Breast
diseases
Breast
diseases can
be classified either with disorders of the integument, or disorders of
the reproductive system. A majority of breast diseases are noncancerous.
Most
women experience breast changes at some time. Your age, hormone levels, and
medicines you take may cause lumps, bumps, and discharges (fluids that are not
breast milk).
If you have a breast lump, pain, discharge or skin irritation,
see your health care provider. Minor and serious breast problems have similar
symptoms. Although many women fear cancer, most breast problems are not cancer.
Some
common breast changes are-
·
Fibrocystic breast
changes - lumpiness, thickening and swelling, often just before a woman's
period
·
Cysts - fluid-filled
lumps
·
Fibroadenomas - solid,
round, rubbery lumps that move easily when pushed, occurring most in younger
women
·
Intraductal papillomas
- growths similar to warts near the nipple
·
Blocked milk ducts
·
Milk production when a
woman is not breastfeeding
Symptoms
Symptoms related to
the breast are common. They are the reason for more than 15 million visits to
the doctor each year. These symptoms include
·
Breast pain
·
Lumps
·
A discharge from the
nipple
·
Changes in the breast's
skin (for example, the breast's skin may become pitted, puckered, red, thickened,
or dimpled)
More detailed information about common breast
problems is available separately.
Recurring Subareolar Abscess
Recurring
subareolar abscess (Zuska’s
disease) is a rare bacterial infection of the breast that is characterized by a
triad of draining cutaneous fistula from the subareolar
tissue; a chronic thick, pasty discharge from the nipple; and a history of
multiple, recurrent mammary abscesses. The disease is caused by squamous
metaplasia of one or more lactiferous ducts in their passage through the
nipple, probably induced by smoking. Keratin plugs obstruct and dilate the
proximal duct, which then becomes infected and ruptures.
Treatments
The
first stage of treatment is taking antibiotics. Depending on the size of the
abscess and your level of discomfort, your doctor may also want to open up the
abscess and drain the pus. If the infection doesn’t go away with a
course or two of antibiotics, or if the infection comes back repeatedly after
initially clearing up, you may need surgery. During surgery, the chronic
abscess and any affected glands will be removed. If nipple inversion has
occurred, the nipple can be reconstructed during surgery.
Foreign Body
Reactions
Foreign materials, such as silicone and
paraffin, which are used for both breast augmentation and reconstruction after
cancer surgery, may cause a foreign body-type granulomatous reaction in the
breast. Silicone granulomas (“siliconomas”)
usually occur after direct injection of silicone into the breast tissue or
after extracapsular rupture of an implant.
Cysts
Cysts
are fluid-filled, round or ovoid structures that are found in as many as one
third of women between 35 and 50 years old. Although most are subclinical
“microcysts,” in about 20%–25% of cases, palpable (gross) cystic change, which
generally presents as a simple cyst, is encountered. Cysts cannot reliably be
distinguished from solid masses by clinical breast examination or mammography;
in these cases, ultrasonography and fine needle aspiration (FNA) cytology,
which are highly accurate, are used.
Treatment
No treatment is necessary for simple breast cysts — those that
are fluid-filled and don't cause any symptoms — that are confirmed on breast
ultrasound or after a fine-needle aspiration. If the lump persists or feels
different over time, follow up with your doctor.
Adenosis
Adenosis of the breast is a proliferative lesion that is characterized
by an increased number or size of glandular components, mostly involving the
lobular units.
Treatments
Treatment of adenosis of
the breast, in the first place, depends on its form and the nature of the
course of the disease. In diffuse adenosis,
conservative treatment with hormonal therapy is indicated. Therapy consists in
the use of combined oral contraceptives and progestogens.
With mild forms of adenosis, oral contraception is
used for at least six months. The drugs of choice include Lindineth
30 due to the proven positive effect on glandular adenosis,
which reduces its clinical manifestations. In patients during the first two
months, the clinical signs of adenosis of the breast
and the normalization of menstrual function were eliminated.
Hyperplasia
Hyperplasia describes
an overgrowth (proliferation) of cells. It most often occurs on the inside of
the lobules or milk ducts in the
breast. There are 2 main types of hyperplasia—usual and atypical. Both increase the risk of breast cancer, but atypical hyperplasia
does so to a greater degree.
Treatments
Hyperplasia
is generally treated with surgery to remove the abnormal cells and to make sure
no in situ or invasive cancer also is present in the area. Doctors often
recommend more intensive screening for breast cancer and medications to reduce
your breast cancer risk.
Fibroadenomas
Fibroadenomas are
solid benign tumors. They are most common in women
ages 15-35. Most fibroadenomas don't increase the
risk of breast cancer. Often, a fibroadenoma doesn’t
need treatment. However, if it’s large or causes discomfort or worry, it may be
removed.
Treatment
In many cases, fibroadenomas require no treatment. However, some women
choose surgical removal for their peace of mind.
Intraductal papillomas
Intraductal papillomas
are small growths that occur in the milk ducts of the breasts.They are usually
close to the nipple and can cause nipple discharge and pain. You may feel a
lump.They occur most often in women ages 35-55. Intraductal papillomas are
removed with surgery, but need no further treatment.If you have 1 intraductal papilloma, it does
not increase the risk of breast cancer unless it has abnormal cells or there
is ductal carcinoma in situ(DCIS) in the nearby
tissue. Having 5 or more intraductal papillomas may increase the risk of breast
cancer.
Treatments
Standard treatment
for this condition involves surgery to remove the papilloma
and the affected part of the milk duct. The surgery is typically done under
general anesthesia, which means that you’ll be asleep
during the procedure.
Radial
scars
Radial scars (also
called complex sclerosing lesions) have a core of connective tissue fibers. Milk ducts and lobules grow out from this core. Although
radial scars can look like breast cancer on a mammogram, they are not cancer.
Treatments
Radial scars are
surgically removed, but need no further treatment. Most
often, radial scars are a secondary finding when a biopsy is done for other
reasons.
Fibrocystic
Most women have some general lumpiness in the
breasts, usually in the upper outer part, near the armpit. Many women have this
kind of lumpiness, breast pain, breast cysts,
or some combination of these symptoms—a condition called fibrocystic changes.
Treatments
Most women who have fibrocystic breast
disease don’t require invasive treatment. Home treatment is usually sufficient
to relieve associated pain and discomfort. Over-the-counter pain relievers such
as ibuprofen (Advil) and acetaminophen (Tylenol) can
usually effectively relieve any pain and discomfort. You can also try wearing a
well-fitting, supportive bra to reduce breast pain and tenderness. Some women
find that applying warm or cold compresses relieves their symptoms. Try
applying a warm cloth or ice wrapped in a cloth to your breasts to see which
works best for you.