Adenos breast cancer is one of the varieties of mastitis (changes in the gland that occurs due to hormonal imbalance), which expands the glandular tissue.
Pathology can provoke a kantserofobiey – suspicion and fear of the patient about the fact that she had a malignant neoplasm, as adenos of the breast, amongst other symptoms, manifests itself by the formation of her tight seals and suspicious nipple discharge. Adenos breast cancer refers to a category of diseases that are treated by conservative methods (namely prescription of hormones) and surgery.
Pathology has other names – is a fibrosing adenos, myoepithelial hyperplasia and lobular sclerosis.
Adenos of the breast is a benign entity which has a hormonal dependent manner, as evidenced by the manifestation of clinical symptoms in the second phase of the menstrual cycle.
Pathology occurs in women of reproductive (child-bearing) age. It is often detected in patients aged 30-40 years, this age category, falls to 70% of all patients with this diagnosis.
If the woman suffers from any disease of the gynecological sphere, adensam incidence of breast cancer is, according to various estimates, from 90 to 100%. In other words, all patients with diseases of the sexual sphere should be tested for the presence of adenoca breast cancer.
This condition develops not only as a pathological, but also physiological. Adenos breast cancer normal seen in:
- girls in the period of the establishment of menstruation;
- women in the first trimester of pregnancy.
In both of these cases the manifestation of adenose regress and disappear on their own after equalization of hormonal levels. However, when this condition requires monitoring on the part of the gynecologist, as a pathological adenos mammary glands may develop on the background of physiological.
The immediate cause of the described condition is an imbalance on the part of the female sex hormones – thus observed:
Selected etiological factors that cause a hormonal imbalance, and, therefore, are indirect causes of adenoca breast cancer. This:
- burdened obstetric and gynecological anamnesis;
- taking certain medications;
- gynecological pathology;
- some somatic diseases are those which are not associated with sexual sphere of women;
- unfavorable ecological situation;
- bad habits.
Of all the types of metabolic disorders in the development of hormonal imbalance of the most important is obesity. The relationship is that adipose tissue can produce estrogens. Every extra kilogram with obesity almost proportionally increases the synthesis of estrogen. At the same time developing relative (not always expressed) of hyperestrogenia – but it is enough to trigger the development of adenoca breast cancer. The amount of progesterone in the blood remains at a normal level.
Factors burdened gynecological and obstetric history, against which develops a hormonal imbalance, giving rise to the development of adenoca breast cancer are:
- late pregnancy;
- refusal to breast feed.
To hormonal imbalance are as spontaneous abortions (miscarriages) and artificial (done in hospital for medical reasons). Particularly strong aggravating factor is the termination of pregnancy on her late lines (15-22 weeks). It leads to a very sharp hormonal changes the body, in this case compensatory mechanisms are not triggered, the body is unable to immediately correct the failure. The level of sex hormones returns to normal gradually over this time to develop endocrine problems – in this case, with such consequences as adenos mammary glands.
This pathology develops in late pregnancy in women over 35 years of ovarian function starts to wane, increases the likelihood of hormonal imbalance. When pregnancy occurs, the ovaries aktiviziruyutsya – this leads to a failure of postnatal production of estrogen and progesterone, as a result, developing a hormonal breakdown.
In case of refusal of breast-feeding increases the concentration of prolactin in the milky ducts occurs stagnation of milk. Because of this stagnation clogged ducts and dilate, and this in turn leads to the formation of cysts and further disruption of the internal structure of the mammary glands with the formation of denosa.
Often indicates that the cause of adenose may be postpartum agalactia – complete lack of milk production. In fact, adenos breast may just occur on the backdrop of agalactia – but it is not the direct cause, but only “light” about the possibility of its development. Adenos and agalactia are two consequences of hormonal failure. Agalactia develops due to lack of progesterone, which regulates the development and “specialization” of cells parenchyma of mammary glands and also due to excess of estrogen. In her case, hyperestrogenism grows stroma (the connective-tissue basis) glands, and the lack of progesterone triggers the uncontrolled growth of glandular epithelium.
To the development of adenoca of the breast can lead to the uncontrolled admission of combined oral contraceptives (COCs) drugs to prevent unwanted pregnancy. The reason is that when you receive a COC may not take into account individual characteristics of the woman’s body and non-compliance with regimens. This leads to hormonal imbalance and the development of dysplastic processes in the mammary glands.
Of all the gynecological diseases often the background of the emergence of adenoca mammary glands are:
Physical illness can be a trigger adenoca breast cancer (in the literal sense – starting hooks) is a pathology, which in themselves cause the described diseases are not, but are able to run the pathological process. Most often these pads pathologies are:
- hypertension – severe persistent increase in blood pressure;
- diseases of the pancreas;
- pathology of the liver;
- chronic stress;
- disorders of the sexual sphere.
