lobular hyperplasia
Introduction
Introduction to lobular hyperplasia Breast hyperplasia is a common breast disease in women. The naming of this disease is very confusing, also known as lobular hyperplasia, mammary gland dysplasia, fibrocystic disease. In the past, it was called chronic cystic mastitis. In fact, there is no inflammatory change in this disease, so it is not suitable for application. The disease is characterized by the proliferation of components of the breast, showing abnormalities in structure, quantity and histomorphology, so it is called cystic hyperplasia or mammary gland dysplasia. basic knowledge Probability ratio: about 60% of all breast diseases Susceptible people: women Mode of infection: non-infectious Complications: cystic hyperplasia of the breast
Cause
Causes of lobular hyperplasia
There are many causes of lobular hyperplasia of the breast, but it is mainly related to endocrine disorders or mental emotions. The mammary glands of women of childbearing age are controlled by ovarian endocrine, once the ovarian function is affected by certain factors, such as emotional instability, uncomfortable mood, overwork, sexual disharmony, changes in living environment, or overeating hormone-containing tonics. And the long-term use of cosmetics containing hormones, etc., can affect the proportion of estrogen and progesterone secretion in women or the secretion of rhythm disorders and cause breast tissue hyperplasia. Lobular hyperplasia is a relatively increased secretion of estrogen, which causes the mammary gland to expand into a saclike shape. The epithelial cells of the cyst wall proliferate vigorously, forming one or more cysts, which are characterized by multiple tumors of different sizes on one or both sides of the breast. It has a round or irregular shape and is hard and tough when touched. It has a feeling of touching the rubber block.
Prevention
Lobular hyperplasia prevention
1. Keep your mood comfortable and your mood stable. Emotional instability can inhibit the ovulation function of the ovary, and the decrease of progesterone causes the relative increase of estrogen, leading to hyperplasia of the lobular lobe of the breast. Avoid mood swings, and do not have long-term depression, especially in the early menstrual period.
2, to marry at the right time. It is necessary to advocate late marriage and late childbearing, but it should not be too late. It is best for women to marry at the age of 28, to give birth before the age of 30, and to give birth to eugenics too late. Second, we must do a good job of contraception. Because at 6 weeks of pregnancy, estrogen and progesterone secreted by the embryo's villi stimulate breast hyperplasia. If the flow of people, the proliferation of breast tissue is not easy to shrink, it is more difficult to restore the original state, which is easy to form lobular hyperplasia.
3. Avoid using estrogen-containing creams and medications. Some women use estrogen-containing creams for skin beauty for a long time, which can induce breast lobular hyperplasia. Do not use long-term makeup products containing hormones; but eat hormone-containing tonics and use hormone drugs to treat this disease.
Complication
Lobular hyperplasia complications Complications cystic hyperplasia of the breast
1, nipple discharge: a small number of patients may have nipple discharge, a spontaneous discharge, grass yellow or brown serous discharge.
2, menstrual disorders: patients with this disease can also see irregular menstruation before and after, the amount is small or pale, can be associated with dysmenorrhea.
Symptom
Symptoms of lobular hyperplasia Common symptoms Premenstrual breast pain Breast lumps Breast pain Breast pain Pain dysmenorrhea
The clinical manifestations of lobular hyperplasia in the breast are: 5-7 days before menstruation, breast fullness and pain, menstrual cramps, breast pain relief, and even disappear, until the next menstrual cramps, there are periodic changes. There are generally three manifestations:
1, breast pain
Breast pain on one or both sides, tingling or painful discomfort, severe pain can not be touched, walking, pain is mainly breast lumps, can be radiated to the armpits, chest flank, shoulders, upper limbs, and some manifest as nipple pain or itching Pain fluctuates with changes in mood and menstrual cycle, often before menstruation, and pain is significantly reduced or disappeared after menstruation. However, a small number of people have developed pains about a week after the menstrual cramps.
2, breast lumps
One or both breasts, single or multiple lumps, often on the outer top of the breast, in a patchy, nodular, granular or cord-like shape, more common in lumps, unclear lumps, medium or Slightly hard, the activity has no adhesion to the surrounding tissue, it can be tender, the size of the tumor is different, the small one is like sand, the larger one can exceed 3-4CM. Breast lumps increase before menstruation, and shrink and soften after menstruation.
