Diagnosis of adenoma in the mammary gland. Breast adenoma - what is it, treatment. Factors affecting the development of mammary adenoma

Breast adenoma is a type of mastopathy. With such a disease, a benign tumor forms in the breast parenchyma. Adenoma appears against the background of unnatural cell division. Pathology is diagnosed in women of average childbearing age. The development of adenoma is associated with increased load on the chest. The disease can occur in the postpartum period and have a relationship with lactation.

Adenoma has a number of causes. After 39 years, there is a replacement of glandular tissue with adipose tissue. Because of this, the disease rarely overtakes women who are in menopause. Breast adenoma occurs against the background of dysplasia of tissue structures. The tumor is associated with a violation of the production of hormones. It appears when there is a hormonal imbalance in the body. A predisposing factor is a violation of the level of estrogen, progesterone or prolactin. The latter is responsible for lactation.

The glandular tissue is formed with the participation of progesterone, the connective tissue functions well thanks to estrogen. If the ratio of these hormones changes and the level of progesterone increases, breast adenoma disease develops. Excess estrogen leads to fibrous adenoma. This pathology often occurs against the background of obesity. In patients with overweight estrogen levels are usually elevated. The cause may be a deficiency of thyroid hormones. This problem seen in thyroid disorders. The body also experiences a lack of thyroid hormones in diseases of the gastrointestinal tract. The pathology of adenoma may be related to liver diseases, in which there is an increase in this organ.

Other possible reasons:

• stress;
• undosed physical activity;
• hypodynamia;
• breast tumors;
• childbirth;
• breast-feeding;
• menstruation with pain.

If a woman experiences stress regularly, the body produces a large number of corticosteroids, due to which metabolism is disturbed.

Clinical signs

An adenoma is a formation located in the structures of the glandular tissue. It is spherical in shape, dense to the touch. The average seal diameter is 15 mm. Unlike malignant tumor, it has clear contours and moves normally in the structures of the glandular tissue. Adenoma does not hurt. With such a pathology, the skin tone remains unchanged, but before menstruation there is an increase in the glands.

When exposed adverse factors the tumor grows and reaches 3 cm. In some cases, it becomes painful. Pain syndrome is associated with the fact that education presses on nerve endings. When pregnancy occurs, a hormonal imbalance occurs. Some women are diagnosed with adenosis of the physiological type. If, with such a disease, the glandular and connective tissues were affected, the patient feels pain when pressing on the chest area.

Species, including tubular adenoma of the breast

Breast adenoma includes glandular tissue. Fibroadenoma is diagnosed more often. It contains part of the connective tissue. The progression of fibroadenoma is associated with disease in mastopathy.

There are two types of fibrous formations.

1. Nodal. These are seals located at a distance from tissue structures.
2. Foliate. Such tumors contain several layers. A feature of leaf-shaped neoplasms is rapid growth.

To distinguish fibroadenoma from normal, you need to conduct a comprehensive diagnosis.

Another classification of neoplasm.

1. Tubular adenoma of the breast. The neoplasm in the form of a node has tubular structures. It is not accompanied uncomfortable sensations during palpation.
2. lactating. This type has an active secretion.
3. Sosovskaya. A seal forms in the milk ducts. The disease manifests itself as a nodule on the surface of the nipple, in some situations it is accompanied by colorless discharge.

Diagnostic methods

To confirm the tumor, it is necessary to conduct a comprehensive examination. The doctor listens to the patient's complaints, performs palpation. A woman should examine her breasts on her own. It is recommended to inspect every 20 days after the end of menstruation. You need to feel the chest, moving clockwise. To identify seals, it is necessary to carry out a non-intensive tissue massage.

Timely detection of the tumor will improve the prognosis of the disease and help avoid complications. If an adenoma or other seal is detected, you should contact a mammologist or gynecologist. Your doctor will order a blood test to help determine hormonal disorders.

Diagnosis involves the use of hardware techniques: ultrasound and mammography. Ultrasound is a harmless procedure, it is carried out even during pregnancy. If necessary, the doctor prescribes an x-ray using a special tool. If a mammologist suspects a malignant tumor, he refers the patient to aspiration biopsy. After the procedure, tumor fragments are sent for histological analysis.

Instrumental methods of diagnostics.

1. MRI. The procedure makes it possible to see the structure of the adenoma.
2. contrast radiography. Thanks to this manipulation, the doctor assesses the condition of the milk ducts.
3. radioisotope scanning. The procedure helps to identify the etiology of the tumor.

In addition to these methods, a blood test for tumor markers is required.

Therapy Methods

Patients are interested in how to treat breast adenoma. Therapy of the disease must be competent. The doctor prescribes drugs with hormones, poly vitamin complexes. The patient may be recommended the drug Klamin. It is available in the form of tablets and capsules. Klamin compensates for the lack of iodine, which is necessary for the smooth functioning of the thyroid gland. The dosage of the medicine is individual. Klamin regulates lipid metabolism and improves the functioning of the mammary glands.

If the patient is diagnosed with a formation larger than 10 mm, you should visit a mammologist, periodically undergo an ultrasound scan. Breast adenoma may be asymptomatic. Neoplasm does not impair the functioning of organs. AT clinical practice there are cases when fibroadenoma disappeared on its own. Hormones are also prescribed to treat the disease. They are taken in order to normalize the level of estrogen and progesterone. Therapy is carried out according to hormonal background women.

Parlodel

Parlodel is prescribed for treatment. The drug inhibits the production of prolactin. The doses of the medicine are individual, the course of treatment lasts 3 months. Parlodel can give side effects, among them:

• headache;
• malaise;
• severe nausea.

The medicine has contraindications. It is not assigned:

• with hypertension;
• with pathologies of the gastrointestinal tract;
• in cardiovascular diseases.

Diferelin

Normalizes estrogen levels and suppresses excess progesterone production. Diphereline is administered intravenously at intervals of 1 time per month. The course of treatment is 90 days. The disadvantage of the drug is that it makes the bones more brittle.

Other side effects:

• dysfunction of the ureter;
• weakness;
• nausea;
• edema;
• hypertension;
• respiratory dysfunction.