Most often of all the factors to unfavorable environmental conditions, the development of adenoca breast provoke an increase in the amount of harmful substances in the atmosphere and water.
Bad habits that can trigger the development of the described diseases are not only Smoking, alcohol abuse and use of narcotic drugs, but persistent chronic sleep disorder (a constant lack of sleep due to domestic and industrial circumstances, the lack of satisfaction with sleep), as well as the regular violation of the diet (particularly the consumption of junk food).
The development of the disease
Cyclic changes that occur in the mammary glands, is regulated in such biologically active substances as:
- hypothalamus-releasing factors;
- follicle-stimulating hormone (FSH);
- luteotrophic hormone (LH);
- human chorionic gonadotropin;
- thyroid hormones;
- hormones of the pancreas.
Central to the development of the disease are:
- hyperestrogenemia – the excess of estrogen;
- a progesterone deficiency.
The hyperestrogenia can be:
The influence of estrogens leads to the fact that the milky way grow, as it increases the reproduction of cells. The consequences of a lack of progesterone following: it is normal inhibits the activity of estrogen, this means that because of a shortage of progesterone is enhanced and so excessive action of estrogen on the mammary glands. In fact, cells multiply unchecked and unrestrained. From the point of view of the structure of the breast tissue, it looks like this:
- it grows and swells the connective tissue within the lobules of the breast;
- rapidly developing glandular cells in the milky ducts – because of this, and there are above described a blockage and the expansion and further growth of the glandular tissue.
There are several types of adenoca breast cancer – they are distinguished by:
- the area affected tissues of the gland;
- histological (tissue) structure.
On the prevalence of pathological education there are 2 forms of this pathology as:
- focal (or local). While in the mammary gland formed a large mobile education in the form of a ball or disc. The node itself consists of individual slices and covered with a fibrous capsule;
- diffuse. It is characterized by the fact that in the breast are formed from several sections of the seals, with their shape and borders are fuzzy, blurry. These seals grow in different areas of the breast, the tissues are unevenly distributed.
On tissue structure (the type of cells that grew) distinguish such types of adenose as:
- sclerosing. Some parts of the lobules of the breast (also called acini) grow. While the acini presses overgrown connective tissue, but their shape does not change;
- apocrine. In this type of pathology epithelial cells of the same species develop in the epithelial cells of another – namely apocrine, which secrete a secret. For a fabric structure such adenota infiltrade similar to cancer that could cause confusion in the diagnostic process. It should be recalled that, in contrast to the infiltrative cancer of the apocrine adenos is a benign disease;
- ductal. At the heart of its development is the expansion of ducts. This kind of disease like sclerosing adenos;
- microglandular. For it is a characteristic chaotic growth of small ducts throughout the mammary gland, but multiple sclerosis and compression of the tissue is not marked;
- denominationally. When in the tissues of the breast are formed isolated pockets of growths. This Adanos is quite rare and generally combined with the formation of adenopituitary – benign tumors of the breast.
Symptoms of adenoca breast
The clinical picture of adenoca breast cancer manifests similar features, as with other types of mastitis. The symptoms can vary depending on the form of the disease.
Common signs of this pathology are:
- the mastodynia – pain and engorgement of the glands, and increased the sensitivity of their skin;
- discharge from the nipple.
Characteristics of pain:
- localization – development of the pathological focus;
- distribution may be sore the whole breast;
- nature – aching, pressing;
- intensity – moderate, worse before menstruation;
- the appearance – may develop late.
If there is a local form of adenoca breast cancer, while it is found education. Its characteristics are the following:
- shape – rounded or irregular shape;
- size – from 1 cm in diameter or larger;
- the consistency is dense;
- the structure – lobed structure;
- mobility – mobile;
- correlation with the surrounding tissues – not welded with them.
For local form adenota missing features such as mucus or milk from the nipple, the deformation of the skin and increase in the axillary lymph nodes. Also not noted pain on palpation.
In the case of diffuse forms see the following symptoms:
- swelling of the breast before menstruation;
- discharge from the nipple;
- education in the gland in the form of nodules.
Characteristics of pain:
- localization – spilled across the breast;
- distribution – can you give the attached to the breast tissue of the chest wall;
- nature – aching, pressing;
- intensity – moderate;
- the appearance – mainly developing late.
Characteristics of secretions:
- color – yellow or colorless;
- the consistency is a liquid;
- the number is scant.
