Mammalogy: diseases — симптомы, диагностика и лечение

Breast cancer is the most common malignant tumor in women. And at the same time, one of those where early treatment changes the outcome the most: a tumor found up to 2 cm in size without affecting the lymph nodes is treated fundamentally differently and with a fundamentally different prognosis than an advanced one. The main problem is not that the disease is difficult to treat, but that at an early stage it shows almost nothing: it does not hurt, does not interfere, does not raise the temperature. This is why self-examination and routine ultrasound or mammography are crucial, rather than waiting for symptoms.

Fibroadenoma is a benign tumor of the breast and the most common reason why a young woman finds a “ball in her breast.” It is not cancer and practically does not turn into cancer. But it is fibroadenoma that most often becomes a cause for alarm, because it is palpable as a distinct dense node. The key question in this diagnosis is not “is it dangerous”, but “is it really a fibroadenoma” - and the answer to this is given not by palpation, but by examination.

Mastitis is inflammation of the breast tissue. Most often it develops in nursing women in the first weeks after childbirth, but it also occurs outside of lactation. The disease is unpleasant because it develops quickly: from the first compaction and increase in temperature to the formation of an abscess, it can take only two to three days. That is why in case of mastitis, it is not the choice of medicine that decides, but the speed of treatment - at the infiltrate stage, conservative treatment helps, but with an abscess formed, surgery is needed.

Breast asymmetry is the difference between the right and left breasts in size, shape or position. There are practically no completely symmetrical breasts: most women have a slight difference, like any paired organs, and this is not a disease. Noticeable asymmetry most often forms during adolescence, when one gland develops faster than the other, and over time the difference decreases. You need to pay attention to asymmetry that has appeared or intensified in an adult woman in a short time, especially if it is accompanied by thickening, retraction of the skin or nipple, or discharge. Such a change requires examination by a mammologist.

Intraductal papilloma is a benign growth inside the milk duct of the mammary gland, most often near the nipple. Its main symptom is discharge from one nipple: transparent, yellowish or bloody, appearing spontaneously, without squeezing. The papilloma itself is not cancer, but it can bleed, and in some cases atypical cells are found next to it, so such formations are usually removed and must be examined histologically. It is important to understand: any spontaneous discharge from one nipple, especially with blood, requires a visit to a mammologist and examination, and not observation at home.

An inverted nipple is a condition when the nipple does not protrude above the areola, but goes inside the gland. There are two fundamentally different groups of reasons, and everything depends on which particular case belongs to. The first is a congenital structural feature: short ducts and cords retract the nipple from adolescence, this is common and in itself is not dangerous. The second is an acquired retraction that has appeared recently, especially on one side: it can be a consequence of inflammation, scars after surgery or tumor growth. Therefore, any new nipple retraction in an adult woman requires examination by a mammologist.

Galactorrhea is the discharge of milk or colostrum-like fluid from the nipple in a woman who is not pregnant or breastfeeding, and sometimes in men. Most often, the reason lies not in the mammary gland itself, but in hormones: milk production is stimulated by prolactin, and its excess triggers secretion. Prolactin levels are increased by a pituitary tumor (prolactinoma), decreased thyroid function, a number of medications, and frequent breast stimulation. Galactorrhea is often combined with cycle disorders, difficulties with conception, and decreased libido. The condition itself is not dangerous, but its cause is important to find. Bloody or one-sided discharge is another signal that requires examination by a mammologist.

Hypoplasia of the mammary glands is insufficient development of the glandular tissue of the breast, in which the volume is noticeably less than expected. It is important to immediately separate the two concepts: small breasts with a normally formed gland are a constitutional feature, not a disease, and they are very common. They speak of hypoplasia when the glandular tissue is truly underdeveloped, the breasts have an unusual shape, there is a large distance between the glands, the areolas are large relative to their volume, and during pregnancy the breasts almost do not increase. This situation may be due to hormonal and genetic reasons and deserves examination, especially if breastfeeding is planned.

Polymastia is the presence of an accessory mammary gland outside its usual location, most often in the armpit. This is a congenital feature: in the embryo, along the so-called milk lines running from the armpits to the groin, several rudiments of glands are laid, and usually all the extra ones disappear. If one of them persists, it behaves like real gland tissue: it swells and hurts before menstruation, enlarges during pregnancy, and can secrete milk after childbirth. The condition itself is not dangerous, but requires attention, because in such tissue the same diseases are possible as in a normal breast.

Fat necrosis of the breast is a benign change in which an area of ​​fatty tissue dies due to impaired blood supply and is replaced by inflammatory and scar tissue. Most often this is a consequence of a blow, a fall, compression by a seat belt, as well as chest surgery, lipofilling and radiation therapy. Sometimes a woman does not remember the injury at all. The main problem of fat necrosis is not medical, but diagnostic: it forms a dense, fixed nodule, can retract the skin and give calcifications on mammography, that is, it looks very similar to a malignant tumor. Therefore, it almost always needs to be confirmed by examination.