A patient who has a fibrous adenoma of the breast is prescribed Provera. It reduces the level of gonadotropins. The dosage depends on the characteristics of the body. Sometimes the remedy gives side effects, including:

• weakness;
• depressive syndrome;
• violation of the blood circulation of the brain;
• allergy;
• hair loss.

To strengthen the immune system, the doctor prescribes vitamin A. The medicine is available in tablet form and has a number of indications.

1. Vitamin A improves the protective properties of the body, increases resistance to diseases of the genitourinary system.
2. The drug normalizes visual functions, prevents ophthalmic pathologies.
3. Vitamin A has a beneficial effect on the genitourinary system of a woman.

The dosage of this remedy is individual. Vitamin is consumed a few minutes before meals, drinking a small amount water. The drug is prescribed by a doctor. Overdose leads to severe poisoning. Vitamin A provides prevention of the pathology of beriberi, which is manifested by a breakdown. The medicine is drunk to prevent diseases associated with the mammary glands. Vitamin A is not prescribed infants and people with pathologies of the biliary tract. Contraindication is individual hypersensitivity.

Surgery

If the doctor assumes that the adenoma is degenerating into a malignant tumor, he prescribes an operation. The indication for the procedure is the growth of education. The surgeon performs a sectoral resection or enucleation, which involves husking. If a malignant tumor is detected, a mastectomy is prescribed.

Sectoral resection

The doctor prescribes this operation if the tumor grows and becomes a cosmetic defect. The procedure is also indicated for patients who do not have a malignant type of tumor. Indication for sectoral resection there may be a suspicion of an oncological process. AT this case it allows a diagnosis to be made. The procedure is carried out with lipoma, chronic form mastitis.

If the doctor has confirmed breast cancer, the resection is part of the organ-sparing surgery. If the resection is part of a breast-conserving operation, the doctor will administer general anesthesia.

Operation progress:

1. Lines are drawn first. The surgeon uses cotton swab dipped in green.
2. Then semi-oval incisions are made.
3. The breast tissue is dissected with an arcuate incision. To perform the removal of the tumor, it is necessary to make an incision near the pectoral muscle.
4. Then the bleeding stops.
5. The wounds are sutured.

The surgeon performs the procedure so that there are no cavities. If necessary, he sutures the area subcutaneous tissue. Then cosmetic sutures are applied. A fragment of the removed tissue is sent for histology. If a malignant tumor was confirmed during histology, it is necessary to repeat the operation. Carry out more extensive manipulation.

AT rare cases sectoral resection leads to suppuration and infection. If the surgeon does not properly stop the bleeding, a hematoma appears. The cause of the complication may be a violation of blood clotting. The doctor removes the stitches on the 8th day.

Surgery is stressful for a woman's body. Before the manipulation, sedatives should be taken. During the resection, you should not be nervous. The patient must listen to the doctor. If she feels pain, it is worth reporting it. The surgeon will inject an additional dose of the drug.

After a sectoral resection, the patient independently performs the dressing. Before carrying out such procedures, you need to thoroughly wash your hands and apply alcohol. The bandage is carefully removed, the surface of the wound is treated with a swab dipped in alcohol. The bandage is fixed with a plaster. It is forbidden to use folk remedies. In some patients, the temperature rises, intense pain occurs at the site of the surgical intervention, and pus comes out of the wound. In this situation, you should immediately consult a doctor.

Enucleation of a benign seal

The procedure involves exfoliation. During enucleation, tumor cells should not enter the wound. Breast adenoma is a neoplasm enclosed in a capsule. The essence of enucleation is to remove the formation along with the capsule. The procedure is prescribed for fibroadenoma, if the possibility of cancer has been excluded. Enucleation is recommended for patients who have been diagnosed with a breast lipoma and there is no suspicion of an oncological process.

Manipulation is carried out under local anesthesia. The doctor uses Novocain. After anesthesia, he makes an incision in the form of a semicircle (the location depends on where the seal is located). The neoplasm is taken out and husked, then the bleeding is stopped, the wound is sutured. The doctor stitches the subcutaneous fat and applies cosmetic sutures.

After enucleation, the patient can use dry cold. Some women get pains from a wound there is blood and gray liquid. At profuse bleeding or discharge of fluid should consult a doctor. In rare cases, the operation leads to the appearance of a hematoma. Blood accumulates in a certain area of ​​the breast. Possible suppuration.

The sutures are removed on the 8th day. cosmetic effect depends on what material was used during the manipulation. Every day you need to process the seam using an antiseptic. The patient should consult a doctor if the temperature rises to 38 degrees or the general state of health worsens. It is necessary to come to the doctor if suppuration is detected.

Mastectomy

A surgical procedure is prescribed if a malignant tumor has been confirmed. During a mastectomy, the doctor removes the affected mammary gland (the operation is not organ-preserving). The surgeon removes the mammary gland along with adipose tissue, where there are lymph nodes. Metastasis often occurs in the lymph nodes. The indication for the procedure is cancer and suppuration that affects significant areas of the chest.

Before performing the operation, the surgeon performs anesthesia. Anesthesia is given intravenously or through the respiratory tract.

The course of the procedure:

1. The doctor wants two incisions in the shape of an oval.
2. Cuts through the skin and subcutaneous fat.
3. Removes tissue.
4. Removes the pectoralis minor muscle.
5. Removes subcutaneous fat with lymph nodes.
6. Connects drain.
7. Puts stitches.

The drainage is removed on the 6th day after the procedure, the sutures are removed on the 10th. Radical surgery may be accompanied by complications in which lymphatic fluid accumulates in a certain area. Lymphorrhea is a normal postoperative disease. The wound may fester. During the rehabilitation period, the patient is under the supervision of the attending doctor.

Prevention and prognosis

To avoid adenoma and other breast diseases, you need to control your health. It is recommended to examine the mammary glands for the detection of seals. It is better to palpate once every 20 days. Timely examination by a doctor will improve the prognosis of adenoma. Eat rationally, avoid excessive physical activity. You need to protect yourself from stress.

A balanced diet will help to avoid excess weight, in which hormonal failure occurs. Having found a seal or pain in the mammary gland, you should immediately contact a gynecologist. Once every 6 months, you need to undergo a comprehensive diagnosis.

