Adenoma of the breast: causes, symptoms, treatment

Adenoma of breast cancer is it benign neoplasm that arises from glandular epithelium. The peculiarity of the pathology lies in the fact that it mostly affects young women.

In the light of universal precautions in relation to cancer incidence of breast cancer in women with this pathology may occur kantserofobiey – the fear of development of malignancy. But the consequences of such fear in the form of psychological discomfort are not so serious in comparison with what the woman trifled on identified suspicious node in my breast that she would be a benign tumor.

To get rid of the adenoma of the breast is possible only surgically.

General data

Adenoma of the breast is considered as a kind of mastitis – changes in the tissues of glands, which develop on the background of disturbed balance of female hormones. However, it highlighted as a separate, distinct disease.

Adenoma of the breast is considered a disease of adolescence and young age – it is often diagnosed at the age of 15-35 years. Women in the age group of 40-45 years after this disease practically does not reveal. But if the age barrier adenoma of the breast was diagnosed and then stopped its growth and development, in pre-menopausal and post menopausal it can recur, even though the new tumors are formed.

Interesting is the fact that this pathology can develop in healthy women during pregnancy.

Adenoma of the mammary gland identify less common than fibroadenoma the same localization – a benign tumor that consists of fibrous and glandular tissue.

This neoplasm belongs to the category of hormone-dependent tumors. This means that it undergoes certain changes, which depend on:

  • the phase of the menstrual cycle;
  • pregnancy;
  • lactation (formation of breast milk in the postnatal period).

Adenoma of the breast is not prone to malignant degeneration, and if recorded any cases of malignancy, they are sporadic (isolated) and conventional treatment of this pathology is not affected. However, diagnosis and treatment of adenomas of the mammary gland jointly by oncologists and mammologists (in larger clinics, oncologists mammologists).

Reasons

The main reason for the emergence and development of an adenoma of the breast is the imbalance of female hormones. In particular, the role conjunction occurring:

Also revealed that the role in the formation of adenomas of the mammary gland may play a increase in the synthesis (production) of prolactin.

The end result is an adenoma of the breast occurs at the same time manifested in the following factors:

  • the imbalance of these hormones;
  • the change of the mammary glands in the period of gestation (pregnancy);
  • significant functional load during the period of lactation.

Under the influence of these factors creates favorable conditions for excessive proliferation (reproduction, growth and development) glandular epithelium, which is the adenoma of the breast.

In addition, highlighted a number of factors that are direct causes of the development of this tumor are not, but are the contributing, and if the tumor has already formed, the further growth and development. Factors such as:

  • some hormonal disorders non-gynecologic sphere;
  • genetic predisposition;
  • bad habits;
  • oral contraceptives – drugs that prevent the occurrence of unwanted pregnancy.
  • some diseases of the reproductive organs – those which are related to childbirth;
  • stressful situation;
  • some serious liver disease.

Most often, women diagnosed with adenoma of the breast identify these endocrine pathology non-gynecologic areas as:

  • hypothyroidism – the inadequate intake of thyroid hormones associated with the violation of synthesis (production);
  • hyperthyroidism – excessive thyroid hormones;
  • diabetes mellitus is a metabolic disorder of carbohydrates, which occurs when persistent deficiency of the hormone insulin.

Genetic predisposition is one of the factors most frequently contributing to the development of an adenoma of the breast. It is noticed that the adenoma of the breast may be identified in the genus of several women. Moreover, the combination of sick relatives may be different – for example:

  • grandmother and mother;
  • mother and granddaughter;
  • cousins whose mothers are sisters, and one maternal grandmother

and others.

Of all bad habits the appearance of an adenoma of the mammary gland most often contributes to Smoking. We also study the role of alcohol and drugs in active reproduction, growth and development of the glandular epithelium of the mammary glands.

Oral contraceptives alone is rarely a push to the appearance of an adenoma of the breast is of great importance to their long uncontrolled application. This is due to the influence of oral contraceptives on the female sex hormones – namely the occurrence of hormonal imbalance.

Diseases of the female reproductive system, against which adenoma of the breast develops more readily, is:

  • ovarian cyst – formation in the form of a cavity with liquid;
  • oophoritis – inflammation of the ovaries;
  • ovarian cancer – it is malignant neoplasm arising from epithelial cells;
  • endometriosis – a disease in which cells of the endometrium (internal layer uterus) appear in other organs and tissues.

Stress leads to the peak (acute) increase the number of corticosteroids (adrenocortical hormones), which contributes to the development of an adenoma of the breast. More important is the regularity of such stress, rather than their severity. But there are cases when, adenoma of the mammary gland appeared in women some time after a short but strong emotional experiences.

If the woman developed a serious liver disease, it leads to violation of its functions – in particular, comes crashing cleavage in the liver of sexual (and other) hormones, which in turn contributes to the appearance of an adenoma of the breast.

