.

From innovative methods of treatment of the disease are applied
cryoablation (destruction of a tumor by low temperatures – liquid
nitrogen) and laserablation (the effect on the tumor laser
irradiation). The advantages of such methods is the lack
cosmetic defect (small and inconspicuous scar) and minimum
complications in the removal process (no bleeding).

Question answer

Вопрос: Может ли аденома груди переродиться в рак?

Ozlokachestvlenie adenoma is extremely rare, so when
timely treatment and regular supervision from a specialist
with this disease is favorable.

Вопрос: Как можно предупредить развитие аденомы
chest?

There is no specific prophylaxis for this disease.
You must be checked regularly by a doctor (gynecologist, breast specialist),
conduct self-examination of the breast, timely diagnose and
eliminate endocrinological problems, stick to healthy
lifestyle and abandon abortion.

Вопрос: Три года назад мне проводили операцию по
removal of breast adenoma (exfoliation of the tumor). Now I want
insert implants into the mammary glands to increase their size.
Is it possible?

No way. Any breast disease (cyst,
adenoma, fibroadenoma and others), even if you got rid of it,
when installing implants threatens to relapse and complications. It is better
small breasts, but healthy.

Вопрос: Мне провели биопсию аденомы и по
the results of histology, it became known that I have leafy
adenoma. The doctor insists on surgery, although the size of the education
small, only 14 mm. Should I remove a tumor?

Required. The point is not in the size of education, but in its structure.
Sheet adenoma is one of the most adverse adenomas and its risk
rebirth into cancer is much higher compared to other types
data tumors. Therefore, education should always be removed, and
the sooner, the better.

Вопрос: До беременности я наблюдалась по поводу
adenomas with sizes 9 by 8 mm. How pregnant, swelling
increased to 3 cm. What to do?

If there are no other complaints and additional research
it is confirmed that the tumor is benign, then it is
pregnancy and breastfeeding do not touch. After childbirth and
termination of lactation, the tumor is likely to return to its
original sizes. Otherwise, it should be removed.

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