Breast adenoma has a good prognosis. Chance of being reborn oncological tumor minimal. Timely therapy will allow you to return to breastfeeding. However, if the doctor diagnosed the fibrous form of the adenoma, the risk of degeneration into malignancy above. Breast adenoma has a relationship with fluctuations in hormones. It should not be thought that it is a precursor of oncology. In any case, you need to contact the doctor in a timely manner and conduct an examination.

Breast adenoma is a form of mastopathy that is diagnosed in women aged 15 to 40 years. The seal is considered benign and does not pose a serious danger to life.

What is

It is an elastic seal in the form of a ball, characterized by mobility and located close to the surface. It is localized immediately in two glands and only in one.

The tumor grows from the glandular tissue due to an abnormal process of its development. Induration is detected in women under 40 years of age. At this age, there is a peak in the development of milk passages, lobules, ducts, and there is a large load on the mammary glands. This is due to such important periods in life as pregnancy and lactation.

At the age of 40, the process of replacing the glandular tissue with adipose and fibrous begins. Pathology in women at this age is diagnosed extremely rarely.

Seals are divided into the following types:

• Phylloidal- characterized by rapid growth.
• Fibrous- node formation occurs in fibrous tissue.
• Pericanalicular- localized around the ducts.
• Intracanillicular- grows inside the ducts.
• mixed- combines several varieties.

Depending on the type of tissue in which the seal has formed, tumors are classified according to a different principle. Each of the varieties has its own distinctive characteristics.

tubular

Make an accurate diagnosis upon detection of this benign education succeeded only after the operation. The node is able to imitate fibroadenomatous compaction; microcalcifications can often be present in its composition. Due to this, it is often confused with cancer.

The neoplasm is not prone to malignancy. When it reaches 7.5 centimeters in size, they resort to partial removal breasts and subsequent mast-economy.

lactating

Compaction is found in women in lactation. After graduation breastfeeding the neoplasm disappears on its own due to the restoration of normal hormonal levels. Only in extreme cases resort to surgical intervention.

Fibroadenoma

The most common type of benign nodules affecting the mammary glands. Specific Therapy in this case is not required. Operable treatment is carried out with suspicion of oncology and severe discomfort. The neoplasm of this variety is prone to relapse. Radical methods of therapy do not guarantee that the tumor will not reappear.

Pleomorphic

Pathology is rare. The seal is localized under the areola. The neoplasm is capable of transforming into carcinoma and is therefore considered dangerous. In the process of therapy, doctors resort to surgical intervention. Thus, it is possible to prevent malignancy.

Nipple adenoma

A rare type of neoplasm. The tumor strikes inner part ducts located in the region of the nipple. Clinical manifestations in this case differ from the symptoms of other types of adenoma. There is a clear (watery) discharge from the nipple and pain.

Sometimes there are such clinical manifestations like itching, ulcers, an increase in the size of the nipple and its significant induration. Therapy is carried out by surgical intervention.

The reasons

There is a direct relationship between sex hormones and functional activity mammary glands. The development of the alveoli and lobules, in which the production process is carried out, directly depends on the level of progesterone. breast milk. The concentration of estrogen affects the condition of the fibrous tissue and ducts.

The ratio of hormones throughout life changes repeatedly. This process is observed during puberty, childbearing, lactation, menopause and menopause, as well as after childbirth. At the same time, the ratio of hormones remains normal, but even a slight failure can lead to the development of diseases. main reason the appearance of adenoma is considered to be a hormonal disorder.

Similar changes occur after abortive measures, cessation of lactation in postpartum period and at prolonged absence intimacy.

In addition, pathologies of the endocrine system and liver are capable of provoking a failure. There are a number additional factors that affect the hormonal background:

• smoking;
• excess the weight;
• stress;
• heredity;
• reception hormonal means of contraception.

These factors affect the state of the endocrine system. With any violations in its activity, hormonal failure is observed.

The reason for the formation of tumors, and not only adenomas, often lies in stressful situations. Nervous shock leads to excessive production of corticosteroids and, as a result, metabolic disorders.

Symptoms

Breast adenoma differs from other tumors in shape and size. She can be recognized by education movable seal round shape inside the gland. The diameter of the formation, as a rule, is only 1-2 centimeters. When it appears, there is a change in the appearance and shape of the breast. Skin covering remains the same.

There is a slight increase in the size of the seal before the arrival critical days. After the end of menstruation, the adenoma becomes the same. Sometimes there is a growth of the tumor up to 15 centimeters in diameter. At the same time, it turns out strong pressure on tissues and nerve endings, palpation pain.

The formation of a seal can also be suspected by the release clear liquid and milk from the nipples.

As a rule, neoplasms do not cause even the slightest discomfort in women. They are discovered by chance, during the next probing of the chest. Adenoma is a kind of ball with clear boundaries. With careful study, it is even possible to determine its size.

Can it turn into cancer

Medical studies have proven that breast adenoma is not capable of degenerating into cancerous tumor but there is a risk of misdiagnosis. In medical practice, there have been cases when a benign seal is detected in women, which, after histological examination and the removal turns out to be malignant.

This is not about cell mutation, but about misdiagnosis. Before the operation, the doctor assumes that the seal is benign, but after the operation, he finds out that it was breast cancer.

The only one possible variant the transformation of an adenoma into a malignant formation is a sarcoma, but at the same time, we are not talking about cancer either.

Diagnostics

You need to feel your glands and conduct an independent examination monthly. These manipulations are performed after the end of menstruation and strictly on the same day. The glands are examined by deep tissue massaging in a clockwise direction. At correct execution all actions will be able to notice any changes. If you find seals, you need to seek help from a doctor.

On the initial stage diagnostics, the specialist studies the anamnesis, listens to the woman's complaints and examines the mammary glands. After that, the mammologist prescribes a biochemical study of the blood serum for the presence of steroid hormones and hormone-like compounds in it, as well as a general blood test.

Additionally, they resort to hardware diagnostic methods. The woman will need to undergo an ultrasound and an x-ray of the breast (mammography). X-ray examination with the introduction of a contrast agent into the milk ducts (dictography) is also used in the diagnostic process. If malignancy of the seal is suspected, an aspiration biopsy and histological examination are performed.