The development of the disease

Adenoma of the breast is a benign tumor. It can be both single and multiple, equally often develops in one or both Breasts.

According to the latest adopted who classification there are two types of adenomas:

  • nipple;
  • the actual breast tissue.

In turn, adenoma of the nipple is:

  • normal;
  • syringomelia. At the histological (tissue) structure similar to carcinoma, sometimes causing confusion during the diagnostic process, as histological examination is often the last method of assessment of pathology and is regarded as the most reliable.

Adenomas of the breast are the five types is:

  • tubular;
  • lactating;
  • apocrine;
  • pleomorphic;
  • Doctrina.

Ordinary adenoma of the nipple is formed in the soft tissues of the breast and the milky ducts that are located directly in the peripapillary area. Differs in that in some cases, possible malignant degeneration.

Syringomelia adenoma develops in podroskovoe area obrazujas from the epithelium of sweat glands. Its peculiarity is that such a tumor will not grow breast tissue and develops as a separate node. At the same time such a site has no clear boundaries.

Tubular adenoma of the breast is a glandular tumor with clear boundaries, consisting of closely lying tubular (resembling tubules) structures.

Lactating adenoma of the breast is a tumor that appears in the milky lobules and ducts in pregnant women or new mothers who are breastfeeding my baby. In these two periods (pregnancy and lactation) in a woman’s body run significant hormonal changes, against which changes in tubular tumors, and it turns into lactating.

Apocrine adenoma of the breast by morphological structure similar to a tubular, but at the same time, there is a so-called apocrisiary cells – they are able to develop a secret, but emphasizing it, are destroyed.

Pleomorphic adenoma is similar to the benign tumor of the sweat and salivary glands.

Doctrina adenoma is adenomatous (glandular) polyps, which acts in the lumen of the lacteal duct.

Pleomorphic and Doctrina varieties of adenoma in the breast are rare.

In preklimaktericheskom and menopause mammary glands undergo involution changes – in them there are processes in its physiological essence of the opposite processes of growth and development of tissues. Glandular epithelium slowly but steadily replaced by adipose and fibrous (connective) tissue. Such a process is the reason that after the age of 40-45 years adenoma of the breast is practically not formed.

Symptoms of adenoma of the breast

In most cases, adenoma of the breast is asymptomatic, the patient is not worried, therefore, as a rule, revealed:

  • during a checkup;
  • during the examination by a mammologist and/or gynecologist about the symptoms of any other disease of the breast or female reproductive organs;
  • in the self -;
  • accidentally during hygienic procedures;
  • the sexual partner during sexual intercourse.

Characteristics proper of adenoma of breast the following:

  • location – most often localized closer to the surface may be very close to the skin of the breast;
  • shape – spherical (in the form of a ball or a pea) or spherical;
  • to shape – with clear contours;
  • size – from 1 cm in diameter and more, may increase in size before menstruation and then returns to its original size;
  • consistency – thick, but not solid, and elastic;
  • the type of surface is often smooth, sometimes revealed her slight tuberosity;
  • for cohesion with the surrounding tissues – not welded;
  • mobility – mobile;
  • subjectively, often painless, in the period of hormonal changes (menstruation, pregnancy, lactation) – sensitive. You may experience mild discomfort by mechanical action on the mammary gland in the tumor site is happens during hygiene, sexual intercourse, when unexpressed household trauma (accidental injuries), and so on.

The skin over the tumor is not usually changed, the color is the same as that on healthy parts of the gland.

This tumor is generally not prone to rapid growth, but in some cases could increase in size. It may be observed:

  • under unfavorable circumstances – injuries, hormonal disturbance and so on;
  • in the period of pregnancy.

On the other hand, there are cases when during pregnancy adenoma of the mammary gland was reduced to a very small size or even disappear completely. Also, the reduction of the tumor after the end of lactation.

Adenoma of the breast is often solitary, although cases were observed with the formation of multiple adenomatous nodes, which was diagnosed in one or both Breasts.

Signs of adenoma of the nipple are:

  • the presence of the node in the thickness of the nipple;
  • swelling of the nipple;
  • his hyperemia (redness);
  • allocation;
  • ulceration.

The characteristics of the adenomatous site:

  • by location and size – can occupy almost the entire teat;
  • shape – spherical or spherical;
  • to shape – with clear contours;
  • consistency – soft, smooth;
  • the type of surface is often smooth;
  • for cohesion with the surrounding tissues are not soldered;
  • mobility – relatively flexible as may occupy the entire thickness of the tissue of the nipple;
  • subjectively, mostly painless, in the period of hormonal changes sensitive. It may be slight discomfort when a mechanical force on the nipple.

Discharge from the nipple are:

  • serous;
  • sukrovichnye.

The surface of the nipple ulcerate not always, however, it also may be covered with crusts.

Diagnosis

As the patient’s complaints on any unpleasant subjective sensations are virtually absent, the diagnosis put on the basis of physical, instrumental and laboratory methods of examination.

