Plus the breast is considered to be ectopic (outside the natural location) the location of the lymph node tissue in the form of individual segments, portions, or complete an additional breast cancer. Is it good or bad? From the point of view of aesthetics – at least not corresponds to the usual ideals of female beauty. From a medical point of view the atypical growth of all tissues of the human body should cause medical vigilance – particularly in light of the fact that in the 21st century, cancers are one of the top medical problems.
The development of incremental segments, the share or full the breast is a relatively rare birth defect of prenatal development. Pathology belongs to the category of rudimentary formations – that is, those who were present as a normal variant, but in the process of evolution disappeared. Similar rudimentary formation can be:
- along the milk lines. This is the place where natural bookmarks embryonic lymph node tissue normal she as the embryo undergoes involution (reverse development);
- in other parts of the body – under the arm, back and even in the vulva and thighs.
This diagnosis women. According to anatomical canons, men are not dairy and breast cancer, lymph node tissue itself is not, and therefore no chance to the representatives of the strong half of mankind additional iron increased in atypical locations. But the result of some genetic and teratogenic (causing developmental disturbances of the fetus) factors in men can appear extra nipple, which is located, moreover, in locations that are not typical for men’s nipples.
Contrary to popular stereotypes about almost the leading role of breast in sex, plus mammary gland is not good – her sexual value is highly questionable. In practice, men perceive breast plus their partners not as an integral element of feminine beauty and sexuality, but as the tumor that may reduce their level of sexual libido (attraction to the opposite sex), and at the very impressionable and potency (ability to have sexual intercourse).
The most plausible is the following theory of the origin of the extension of the breast: pathology develops during embryogenesis, the normal course has been disrupted due to violations of the genetic set of rights.
The key factors, whose role in the emergence of incremental breast cancer has been proven. This:
- genetic predisposition;
- the effects of damaging factors in the antenatal (before birth) period.
- provocations in the postnatal period.
It is important
Incremental slices, share and mammary glands are more common in patients close relatives which suffered the same rejection. However, the genes responsible for the development of incremental glands, has not yet discovered.
The impact of damaging agents on the fetus, which causes the extension of the lymph node tissues, leads to:
- pathological delay normal involution (namely, the reverse development) processes that occur in utero development and prevent further formation of the rudiments of mammary glands in their atypical location.
- stimulation of further growth of the rudimentary mammary glands at their atypical location.
The factors provoking the failure of the fetal development with the formation of additional lymph node glands, are the ones that negatively affect the maternal organism and as a result, on the body of the fetus. Often:
- physical factors;
- chemical factors – including a number of medicines;
- infectious diseases;
- harmful habits of the mother;
- her somatic diseases;
- mental factors.
Physical factors that can trigger the development of this pathology is:
The change in temperature affects negatively on the development of the fetus mainly in:
- a long stay in terms of temperature deviations;
- too critical deviation of the temperature from the normal in which we live.
In other words, the rudiments of the mammary glands will develop in the fetus in a non-standard location in the case that the average pregnant Caucasian race will live in the burning desert, or pronounced sub-zero temperatures. Non-critical non-durable exposure to abnormal temperatures is less dangerous in terms of developing an additional breast cancer than other identified teratogenic factors.
The mechanical effect, which can be teratogenic, it is abdominal trauma, which can get the expectant mother in the early stages of pregnancy, when there is a bookmark all organs and systems of the fetus. Injuries to the abdomen of the pregnant woman, can trigger a failure of embryogenesis and subsequent development of additional mammary gland in the unborn child of the female sex, are:
Intentional injuries to the abdomen, the woman often gets on the basis of domestic conflicts.
Most often, unintentional injuries to the abdomen of a pregnant originate in such circumstances as:
- drop on your stomach. It doesn’t have to be a big – teratogenic effects may occur when a woman falls, for example, from the chair, before climbing to his feet, and then lost his balance;
- RTA (road traffic accident). Abdominal trauma in this case can occur if the woman is not wearing a seat belt or driving;
- too high activity of the child, which can hit pregnant mother in the stomach during a game or escaping from the hands
and so on.
The negative impact of ionizing radiation on the fetus and the subsequent development of described pathology is observed at:
- radiotherapy. This rarely happens, as before her appointment turns out she’s not pregnant, if woman;
- access to ionizing substances associated with professional employment – often in violation of labor protection rules;
- unauthorized access to ionizing substances.