3, accompanying symptoms
Patients often feel uncomfortable or upset and irritated, can see both dysmenorrhea, irregular menstruation, etc., a small number of patients with nipples spilling brown or light yellow liquid.
Examine
Examination of lobular hyperplasia
1, the correct breast examination when touching the palms should be flat and four fingers together, with the most sensitive index finger, middle finger, ring finger end fingertips in order to gently lick the outer upper and lower parts of the breast, the inner lower part, the inner upper area, and finally the breast Middle nipple and areola area. Do not grasp the breast tissue with your fingers during the examination, otherwise the grasped breast tissue will be mistaken for a lump.
2, from the sitting position, any nipple inversion skin depression structure shape is a clue to deep breast cancer. If the patient clapped his hands on his head to contract the chest muscles, the above signs will appear. When the woman is in a sitting position, it is easy to check the upper and lower clavicle lymph nodes. Finally, you need to sit and palpate, and touch the area under the nipple with your fingers.
3, take the supine position, for a wider area of palpation. A pillow is placed under the breast on the same side, and the hand on the same side is lifted over the head so that the breast is evenly spread on the chest wall, so that the finger can easily reach the deep part. The palpation of the middle finger of the middle finger of the index finger is used instead of the fingertip for palpation. The way of palpation should be rotated from the nipple to the lateral direction. It is especially important to check the breast that extends to the armpit.
4, breast examination should first observe the development of the breast. Whether the breasts on both sides are symmetrical, whether they are similar, whether the nipples on both sides are at the same level, whether the nipple has a retraction depression; whether the nipple areola is erosive, how the skin color of the breast is, whether there is edema and orange peel-like changes, whether there is redness or inflammation Sexuality, showing whether the superficial veins in the breast area are angry.
5, ultrasound examination: When it is suspected that there is a lump in the breast, ultrasound examination must be done. This is a preliminary screening method for screening breast lumps that can be used to determine the nature and location of the mass. However, it has a poor ability to recognize tumors with a diameter of less than 1 cm. If this test is performed alone, a smaller lump may be missed.
6, infrared scanning: infrared scanning is especially suitable for screening during pregnancy and lactation. The examination mainly uses the normal tissue and the diseased tissue to distinguish the infrared absorption rate, and displays different grayscale images such as light transmission and darkness to diagnose the breast disease. Because of the speed and non-radioactivity of this test, it is often used as a screening test for breast diseases in physical examination. Although this test is not a professional examination of the breast, it can still be used as an examination method for breast lesions.
Diagnosis
Diagnosis of lobular hyperplasia
Differential diagnosis
First, breast lobular hyperplasia (stage I breast hyperplasia): is the initial hyperplasia of the breast, mostly occurred in the 25-35 years old, the symptoms are mild, belong to the breast hyperplasia stage I. It accounts for more than 70% of the prevalence of breast hyperplasia, and is often not taken seriously, and it is not actively treated for development.
Second, breast adenosis (breast ductal dilatation, stage II breast hyperplasia): is the further development of early breast hyperplasia, from lobular hyperplasia to mammary duct dilatation, known as breast adenosis, mostly in 30-45 years old, severe symptoms It belongs to stage II of breast hyperplasia. It is easy to attract attention, and it is often difficult to cure. The long-term cure will cause mental depression and lead to increased symptoms. Seriously leading to endocrine disorders, the body has a series of disease symptoms, such as irregular menstruation, insomnia, dreams, dark complexion and other series of reactions.
Third, cystic hyperplasia (breast ductal dilatation with epithelial hyperplasia, stage III breast hyperplasia): is the further development of breast second-stage hyperplasia, mostly occurred in 40-55 years old, the symptoms are very serious, belong to the third stage of breast hyperplasia. The malignant rate of the third stage hyperplasia is above 70%. It is very necessary to actively treat and regularly check. The third stage of breast hyperplasia often brings mental depression and fear to the patient.
Fourth, breast cyst disease (stage IV breast hyperplasia): breast ductal cells and epithelial cells accumulate a large number of death, the formation of cystic mass, cancer rate of more than 90%.
Fifth, breast cancer (V stage breast hyperplasia): more developed from cystic hyperplasia and cysts, the early treatment of breast cancer is only surgery, breast-conserving or not is the choice of surgery. The probability of developing breast cancer in stage I and stage II breast cancer is 1-3%. All patients with breast hyperplasia must be treated promptly and cannot develop during the term.