The following instrumental methods are used in the diagnostic process:

• MRI– layered visualization of compaction. Thanks to this, it is possible to carefully study its structure.
• Contrasting radiography - makes it possible to assess the condition of the channels and their patency.
• radioisotope scanning - allows you to determine the etiology of the neoplasm and the risk of metastasis.

In order to clarify the characteristics of the tumor and correct selection treatment regimens, blood tests for the level of progesterone, estradiol and tumor markers are additionally prescribed.

It is extremely important to identify breast adenoma at the initial stage of its development. In 10% of women small seals, whose diameter does not exceed 1 centimeter, disappear without the implementation of therapeutic measures. For larger tumors, constant control. The doctor should be visited at least once every six months.

Treatment

Depending on the characteristics of clinical manifestations, the treatment of pathology is carried out by a conservative or surgical method. For this reason, it is so important to make a diagnosis at an early stage in the development of the disease.

If the seal does not exceed 2 centimeters in diameter, does not cause pain, does not progress over time, and the results of the biopsy do not cause concern, then no therapeutic measures are taken. Despite this, the woman is registered with a mammologist. Control ultrasound is performed every six months. Thus, the doctor monitors the changes that occur in the neoplasm.

In the event that the diameter of the breast adenoma becomes more than 3 centimeters and the results of the biopsy showed the presence of atypical cells, surgical intervention is performed. Excision is performed if there is a suspicion of cancer, a significant increase in the size of the old seal and an aesthetic defect, characteristic of neoplasms of this group.

You need to respond to the problem without delay. At the same time, there is no particular cause for alarm. The operation is not difficult. In addition, hospitalization is not even necessary.

The therapy is carried out in a complex manner. First of all, in the fight against the tumor process, it is necessary to normalize the hormonal balance, due to a failure in which the compaction occurred. At the same time, the clinical manifestations of the pathology are stopped. Vitamin complexes are prescribed that activate the protective functions of the body.

Of particular importance are vitamins C, A, B6, E and P. They will affect the synthesis of steroid hormones and direct the endocrine system in the right direction.

Drug treatment, as a rule, does not give the desired effect. This is due to the fact that therapy begins late. Timely diagnosis of pathology is not always possible. If the seal begins to progress, they resort to its surgical removal.

In addition to an increase in the size of the neoplasm, the following reasons may be indications for surgical intervention:

• Suspicion of malignant the nature of education. Compaction during mammography and ultrasound is capable of impersonating a cancerous tumor, and a malignant formation can also be perceived as benign during the diagnostic process.
• Swift increase compaction in size, as a result of which there is a risk of an aesthetic defect.
• Adenoma, which was detected by visual examination at a specialist.

Surgical intervention can be carried out in several ways: enucleation and sectoral resection of the affected mammary gland. Depending on the option chosen, the course of the procedure has its own differences.

During enucleation with a scalpel, a small incision is made and the seal is peeled through it under local anesthesia. This method is used in cases where there is no suspicion of malignancy of the tumor.

With a sectoral resection, not only the seal is removed, but also nearby tissues. These manipulations are resorted to in the presence of suspicions of cancer.

Among the modern methods of removing seals, cryoabulation and laser ablation are especially popular. After these procedures, hospitalization is not required and there is no visual defect in the chest area.

Regardless of the chosen method of surgical intervention, a woman needs a long course of rehabilitation. The doctor discusses its features on an individual basis.

Despite the fact that the clinical outcome in most cases is favorable, the patient after surgery continues to be at risk. It is possible that after a while she will again have seals.

After therapy, you need to undergo twice a year ultrasound procedure and be examined by a mammologist. Thus, it will be possible to timely identify the newly appeared seal and avoid its growth.

Possible Complications

breast adenoma long time may develop asymptomatically and not show a tendency to progression, and therefore not cause any complications.

Sometimes in women, the tumor begins to grow rapidly and deform the breast. In rare cases, the seal reaches a gigantic size and completely fills the mammary gland. At the same time, there is a significant increase in its size and the appearance of pain.

Forecast

The degeneration of a tumor into a malignant formation is considered unlikely. Due to this, the prognosis of therapy is favorable. The formation of a seal is not considered an obstacle to pregnancy and lactation. This pathology is a consequence of hormonal imbalance, and not a harbinger of cancer.

The risk of mutation into a malignant formation exists only when a fibrous adenoma of the breast is detected. The prognosis is considered only conditionally favorable.

In addition, after removal of the seal, the risk of their reappearance still exists. Relapses in medical practice meet frequently.

It should be understood that any neoplasm, including breast adenoma, is a reason to see a doctor. Only after a full diagnosis and determination of the nature of the compaction, the degree of its danger, will it be possible to select an adequate course of therapy.

Prevention

All women should take care of their health. Every month you need to independently examine the mammary glands in front of the mirror. Especially if one of the close relatives was diagnosed with pathologies of the genitourinary system and chest. In addition, every six months you should undergo a scheduled examination by a gynecologist, take tests and monitor the condition of the mammary glands.

With the development of pathologies of the thyroid gland and ovaries, treatment should be started as early as possible. Thanks to this, it will be possible to exclude the possibility of hormonal imbalance and avoid the appearance of seals.

An important role in the process of adenoma prevention is played by control over body weight and proper organization diet. Any changes in the state of the mammary glands should be alarming.

When they appear, you should immediately seek help from a doctor. Keeping all these preventive measures, it will be possible to avoid the appearance of seals in the chest and maintain its attractiveness for many years.

Breast adenoma appears due to hormonal disorders. The seal of this variety is considered benign and not prone to malignancy. Despite this, the pathology must be treated in a timely manner. This is the only way to avoid unwanted complications.

Breast adenoma refers to benign tumors that develop from cells of the glandular epithelium. Young women are susceptible to the disease, after forty years there are practically no cases of breast adenoma. The main cause of the disease is believed to be hormonal balance. In its appearance, it is an elastic formation in the form of a sphere.

Adenoma can be single or multiple. Its localization is different - in one breast or both at once. The disease is diagnosed during an annual examination, supported by research: magnetic resonance imaging, ultrasound, biopsy.

Description and types of adenomas

Breast adenoma is a benign neoplasm that arises from the cells of the glandular tissues of the breast. The disease most often affects young women between the ages of fifteen and thirty. After forty years, it is practically not diagnosed.

