multiple breasts
Introduction
Multi-breasted introduction Multiple breasts (secondary milk or accessory breast), that is, multiple papillae, is not uncommon. It means that in addition to the normal 1 pair of breasts, there are 1 or more breasts, also called extra breasts, but the excess breasts are in the mammary gland. on. The secondary breast can also occur with any disease occurring in the normal part of the breast. It has been reported that the incidence of paraneoplastic breast cancer is 0.1%, and the incidence of benign tumor of the secondary breast is also about 0.1%, which should be noted. basic knowledge The proportion of illness: 0.0003% Susceptible people: good for women Mode of infection: non-infectious Complications: breast pain
Cause
Multi-breast cause
(1) Causes of the disease
Polyemia is a congenital dysplasia. When the fetus is 9 mm long, on both sides of the ventral side, from the armpit to the groin line (the milk line), from the epithelial tissue of the ectoderm, 6-8 pairs of papillary local thickening, ie breast In the normal situation, except for the chest, the rest of the primordial group disappears before birth. If there is no degeneration, the accessory mammary gland forms a multiple nipple or multiple breasts. If there is a gland under the nipple. Body tissue is called complete sore milk; while only nipples without mammary gland are called vice nipples, some have no nipple protrusions, only bilaterally symmetrical localized depressions or fine areas of skin pigmentation.
(two) pathogenesis
1. The location of the disease: The secondary breast can be seen at any point on the chyle, but it is more common in the chest. It is rare in the area other than the chyle, such as the face, upper arm, shoulder area, back side, thigh, etc. This is called Malposed mamma, lost breast or vagus breast, more common in the armpit, Zhang Fengzhen (1993) reported a case of primary breast squamous cell carcinoma of the axilla, Deng Huixu (1993) reported a case of male 1984) 100 For example, the secondary breast, 95% of which is in the bilateral axilla, only 5% in other parts.
2. Pathological changes
(1) Generally seen: multiple breasts are located under the armpits, which are masses with a diameter of 1 to 6 cm. They are non-enveloped, soft in texture, and can be adhered to the skin. The cut surface can be seen in adipose tissue with grayish white or grayish yellow. Flexible breast tissue in which scattered yellow adipose tissue is visible.
(2) Microscopic observation: breast ducts and mammary gland lobes composed of acinar cells can be seen. The interstitial fibrous tissue and some of the mammary gland ducts are proliferated and expanded in the leaves, forming a cystic mammary gland-like structure. Lymphocyte infiltrator, a chronic cystic mammary inflammation-like change.
Prevention
Multiple breast prevention
prevention:
1. The mood is good, the ovary maintains normal ovulation, the progesterone secretion is normal, the breast will not be hyperplasia due to the unilateral stimulation of estrogen, and the proliferated mammary gland will gradually recover under the action of progesterone.
2. Follow the "low-fat and high-fibre" diet principle, eat whole-grain foods, beans and vegetables, control animal protein intake, and pay attention to supplement appropriate trace elements.
3. Pregnancy makes progesterone secretion sufficient, can effectively protect and repair the breast, while breastfeeding can fully develop the breast, and it is well degraded after weaning, not easy to proliferate.
Complication
Multiple breast complications Complications breast pain
Multiple breasts can cause pain and sometimes milk secretion in adult women during menstruation, pregnancy or breastfeeding.
Symptom
Multiple breast symptoms Common symptoms Severe pain Breast degeneration Incomplete menstrual swelling Skin tenderness and pain
Multiple nipples or multiple breasts most often occur on the outside of the normal breast, the ankle sub-breast, or the lower inside of the normal breast, between the normal breast and the navel.
According to the degree of development of the secondary breast, there are two types of fully developed and incomplete development.
1. Completely developed type of breast milk: There is a fully developed breast tissue, which is affected by estrogen and has swelling and even pain with the menstrual cycle. It disappears after menstruation. During pregnancy, the breast milk also expands with the breast, lactating. There may be milk discharged from the secondary nipple, which may be soft after weaning and the breast is atrophied.
2. Incompletely developed type of breast milk: It can be expressed as only incompletely developed breast tissue, no nipples and areola, or only pigmentation is the areola, local skin thickening is the nipple's secondary milk, and there are only infants. Nipple without areola, or only pigmented areola without nipples and breasts, with underdeveloped breast tissue, can also have pain with menstruation, only areola or only nipples do not have this performance, there are a few chest The accessory mammary gland communicates with the normal mammary gland and empties the secretions into the normal mammary gland, but most of them are separate, which are non-communicating accessory mammary glands.
Examine
Multi-breast check
Fine needle aspiration cytology to identify breast tumors.
X-ray films of molybdenum target showed that the breast tissue of the breast was fluffy, lumpy or branched, with clear or blurred edges, and discontinuous shadows of the breast tissue, with low-density linear or strip-like fat shadows.
Diagnosis
Multi-breast diagnosis
Physical examination generally does not diagnose multiple nipples, multiple breasts, but for other parts of the mass, with the menstrual cycle, pregnancy, lactation, etc., there are corresponding masses and swelling, pain should consider ectopic breast, if necessary, biopsy Confirmed diagnosis, the paramammary gland near the armpit can be diagnosed by X-ray imaging plus needle aspiration cytology.
Differential diagnosis
1. Axillary inflammatory lymph nodes or inflammatory masses: Axillary lymph nodes or inflammatory masses of the armpits are mostly associated with breast or upper chest and ipsilateral upper extremity inflammatory lesions, while the corresponding lateral skin is nipple-free. The areola, while the breast tissue of the accessory breast can increase and may be painful during the menstrual period, but its connection with normal breast tissue is its main feature.
2. Hyperplasia of the breast tail: Paraneoplastic breast cancer should also be differentiated from the proliferation of the normal breast tail. The milk tail often extends outward to the anterior tibial fold and the armpit. The two are easily confused. The local performance should be understood in detail. Pathological examination was performed to prevent missed diagnosis of cancer.
3. Axillary lipoma or other benign tumors: The following points can be identified: 1 pair of breasts have pains that occur with the menstrual cycle, while lipomas have no, 2 pairs of breasts can reach nodular soft tissue The perimeter is relatively clear, and the secondary breasts of the 3 armpits are mostly soft, lobulated or nodular irregular tissue blocks. The perimeter has no obvious boundary with the normal subcutaneous tissue, and adheres to the skin without adhesion to deep tissues. There is glandular sensation, but no lipoma, 4 pairs of breast cancer are hard nodules, the perimeter is unclear, there is no conscious pain or tenderness, and 5 pairs of sacral masses are considered in addition to other primary tumors or metastases. In addition, the possibility of the secondary breast should be considered first.
4. Abnormal breast tissue: refers to the mammary parenchyma seen beyond the normal breast anatomy. The structure of the duct and lobule that constitutes the abnormal breast is normal, but not as perfect as normal breast or accessory breast tissue. Anatomically speaking, Abnormal breast tissue is not connected to the mammary duct system and therefore cannot be equated with the extension of normal breast tissue to the periphery.
