breast adenopathy
Introduction
Introduction to breast adenosis Adenosis of breast is an early stage of mammary gland dysplasia. The main change is the obvious focal hyperplasia of the acinus and small duct of the breast, and there are varying degrees of connective tissue hyperplasia. The lobular structure basically loses its normal shape, and even Acinar epithelial cells are scattered in the fibrous matrix, Foote, Urban and Dawsorn are called scleradenitis, and Bonser et al. are called sclerema of leaflet. According to the development of the lesion, it can be divided into three stages: lobular hyperplasia. Fibroadenopathy and sclerosing adenosis. It has been reported in the literature that there is no carcinogenesis in the lobular hyperplasia, and there are cancerous changes in the latter two stages. This phenomenon has important clinical significance. basic knowledge The proportion of illness: 3% Susceptible people: women Mode of infection: non-infectious Complications: breast cancer
Cause
Causes of breast adenosis
Endocrine factors (95%)
It is generally believed to be related to endocrine disorders and mental factors, that is, may be associated with ovarian dysfunction, abnormal ratio of estrogen to progesterone, decreased secretion of lutein, and increased secretion of estrogen and prolactin, leading to hyperplasia of breast tissue.
Pathogenesis
The pathological changes of this disease are characterized by:
1. The gross morphological mass is mostly grayish white, harder nodules, no capsule, unclear boundary with normal breast tissue, single or multiple hair, its size is more than 2cm, and the cut surface is grayish or brown translucent granular change. Sometimes it is not easy to distinguish from breast cancer.
2. The main changes in tissue morphology can be divided into 3 or 3 stages.
(1) lobular hyperplasia: the early form of adenosis, mainly for lobular hyperplasia of the breast, intracavernous duct and acinar hyperplasia, increased number, increased lobular volume, mild hyperplasia of fibrous tissue, and intralobular and interlobular Lymphocyte infiltration, the lobular boundary remains clear, the lobular morphology is irregular or the lobules are close to each other. This type can be further divided into:
1 acinar adenosis: mainly in the lobular acinar hyperplasia, the number increases, the acinar epithelium is increased into two or more layers and filled with acinar cavity.
2 glandular adenosis: mainly in the terminal leaf duct hyperplasia and acinar ductalization, the number of catheters increased, and some of the ductal epithelial hyperplasia showed papillary protrusion into the cavity.
(2) Fibroadenopathic type: the metaphase morphology of adenosis, at which time the ductal and fibrous tissues of the lobular lobe proliferate, and there are different degrees of lymphocyte infiltration. The proliferating fibrous tissue separates the ducts from each other, and the lobular structure is disordered. The epithelial hyperplasia of the tube is multi-layered or nipple-like, sieving, or even completely filled with the lumen, and the ducts in the lobes are dilated to form microcapsules. When the ducts and fibrous tissues are further proliferated, fibroadenomas can be formed.
(3) sclerosing adenosis type: also known as fibrosis stage, is the late manifestation of adenosis, which is characterized by excessive proliferation of fibrous tissue in the lobule, resulting in atrophy or disappearance of the vesicle, leaving only atrophic catheter, see gland tube squeezed Distorted, epithelial cells become smaller and darker, but the cells are not heteromorphic (Figure 3).
From the above pathological classification, mammary gland disease is a progressive disease process from light to heavy. It is a combination of various forms of lesions. Each period is dominated by a certain form, with different general morphology and clinical manifestations. .
Prevention
Breast adenosis prevention
1, pay attention to the usual habits, including diet, living and so on.
2, regular physical examination: to achieve early detection, early diagnosis, early treatment.
3, to have the ability to self-regulation of life pressure, adjust a good attitude. In addition, older women should also pay attention.
4, the ray generated by the perspective, etc. have a certain impact on female friends, to reduce contact, to reduce radiation damage.
Complication
Breast adenosis complications Complications
Although this disease is a benign disease, it may be cancerous.
Symptom
Symptoms of breast adenosis Common symptoms Breast gland upper gland thickening breast with menstrual pain, breast cystic hyperplasia, nodular breast pain, breast mass, menstrual cycle, chest tightness, hardening, breast sclerosis
The disease occurs in middle-aged people. The time from onset to treatment is about 2 years. The age of onset is about 5 years earlier than the cystic hyperplasia of the breast. The periodic pain and mass of the breast are the main manifestations of this disease.
Periodic pain
It is characterized by increased pain and swelling of the breast before menstruation, enlargement of the mass; pain relief or remission after menstruation, and the mass of the tumor becomes smaller. This type of periodic pain often differs depending on the type of lesion. In the case of lobular hyperplasia, the periodic pain is very obvious. In the case of fibrosis type, the pain is relieved, and there is almost no pain in the sclerosing type. The pain is often painful, acupuncture-like pain or dull pain, and can be radiated to the affected armpit and shoulder.
2. Breast lumps
Often more than one, can involve both sides of the breast, but can also be single, the mass is generally small, the diameter is more than 2cm, the shape of the mass is not the same, is a piece, nodular and cord-like, the edge is not very Clearly, the hardness of the mass varies with the degree of fibrous tissue hyperplasia, lobular hyperplasia, mass lump; fibrous adenosis, moderate hardness; sclerosing adenosis, hard, sometimes misdiagnosed as cancer, lumps of tenderness to lobular hyperplasia The type is obvious, followed by fibroadenopathy, and there is no tenderness in sclerosing adenosis. Breast lumps and pain are often changed due to emotional changes such as chest tightness and impotence, especially in patients with lobular hyperplasia. When the mood fluctuates, the pain is aggravated. The mass enlarges and hardens.
3. Menstrual disorders
Patients with lobular hyperplasia are often irregular in the month, with short menstrual periods and low menstrual flow.
Examine
Examination of breast adenosis
Fine needle aspiration cytology is the main basis for the diagnosis of this disease.
1. Molybdenum target X-ray lesions can be confined to a certain area of the breast, but can also be widely dispersed in the breast. The density of the proliferating breast is increased, and it is nodular or frosted. The shape of the lesion is irregular and the edges are generally blurred. Diffuse lesions increase the density of the whole breast, the normal glandular structure disappears, the lesion shadow tends to fuse, and a few patients may have relatively large calcifications, which are widely distributed in the lesion area.
2. The structure of the mammary gland is disordered, the echo of the glandular tissue is thickened, the spot is enhanced to be granular, the hyperplastic nodule is characterized by an uneven hypoechoic region with unclear boundary, or the mesh shadow formed by the strong echo of the low echo region. Or a "leopard-like" echo structure.
Diagnosis
Diagnosis and diagnosis of breast adenosis
diagnosis
The periodic pain and mass of the breast in middle-aged women, with regular changes in menstruation, should consider the possibility of the disease, feasible X-ray photography and fine needle aspiration cytology examination, can confirm the diagnosis.
Differential diagnosis
The disease should be distinguished from breast cancer, especially in the case of sclerosing adenosis, when the breast is hard and the painless mass with unclear edges is easily misdiagnosed as breast cancer.