Adenoma can be single or group with sizes from one to five centimeters in diameter, in severe cases it can reach fifteen centimeters - this is already dangerous to health. It can be located both in one and in two mammary glands. It is difficult to determine the origin of the disease, but experts come to the conclusion that this is facilitated by improper production female hormone- estrogen.

According to statistics, in 10% of women, the adenoma spontaneously disappears, but most often reaching a size of three centimeters, it stops in development. Such a disease requires monitoring and timely treatment. The tumor is an elastic formation in the form of a ball, which is located near the surface of the gland.

Its variety is fibroadenoma, which is much more common. A neoplasm is an overgrowth of fibrous and glandular tissue. There are both single and multiple nodes in the form of a bunch of grapes.

The most dangerous type of fibroadenoma is leaf-shaped, which consists of sheet-like slits with mucus. Such a formation is prone to malignant degeneration. The disease is diagnosed as a result of a visual examination of the patient, supported by ultrasound, magnetic resonance imaging and biopsy. It is treated only by surgery.

The reasons

The main cause of adenoma in women is hormonal imbalance in the body. , excess estrogen and increased prolactin can have a significant impact on the occurrence of neoplasm. The period of pregnancy and the load during breastfeeding contribute to the growth of glandular tissue and the formation of adenoma.

adenoma in breast in women occurs due to smoking, taking hormonal contraceptives, stressful situation, liver disease, heredity. Women with this disease are often diagnosed with diseases of the endocrine system, including diabetes, decreased production of thyroid hormones.

After 40 years, adenoma is practically not diagnosed, since at this age the glandular tissue is replaced by adipose and fibrous tissue.

Classification of neoplasms

Adenoma in the breast various forms depending on the site of occurrence and symptoms.

There are such types of tumors:

• tubular;
• lactating;
• apocrine;
• pleomorphic;
• ductal;
• adenoma of the nipple and surrounding area.

Tubular adenoma is a tumor with clear boundaries. It is a node consisting of cylindrical epithelial cells.

During pregnancy and breastfeeding, cells change their appearance and the neoplasm turns into a lactating form.

The third type of tumor resembles tubular, except that in this case, the cells become similar to cells of apocrine glands during metaplasia of the glandular epithelium.

A pleomorphic neoplasm is similar to a similar benign disease of the sweat and salivary glands.

The fifth type of neoplasm is an expansion of the duct, into the lumen of which a polyp appears.

The last two types of breast adenoma are rare.

With nipple adenoma, neighboring tissues do not take part in the process of tumor formation. The occurrence of a neoplasm is determined by typical features- secretion of a colorless liquid and the formation of ulcers. There are the following types:

• Normal.
• Syringomatous.

A common adenoma is a neoplasm that occurs in the ducts or areola. Sometimes there is a possibility of malignant degeneration of the tumor. Syringomatous adenoma is localized under the nipple and is a formation of sweat gland epithelial cells.

Symptoms

Accurately distinguish a fibrous node from adenoma of the mammary gland with visual inspection difficult. For accurate diagnosis need to undergo a more thorough examination.

Noticing any unusual symptom, a woman should be alert. In this case, you need to clearly know that the adenoma is round, soft, elastic and mobile. And malignant nodes have completely different characteristics.

Manual examination reveals a smooth formation of a spherical or spherical shape with clear boundaries, which is palpated separately from the surrounding tissues. The skin located under the tumor does not change its appearance.

During a visit to the doctor or self-palpation of the breast, there is no pain. With a thorough examination, it is possible to immediately determine the size of the neoplasm. It is usually discovered during a self-examination or a scheduled visit to the doctor.

The adenoma is located near the surface, and its size depends on the phase of the menstrual cycle - it increases before the discharge, and decreases towards the end.

It should be borne in mind that during pregnancy, the tumor tends to increase, and after the end of the breastfeeding period, the formation decreases. At other times, the size of the adenoma practically does not change. During pregnancy, the neoplasm can naturally dissolve.

On palpation of the mammary gland, it is determined as a single neoplasm, as well as multiple nodes. During the examination, a woman may experience discomfort, the intensity and nature of which depends on the size of the adenoma and its localization. If a suspicious ball is detected in the chest, a woman should immediately visit a mammologist.

The neoplasm in the nipple is characterized by swelling, hyperemia, the discharge becomes serous or sanious. The surface is covered with ulcers or crusts. The skin surrounding the nipple does not undergo changes, and a soft elastic nodule is palpated inside, not soldered to the surrounding tissues.

For adenoma, the appearance of wrinkling and "orange peel" is not characteristic. The lymph nodes do not change.

Diagnostics

The problem of formation formations in female breast a mammologist or a mammologist-oncologist is engaged. The diagnosis is made on the basis of the patient's complaints, external examination and studies.

The fact of the appearance of adenoma is determined at the stage of palpation. To do this, the doctor must examine the mammary glands in a standing and lying position. If a mobile round formation is found, then the woman will need further examination.

An accurate diagnosis is made on the basis of a complex clinical research: ultrasound examination, mammography, biopsy and examination of the patient.

It is important to do a biopsy: only this examination will give an accurate answer about the malignancy of the formation. To do this, a piece of breast tissue is taken from the patient and examined under a microscope.

For a young woman, it is enough to undergo an ultrasound scan. After the age of 35, a mammography examination is possible. If it is impossible to make an unambiguous conclusion, the doctor sends for an MRI. A blood test will help determine the hormonal failure.

The collected history will allow the doctor to fully assess the situation and choose the tactics of treatment. At the same time, it may be necessary to consult an endocrinologist, therapist or gynecologist to rule out endocrine disorders, accompanying somatic diseases and pathology of the reproductive sphere.

If an adenoma is suspected, the nipple is sent for cytological study, magnetic resonance imaging of the chest and contrast radiography, biopsy. Then proceed to the choice of treatment tactics.

Differences benign adenoma from a malignant tumor of the breast are presented in the table

Prevention

In order to prevent the onset of the disease, a woman should worry about her health and take regular preventive measures. Once a month, you need to carefully probe your chest, examine the skin of the chest for pathological changes. Women over the age of 40 are recommended to have a mammogram every year. Such simple measures allow you to identify the neoplasm at an early stage and take the necessary measures in time.