Physical examination is held in the position of a woman standing. Performed inspection and palpation (probing) of both Breasts – even if the woman indicates that detected the tumor in only one gland. At physical examination the following is important:

  • during the examination – wrinkled skin and a symptom of “orange of three crusts” are not observed;
  • palpation of regional lymph nodes were not enlarged.

In the diagnosis of this pathology involves traditional instrumental methods used in other diseases of the breast. This:

  • mammography – a comprehensive survey of cancer;
  • ductography – study the ducts of the breast, during which they administered the contrast material, then make the x-ray image;
  • biopsy – invasive method during which make the fence of a fragment of the suspicious tissue. Evaluate them visually, and then sent to the laboratory for testing under the microscope.

Comprehensive mammography consists of such methods as:

  • x-ray mammography – make x-ray images of the breast in two or three projections, for monitoring also examined healthy gland;
  • ultrasound mammography – with the help of ultrasound can detect an adenoma of the mammary gland to assess its exact localization, size, shape, structure and so on;
  • tomosynthesis creates a two-dimensional image of the breast, which assessed its internal structure;
  • magnetic resonance ( MRI) mammography tomography examination of the breast;
  • optical mammography for breast cancer study used sensitive optical equipment.

Laboratory methods, which are used in the clinic in the diagnosis of the disease described it:

  • Cytology – study under the microscope a smear of the discharge from the nipple the presence of atypical cells;
  • histological examination under a microscope study of tissue structure biopsy.

Also important is to consult an endocrinologist, internist, and gynecologist.

Differential diagnosis of

Differential (distinctive) the diagnosis of adenomas of the breast are often carried out with such diseases and pathological conditions, such as:

  • abscess – limited ulcer;
  • lipoma – a benign neoplasm of adipose tissue;
  • fibroma – a benign tumor of connective tissue;
  • cancer – a malignant neoplasm of epithelial cells. In particular, this may be a metastatic tumor is formed when entering other cells of malignant tumors located in other organs and tissues;
  • tuberculous infiltration seal in breast tissue, the development of which was provoked by Mycobacterium tuberculosis.

Complications

Complications of adenoma of the mammary glands are quite rare. It can be:

  • malignancy – malignant degeneration. Observed rarely;
  • galactophore – inflammatory lesion of the ducts. Can develop due to the fact that the adenoma presses on the milky duct, contributing to the stagnation in this milk (during lactation) or pathological States;
  • the abscess develops as a complication of galactophore during infection of stagnant content ducts;
  • the deformation of the breast develops when large forms or multiple adenomatous nodes in the tissues of the gland.

Treatment of adenoma of the breast

Treatment of adenoma of the breast can be:

  • conservative;
  • surgical.

Conservative appointments are regulation of diet, sleep, relaxation – to balance the hormonal levels, which led to the development of described pathology. Drug therapy is ineffective.

The only method of getting rid of the adenoma of the breast is surgical intervention. Indications for surgery are:

  • the increase in size of the adenoma that is not associated with menstruation, pregnancy and lactation;
  • the emergence of new nodes;
  • a suspicion of malignancy (malignant transformation);
  • the emergence of pain syndrome;
  • pronounced cosmetic defect.

The method and extent of surgery depend on:

  • the size of the adenoma of the breast;
  • the pathological process.

Varieties of surgical intervention may be the following:

  • enucleation is in the literal sense husking adenomatous nodes from breast tissue. Shown if there are no signs of malignant transformation of the tumor;
  • sectoral resection – removal of adenomatous node together with the surrounding tissues. When you delete a capture is approximately 1-3 cm of healthy tissue. Shows if there are signs of malignancy of prostate.

If it is carried out husking small tumors cosmetic defect is often missing. In the case of removal of large tumors by the method of enucleation or sector resection may form a large tissue defect in the breast, the removal of which will need to do plastic surgical correction.

Prevention

Preventive measures against occurrence of adenomas of the breast are:

  • prevention of hormonal disruptions, and in their presence timely diagnosis and treatment;
  • proper management of pregnancy and lactation period;
  • prevention, early detection and treatment of hormonal disorders non-gynecologic sphere;
  • the rejection of bad habits – particularly Smoking;
  • oral contraceptives under the supervision of a physician;
  • prevention, timely diagnosis and treatment of diseases of the reproductive system;
  • avoiding all stressful situations;
  • warning complex of somatic diseases, in particular pathologies of the liver, and in their development, early detection and relief;
  • a healthy way of life.

Forecast

The prognosis of adenoma of the breast is favorable. In benign course (this means that the tumor does not increase in size, complications do not develop) a woman can live with this disorder for many years.

If you suspect a malignancy should prompt the physician response and a quick decision about performing surgery – this tactic will help to avoid negative consequences.

Kovtonyuk O. V., medical columnist, surgeon, consultant physician