Characteristics of the formations:
- in number few;
- form, without definite shapes and clear boundaries;
- size – in different sizes. Nodules that are close, you can merge – it seems that it formed a tumor of a large size;
- the consistency is dense;
- the structure is homogeneous;
- mobility – mobile;
- correlation with the surrounding tissues – not soldered to them.
The diagnosis of breast adenoca put on the basis of complaints of patient, anamnesis (history of disease) and results of additional methods of examination of physical, instrumental and laboratory.
At physical examination are determined:
- during the inspection, the size and shape of the breast, skin, nipple and areola, the presence or absence of discharge from the nipple;
- palpation – consistency, the existence of entities with soreness.
Instrumental methods of diagnosis assigned to you when you suspect the occurrence of adenoca breast cancer is:
- mammography a comprehensive study of the breast;
- biopsy sampling of breast tissue and their subsequent study under a microscope.
During mammography involved such methods of diagnostics as:
- x-ray mammography – x-ray examination of the breast (do the pictures in two or three projections);
- ultrasound mammography – with the help of ultrasound in breast tissue to identify lesions of the seal, evaluate them;
- tomosynthesis method is based on creating a two-dimensional image of the breast used to measure its internal structure;
- magnetic resonance ( MRI) mammography – a method of tomographic studies of the breast;
- optical mammography – a state of breast tissue studied by means of optical equipment.
Also important in the diagnostic process are the following laboratory techniques:
- General analysis of blood – helps to distinguish this pathology from a malignant tumor. If you have developed malignant tumors, significantly increased erythrocyte sedimentation rate, and in the late period of disease development reduced the number of erythrocytes and hemoglobin;
- the content of sex hormones, determine the level of estrogen, progesterone, prolactin, follicle stimulating hormone (FSH), luteotrophic hormone (LH), and according to the testimony – the level of hormones of a thyroid gland and adrenal glands;
- Cytology – study under the microscope a smear of the discharge from the nipple, determine its cellular composition;
- histological examination in biopsy material under a microscope to determine the degree of proliferation of the cells.
If you have any medical illness, with the aim of detecting them prescribe such methods of examination as:
If necessary, appoint a consultation of a gynecologist, oncologist and endocrinologist.
Differential diagnosis of
Differential diagnosis of adenoca breast often carried out with such diseases and pathological States of the mammary gland, such as:
- adenoma – a benign tumor of glandular tissue;
- fibroadenoma – a benign tumor of glandular and connective tissue;
- the cyst – cavity formation with the liquid contents of the inside;
- cancer – a malignant tumor that grows from the epithelial cells.
The most frequent complications of adenoca breast cancer are:
- inflammatory disease of the breast;
- its deformation;
- the formation of cysts;
- the formation of papillomas in the milky duct – short growths of benign character;
- breast cancer – the likelihood of occurrence in the presence of the described pathology is increased in 5 times. The frequency of malignant transformation depends on the intensity of cell multiplication. So, nonproliferative forms (if these cells are not proliferating) malignities to 0,86%, if there is a moderate proliferation of breast cancer occurs in 2.5%, with severe proliferation of the cancer developing in 32% of cases.
Treatment of adenoca breast
The choice of treatment of adenose (conservative or surgical) depends on the shape and nature of the flow described of the disease.
With the development of diffuse forms are attracted to conservative treatment. It is based on the following assignments:
- correction of diet – limiting animal fats, carbohydrates, increasing the consumption of fresh vegetables and fruits;
- correction lifestyle – if it is sedentary, it is necessary to increase the physical activity;
- normalization of weight;
- avoidance of stressful situations;
- the vitamins – particularly A, E, C, p, and b vitamins;
If you have developed a mild form of the disease, assigned to a monophasic combined oral contraceptive pills, the course of treatment is 6 months. If developed a more severe form of the disease, the treatment is not less than 3 months.
With the development of focal forms of adenoca breast attracted to surgical treatment. While performing sectoral resection of the prostate – excision of education within the healthy tissues.
The main prevention of adenoca breast cancer are the following actions and measures:
- proper planning of pregnancy to prevent abortion;
- planning the first pregnancy before 30 years;
- proper selection of hormonal contraceptives, compliance with instructions of their appointment;
- warning gynecological, endocrine and somatic diseases, and when they occur – early diagnosis and adequate treatment;
- breastfeeding a baby for at least 6 months;
- regular breast self-exams;
- regular visits to the gynecologist at least 1 time in six months;
- the adherence to work, sleep, rest, nutrition;
- the rejection of bad habits.
The prognosis for adenose of the breast is favourable to health and life with early diagnosis and adequate, timely treatment. The development of any complications is possible in advanced cases.