Chemical factors that trigger the development of additional lymph node tissue in the female fetus is a compound, which during pregnancy affect a woman’s body and fetus. They can be divided into two large groups:
- drugs with teratogenic – those that cause failure of fetal development of the unborn child;
- aggressive compounds used in everyday life and at work.
The most pronounced teratogenic effect have such medications as:
- anticonvulsants – anticonvulsant;
- anticoagulants – those that prevent abnormal blood clotting;
- antithyroid drugs are used in excessive production of thyroid hormones;
- chemotherapy – used to suppress the malignant cells of the tumor;
- iodine-containing substances;
- birth control drugs.
Aggressive domestic and industrial substances which are able to disrupt embryogenesis and cause the development of additional lymph node tissue, a lot. This:
- vinyl chloride;
and many others.
In fact, any infectious disease of the mother during the first trimester (3 month period) of pregnancy are risk factors that can lead to a failure of embryogenesis and abnormal development of lymph node tissues.
All known bad habits, from which the woman did not refuse, at least during pregnancy, can become the impetus for the formation of additional lymph node tissue in the fetus is:
- drinking alcohol even in small quantities;
- the use of drugs.
Somatic diseases of the mother Deplete her body, violate the compensatory mechanisms, therefore, are indirect causes of embryogenesis with the formation of additional lymph node tissue from the unborn child of the female sex. So, additional mammary gland is more often diagnosed in children whose mothers had pathology of the heart, liver, kidneys, stomach and so on.
Mental factors influencing pregnant, also play an indirect role in the violation of embryogenesis in General and the formation of the fetus additional lymph node tissue, which formed more mammary gland, in particular.
The development of the pathology
You should understand the following: plus lymph node tissue does not grow like new – its embryonic rudiments already exist, and the pathology develops because the broken process of reverse development of these rudiments.
Mammary glands are laid to the 6th week of fetal development. Normal lymph node tissue are formed along the so-called milk lines that extend from the axillary region to the groin. Under the influence of mutagens (factors that provoke the development of mutations) it is possible to bookmark such tissue in atypical locations.
If the bookmark of organs and tissues of the fetus and their further development are in normal mode, atypical posted the rudimentary elements of the breast over time, undergo regression and disappear. Already on 10 week of pregnancy the fetus is only a couple of mammary glands on the anterior surface of the chest. If the process of reverse development are violated, the extra glandular tissue may persist:
- under the mouse;
- in infraclavicular region;
- between normal mammary glands;
- between the shoulder blades;
- in the genital area;
- in the hip area.
Much less frequently, this pathology appears as an extra nipple, which is formed along or outside the breast line.
For convenience, additional mammary glands klassificeret. This takes into account such factors as:
- the amount of glandular and fatty tissue;
- their ratio;
- the presence or absence of the nipple, areola and milky duct.
Distinguish between these types of pathology described as:
- incremental slice. This means that under the skin located just glandular lymph node tissue, and the nipple is absent;
- polymastia. In an atypical place reveals a full breast with all the typical elements of a nipple, areola and milk ducts;
- polythelia. At the same time developing additional nipple or areola, but the glandular tissue itself is not;
- about the mammary gland. In this case there is unusually located on the nipple under it is fatty tissue and glandular tissue is absent.
Plus mammary gland is manifested mainly due to hormonal changes the body – both normal and pathological. Often the first symptoms of the pathology arise in the period of lactation. Less common pathology seen in adolescent girls at puberty. If formed extra nipple, the disease reveal even baby girls.
Plus if lymph node tissue is available in a small amount, and it has no secondary pathological changes (e.g., inflammation), the extra segments have the form of small painless seals the skin.
Large additional share and additional glands have the following characteristics:
- referring to – the volume of convex formation;
- the consistency is elastic;
- sensitivity painless.
Before menstruation and during the feeding of the child the additional interest and the glands increase in size, swell, and in rare cases can become painful. If additional mammary gland has a nipple during lactation it may release milk from the mother.
Diagnosis is often not difficult – additional mammary gland identified by inspection and palpation. Some difficulties of diagnosis are observed in cases where the extension of iron is small, while it is absent or poorly developed nipple. In the latter case, it is in appearance similar to projecting mole, and patients do not have a suspicion about the presence of any pathology, but as she observed in the clinic frequently, and physicians with little experience may not give the value of this anatomical formation in patients.
Usually the extra mammary gland in all its manifestations is diagnosed if it has any pathological processes manifested by unpleasant subjective feelings, which the woman and turns to the doctor. Abnormalities are identified by using physical, instrumental and laboratory methods of diagnosis.