Treatment

Before prescribing medication or surgical intervention important to put correct diagnosis. Treatment of the disease depends on the stage of its development. It can be conservative or surgical. In the presence of a painless adenoma up to twenty millimeters in size, which does not increase with satisfactory biopsy results, only observation by a specialized specialist is indicated.

With an increase in adenoma more than 30 mm, the result of the biopsy taken is analyzed. If atypical cells are present in the analysis, then they are sent for surgical intervention. In addition, surgery is necessary if the tumor progresses, there is a suspicion that this is a malignant type of formation.

Surgery can be of two types:

• enucleation;
• sectoral resection.

In the case of a benign tumor, the first option is chosen. With a scalpel under local anesthesia education is removed. During the operation, a benign node is removed within healthy tissues.

If the formation is malignant, then a large-scale surgical intervention is performed to remove the tumor along with the surrounding tissues.

AT modern medicine tumor removal using cryoablation and laser ablation is popular. These procedures do not require additional hospitalization and prevent the occurrence of an external defect at the site of removal of the neoplasm.

Surgical operation, even if it is successful, does not guarantee the absence of recurrence in the future. Therefore, it is important for patients at risk to be constantly monitored by a specialist and to conduct an ultrasound examination several times a year.

After surgery, in any case, there will be a recovery period, its duration depends on many factors and is determined individually in each case.

With adenoma of the nipple, they also resort to surgery. Perhaps local excision of the adenoma with the capture of neighboring tissues by 1-2 millimeters or sectoral resection.

After surgery prescribed antibacterial agents. Sutures are removed on the tenth day. At timely handling for help, the prognosis is favorable, additional medication is not required.

Prevention is the key to health

Adenoma is a common problem of modern young women.

This disease is a consequence of hormonal disorders in the body, but not a harbinger of a malignant formation.

It must be remembered that any neoplasm should not be ignored and requires immediate medical attention. Only a specialist can determine the nature of the tumor and make a diagnosis.

Breast adenoma - what is it, how to identify and how to treat the disease. How dangerous is it and is it possible to prevent the disease? Breast adenoma is a benign neoplasm that grows from fibrous tissue. Interestingly, unlike most breast diseases, adenoma develops before the age of 30. The tumor contains many various types cells - connective tissue, fibrous.

Typically, the tumor has a size of 1 to 3 cm, grows to a maximum of 5 cm, and then it is already called fibroadenoma. Treatment is predominantly surgical; various instrumental methods are used for diagnosis.

Adenoma is formed on the background various diseases internal organs. To common reasons include:

• Change in hormonal background.
• Diseases of the endocrine system - especially the thyroid and pancreas.
• Diseases of the liver.

In addition to the causes, there are also risk factors that increase the likelihood of a disease for a particular person:

• Frequent stress.
• emotional lability.
• Pregnancy and lactation.
• Artificial termination of pregnancy.
• Smoking.
• Long-term use oral contraceptives.
• Painful periods.

It is important to take into account the hereditary factor that affects all diseases of the mammary glands. Pathology can develop against the background of almost any chronic diseases internal organs, glands internal secretion and genitals.

Symptoms and signs of the disease

Breast adenoma refers to hormone-dependent diseases. This means that the release of female sex hormones, and primarily estrogen, provokes tumor growth. Therefore, pathology is most often observed in young girls and women. reproductive age- at a time when the level of sex hormones is high.

Any hormonal disorders can provoke the development of the disease - from artificial termination of pregnancy to postpartum hormonal imbalance. All depending on the causes, adenoma is manifested by characteristic symptoms.

There are such symptoms of the disease:

• Compaction in the mammary gland, which has clear contours, a smooth surface. The seal does not exceed a few centimeters in diameter.
• The tumor is mobile, moves on palpation, is not soldered to the skin or surrounding tissues.
• Before the start of the menstrual cycle, the seal increases in size and becomes more noticeable on palpation. This symptom cannot be considered decisive; such a symptom is characteristic of most benign changes in the breast.
• There is a pain syndrome, it is not very pronounced, palpation before menstruation can be painful.

Breast adenoma affects either one breast or both at once. Approximately 20 out of 100 women have multiple adenomas. If not only glandular, but also connective tissue is involved in the process of tumor formation, then burning is added to the symptoms.

The diagnosis can be made only after the examination. Adenoma has typical symptoms, but they can vary depending on individual characteristics organism. Very rarely, a woman has the whole complex of signs characteristic of adenoma.

Classification

There are several types of adenoma, and depending on the tissue. Forming a tumor and features of growth and localization:

• Nodal. The tumor is characterized by clear contours, it is completely isolated from the surrounding tissues.
• Foliate. The contours are indistinct, the tumor consists of several layers. Is different rapid growth and usually reaches a large size. Due to the peculiarities of growth, it requires a particularly careful approach to treatment.
• Tubular - consists of several tightly fitting layers of tissue. Delimited from surrounding tissues by epithelial cells.
• Lactating - the tumor is characterized by active secretion, the process resembles natural lactation.

By location, an adenoma of the peripapillary or nipple zone is also distinguished. Nipple adenoma is characterized by strict localization of the tumor in the tissues of the nipple and areola, breast tissues remain unchanged. In this case, the tumor grows exclusively inside the milk ducts. In that case, to typical symptoms add skin reactions - sores on the skin of the nipple and areola, as well as transparent discharge from the nipple.

Adenoma does not affect the functioning of the lymphatic system, like others benign neoplasms it does not affect the lymph nodes and does not grow beyond the primary tumor. The risk of degeneration is low, the tumor is not subject to decay. Therefore, breast adenoma is a disease with a favorable prognosis, which, even in its advanced form, does not lead to death.

Establishing diagnosis

Adenoma can masquerade as other diseases. An examination is necessary in order to provide the doctor with accurate information about the size and location of the tumor. It is important to know the type of adenoma.

Preliminary diagnosis consists of palpation and physical examination. Then assign a row laboratory tests: from biochemical research blood and general analysis before hormone analysis.

For the final confirmation of the diagnosis, the following diagnostic methods are used:

• Mammography is an x-ray examination of the mammary glands, one of the fundamental diagnostic methods in mammology. Allows you to get a clear picture of the tissues, find out the size and location of the tumor. In the picture, the doctor also evaluates the patency of the milk canals.
• MRI - mainly used in complex cases, allows you to get a layer-by-layer section of the tumor, evaluate internal structure neoplasms.
• Radioisotope scanning - used to determine the benignity of the tumor and the likelihood of metastasis, if there is a risk of degeneration.

Often the doctor prescribes other additional examinations to represent the complete clinical picture of the disease. The tumor can develop in different ways, depending on the causes and individual characteristics of the organism. A complete treatment is impossible without complete information and the structure and nature of tumor growth.

Currently, a blood test for tumor markers is often prescribed to exclude the possibility of a tumor degenerating into cancer.

Disease prognosis

The degeneration of adenoma into cancer is unlikely. To rule out this possibility, special examinations, but statistics show that breast adenoma is not prone to the formation of malignant cells.

because of low risk degeneration, the presence of an adenoma is not a contraindication for pregnancy and lactation. An exception is tumor growth over 5 cm in diameter. Then the prognosis will change from favorable to conditionally favorable, and the attending physician must take into account the high risk of malignancy.

Adenoma in any case requires a consultation with a specialist. Even if dynamic monitoring is scheduled, it is important to undergo examinations on time and attend a scheduled appointment. Effective treatment is possible only if all the recommendations of a specialist are followed.

Treatment

Breast adenoma - treatment. Therapy is prescribed based on the size of the adenoma - with a diameter of not more than 1 cm, dynamic observation is indicated. In this mode, the patient undergoes examinations at set intervals, and further actions are planned based on the growth of the tumor or on the basis of its reduction in size. The timing of the examination is set individually.

The main problem is that drug treatment of adenoma is impossible, and with small size surgical treatment is not suitable for risks. Pharmacological agents can only be prescribed to maintain tone and correct concomitant chronic diseases.

A list of indications for surgical intervention has been developed, on the basis of which doctors decide on the need for surgery:

• High chance of malignancy. In some cases, the adenoma resembles cancer, especially on ultrasound, so surgery may be prescribed to reduce the risks.
• Rapid tumor growth. The operation is prescribed in connection with a cosmetic defect - an overgrown tumor deforms the breast. Intervention is also necessary due to the risk of complications - the tumor can compress blood vessels and nerve endings.

There are several basic methods surgical treatment, they are selected depending on the type and size of the tumor. As for the timing of the operation, when the adenoma degenerates into an intraductal papilloma, the operation is prescribed as quickly as possible. If there are no changes in the ducts, then it is postponed until a favorable moment.

Surgical treatment of adenoma

There are two main methods for removing adenomas:

• Enucleation - only the tumor is excised, healthy tissues are not affected. Suitable for the removal of tumors of small size and without the risk of degeneration. It can be performed under local or general anesthesia.
• Sectoral resection - the tumor is removed along with a section of healthy tissue. Usually capture tissue a few centimeters around the tumor. Sectoral resection is relevant when there are doubts about the diagnosis and a high risk of malignancy. However, this is a more traumatic type of operation. After the operation, a trace may remain, while enucleation is performed without a scar and with minimal cosmetic defects.

Currently leading medical centers removal of an adenoma with the help of laser ablation or cryogenic is gaining popularity. This technique is less traumatic, does not require hospitalization and does not leave cosmetic defects. The only disadvantage of these procedures is the cost and low availability in Russia.

The main advice for prevention is not to forget about self-examinations and annual examinations by a mammologist. And if any disturbing symptoms appear, it is necessary to undergo a diagnosis and make sure that there is no danger to health. It is important to remember that breast diseases can manifest themselves at a young age.

Breast adenoma is a disease in which there is a pathological, abnormally rapid growth cell structures glandular tissues. Pathological formations in the chest is a solid, elastic nodular seal of a spherical, cylindrical, spherical shape.

Neoplasms can be localized in one or both mammary glands. With a strong increase, their size is approximately 25-30 cm. At the same time, women feel unpleasant painful sensations due to a violation of the innervation of the affected areas in the tissues.

With an adenoma, predominantly cellular structures, elements of fibrous, glandular tissues take part in its formation. They consist of milky lobes, intralobular ducts, as well as nipples, the peripapillary region.

Benign tumors in the mammary gland may consist of single, multiple nodular neoplasms of various diameters. The disease has a benign course. Neoplasms are not prone to malignant degeneration, therefore, they rarely provoke breast cancer. The development of breast adenoma occurs gradually and on initial stages the development of pathology, the symptoms are mild or completely absent.

Most often, a benign tumor in the mammary glands is diagnosed in girls after 15 and up to 29-33 years. At this age, there is an active formation, development of the lactiferous passages of the intralobular ducts. This pathology often develops during menopause, in the premenopausal period, while breastfeeding, pregnancy. The disease belongs to the group of benign mastopathy.

In medical practice, breast adenoma is detected less frequently than fibroadenoma, in which benign pathological formation is formed from connective tissue, cellular structures of fibrous epithelium. It is a painless lump. Fibrous tumors are nodular, leafy.

Fibroadenomas are also noted in women after 35-40 years. At this age, glandular is replaced by fatty, connective tissue Therefore, breast adenoma is rarely diagnosed in older patients.

Varieties of adenoma

Breast adenoma, depending on its location, characteristic features, has the following forms:

• tubular;
• lactating;
• apocrine;
• ductal.

Also, in the representatives of the fair half, neoplasms can be localized in the nipples, the peripapillary region.

With a tubular form, the neoplasm is a small nodule, which is formed from tubular elements. Adenomas in the breast usually consist of cylindrical epithelial cell structures. Other elements of the mammary glands may be involved in the pathological process.

With lactating adenoma, the formation of a dense small nodule is provoked by increased functional loads of the mammary glands during the period of feeding newborn babies. It is a tumor of the milk lobules. Formations can also form in the area of ​​the excretory ducts. As a rule, neoplasms of this type disappear spontaneously after the end of the lactation period, after it normalizes, the hormonal background in the body of women will be restored.

With a nipple adenoma, the appearance of formations in the peripapillary zone, a light cloudy liquid is released from the nipple. Small red sores on the surface of the dermis are clearly visible. The dermis is slightly compacted.

Nodular neoplasms in the breast also include fibroepithelial tumors, pleomorphic neoplasms, mixed, leaf-shaped fibroadenomas. This pathology has the most diverse genesis, causes of development.