Data of physical examination:
- during the inspection between normal mammary glands, under the arm, between the shoulder blades, in the region of the genital glands or hip revealed a small swelling of tissue or education in the form of a full breast with nipple or without it;
- palpation (feeling) – tissue homogeneous, supple, pain is not often.
Instrumental methods of diagnostics, which can confirm the diagnosis of extra mammary gland, and also detect its secondary pathological changes of this:
- ultrasonography (us) – at the time estimated the size and localization of tumors volume, especially its tissue structure, the presence or absence of a secondary pathological processes. Also to exclude a malignant process examines the regional lymph nodes;
- computed tomography (CT) – with the help of computer sections appreciate the nuances of extra glandular tissue of the breast and conduct differential diagnosis of tumors (including study the status of regional lymph nodes);
- magnetic resonance imaging (MRI) capabilities are the same as those of CT;
- biopsy are sampling additional tissues of the mammary gland with subsequent study under a microscope.
Of laboratory studies in the diagnosis of this pathology have a value of:
- histological examination under the microscope studying the structure of tissue biopsy;
- cytological examination under a microscope study the peculiarities of the cells biopsy.
The last two methods are recommended for patients who are older than 35 years.
Differential diagnosis of
Differential diagnosis plus the breast is carried out with such pathologies as:
- cyst – a hollow formation with the liquid contents of the inside;
- benign tumors. In particular, it is a lipoma – tumor of adipose tissue;
- malignant tumors, often in the case that the extension of the mammary gland is adjacent to normal mammary glands;
- axillary lymphadenitis – inflammation of axillary lymph nodes.
From the incremental breast cancer can develop complications such as:
- lactose – a milk stasis during lactation (period of milk production and breastfeeding child);
- mastitis – a lesion of inflammatory nature;
- mastitis in different variations – the seal in extra glandular tissue of the mammary gland, which develop on the background of hormonal imbalance. Most often it is cystic (cyst), cystic fibrosis (in the form of cysts and connective nodes) diffuse (in the form of a proliferation of connective tissue throughout additional mammary gland) mastitis;
- benign tumors. The risk of their occurrence increases, if the extension of iron is constantly exposed to mechanical stress, in particular, from the clothing items;
- the malignant degeneration. Was diagnosed with it a few cases but should always take oncological alertness.
If additional mammary gland is quite large, and in her observed pain, women may experience emotional and mental disorders:
- hypochondria – a morbid suspiciousness, depression and discontent;
- depression – depression is a psychological condition.
Treatment of pathology is exclusively surgical: additional breast cancer you can only get rid of it in a speedy deletion. The conventional wisdom about the “effectiveness” of the so-called “biodegradable” means profoundly mistaken – not only do they not help to get rid of the disease, but also can lead to negative consequences:
- the accelerated growth and development of the glandular tissue of this education;
- their rebirth.
The conservative method is very conditional – it is the monitoring of additional breast cancer. If the changes on her part not observed for a long time (it is not increased and is not condensed, from the nipple, nothing is allocated and so on) in this observation and limited.
Surgical removal of the described formation is recommended in the following cases:
- expressed cosmetic defect of a part of the body, often due to the large amount of additional breast or deform;
- severe pain or persistent increase in pain, even if they don’t seem to be too pronounced;
- the presence in the genus cancer.
Surgical volume may be different. It depends on such factors as:
- the amount of additional breast;
- its tissue structure.
There are such types of operations as:
- excision of excess glandular tissue and suturing of the skin over the defect. This operational method of treatment of this pathology is the most common. While surgical intervention removes the nipple and areola (if available), glandular tissue, and excess skin that covered an additional mammary gland. Excised tissue is sent to the laboratory for testing;
- liposuction – removal of fat deposits by suction. Applies to education about breast cancer.
The pathology is congenital, so prevention is the provision of normal conditions of fetal development. This is a range of activities – a pregnant woman must eat right, sleep enough, to carry only manageable loads, to protect against injury and so on.
If additional mammary gland is already present, then such women should be to undergo ultrasound of the vestige, and after 35 years, his mammogram. Additional tissue of the breast needs to be protected from various pathological effects, in particular from mechanical injury.
The prognosis plus the breast is favorable, as she malignities (undergoes malignant transformation) is quite rare. In some cases, with the development of menopause observed involution of small clusters of glandular tissue, and they disappear.
Kovtonyuk O. V., medical columnist, surgeon, consultant physician