Possible causes of pathology

Adenoma in the mammary gland most often occurs due to hormonal imbalance, namely due to a violation of the production of sex hormones. All processes in the mammary glands are carried out under the influence of steroids - progesterone, growth hormone, estrogen (sex hormones).

Important! Estrogen is involved in the development of fibrous tissues. Progesterone is responsible for the formation of glands. If the concentration of progesterone exceeds the permissible physiological norm, this invariably leads to the development of breast adenoma.

Causes of breast adenoma:

• Stressful situations, strong emotional experiences, which are accompanied by increased production of corticosteroids.
• Lack of thyroid hormones.
• Chronic pathologies of the endocrine system.
• Failures in the functioning of the liver.
• Bad habits (smoking, alcohol).
• Irregular sex life.
• Painful periods, unstable menstrual cycle.
• genetic predisposition.
• Abortions, infertility, reproductive dysfunction.

Tumors, neoplasms in the ovaries, excess weight(obesity), diabetes mellitus, abrupt cessation of breastfeeding can cause this pathology. Adenomas in the breast often develop against the background of long-term use oral contraceptives, improperly selected hormonal drugs.

Symptoms

With breast adenoma, the symptoms, clinical manifestations depend on the diameter, localization of the pathological neoplasm, stage, form of the disease. In most cases, neoplasms do not cause discomfort to women. Often, pathology, especially in the initial stages of development, is asymptomatic. Neoplasms in the breast can be detected by chance during palpation (palpation) or during a routine medical examination.

Adenoma in the mammary gland resembles a mobile small tight ball with even borders. It has a rounded, spherical shape, firm texture. The formation surface is smooth. On palpation, it can move within the glandular tissue.

Adenomas in the mammary glands can be localized in any part of the glandular organ.

Clinical manifestations, symptoms:

• discomfort when pressed, palpation;
• expressions on the dermis, hard crusts, cracks in the nipples;
• burning in the chest;
• appearance" orange peel» in the peripapillary zone.

A characteristic symptom of breast adenoma is copious discharge colorless, whitish liquid, ichor, milk from the nipples.

Neoplasms may also have a coarse uneven surface. Pathology is not accompanied by any changes in the epidermis. In this case, neoplasms can increase in diameter in a few days or during menstruation. After the end of the "critical days" they return to their original parameters.

If the neoplasm is enlarged to 5-15 cm, when pressing on the chest, the patient feels discomfort, unpleasant pain, burning.

Diagnostics

The diagnosis is made on the basis of complex diagnostic examinations. Patients are prescribed:

• mammography;
• contrast radiography;
• physical diagnostic methods (palpation, examination);
• radioisotropic scanning;
• serological tests (general, biochemical analysis blood);
• tumor tissue biopsy.

Conduct a comprehensive examination, take into account the data of anamnesis, the results of additional clinical studies.

A biopsy allows you to distinguish adenomas from fibroadenomas, to establish the nature of the neoplasm (benign, malignant). To perform this method, a piece of the affected gland tissue is taken, examined under a microscope. If necessary, conduct a differential diagnosis.

Therapeutic techniques

Treatment for patients should be prescribed by the attending physician, having the results in hand diagnostic studies. In the initial stages of pathology, with properly selected, adequate treatment, the prognosis, as it is correct, is favorable. Often, benign tumors in the breast go away spontaneously, without drug therapy.

Therapeutic therapy, complex systematic treatment for breast adenoma is aimed at normalizing the hormonal background, adjusting, and reducing the concentration of sex hormones. Treatment is selected individually.

For the treatment of breast adenoma in the initial stages, if the size of the benign formation is within 3.5-4 cm, the neoplasms are painless, patients are prescribed symptomatic drug therapy. Conservative therapeutic methods are used with hormonal pharmacological preparations. Methylgesten, Ora-gest, Parlodel, Diferilin are prescribed.

If, based on the results of the biopsy, there are doubts about the nature of the tumor, the formation grows rapidly, disrupts the function of the gland, and with a tendency to malignancy, an operation is prescribed. The excision is carried out under general, local anesthesia. The operation is also carried out in cosmetic purposes if the pathological formation spoils the shape of the breast.

Removal benign tumor occurs by the method of enucleation, as well as during sectoral resection. Enucleation is performed under local anesthesia. rehabilitation period short. The tumor is removed through a small incision in the skin made with a scalpel. The operation is accompanied by minimal traumatism, but relapses are not excluded.

With sectoral resection, the adenoma of the mammary gland is completely excised from the affected tissues. The operation is carried out under general anesthesia. The neoplasm is captured, nearby tissues in the affected area. After surgery, patients are prescribed a course hormone therapy. Prescribe anti-inflammatory drugs, general strengthening medicines for normalization general condition(immunomodulators), vitamin and mineral complexes (vitamin A, B6. B12, E, C, P), preparations based on organic iodine, homeopathic remedies.

If the size of the nodular formation exceeds 10-12 cm, women after medical therapy should constantly monitor their condition, visit a mammologist, endocrinologist.

In modern medicine, laser therapy and cryoblasting are also used for breast adenoma. Therapeutic techniques absolutely painless, have a short recovery, rehabilitation period.

As adjunctive therapy along with drug treatment with breast adenoma, alternative medicine techniques can be used. Well helps tincture of the shell walnuts, herbal preparations, normalizing the function of the liver, endocrine system, gastrointestinal tract.

Prevention

For the prevention of adenoma of the mammary gland of a girl, women several times a year must undergo a comprehensive examination in medical centers and clinics. Representatives of the fair half need to be very careful about their health. Shouldn't be allowed severe hypothermia, often visit solariums, sunbathe on the beach without the use of sunscreens.

To avoid the development of this pathology, it is worth giving up bad habits. It is necessary to observe the diet, daily routine, pay attention to the state of the immune, endocrine system, moderate physical activity is recommended.

Every day, after evening dress, girls should palpate the chest daily for the presence of neoplasms, especially when genetic predisposition to this pathology.

If you suspect the presence of neoplasms in the mammary gland, the appearance of the first symptoms, you should immediately undergo a comprehensive examination, visit a mammologist. If you start medical therapy at the initial stages of the development of pathology, the prognosis is favorable.

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