breast hypertrophy
Introduction
Introduction Generally speaking, breast hypertrophy generally refers to male breast hypertrophy. Male hypertrophy (gynecomastia) refers to male breast hyperplasia, accounting for more than 90% of male breast disease, which can occur in any age group, usually before and after puberty and old age. More thought to be related to the imbalance between estrogen and androgen. Male breast hypertrophy, also known as men's and women's breasts, refers to unilateral or bilateral breast hypertrophy that occurs in men at different times and at different ages, may have breast tenderness, and can be touched under the areola. Individually visible nipple retraction nipple discharge, some of the shape is similar to the adolescent girl's breast, so the clinical also known as adolescent breast hypertrophy, middle-aged breast hypertrophy, idiopathic male breast hypertrophy.
Cause
Cause
1, testicular insufficiency, can be seen in patients after castration and patients in the process of estrogen treatment;
2, patients with liver dysfunction may also develop breast enlargement due to decreased estrogen inactivation;
3, adrenal diseases, pituitary diseases, tumors, etc. can cause breast development;
4, long-term application of spironolactone, isoniazid, foxglove and other drugs, can cause male breast development, self-healing after stopping the drug;
5, some patients have no obvious incentives, mostly for adolescent patients. Occasionally there is a family onset, but there are genetic reasons for further study.
Examine
an examination
Related inspection
Near-infrared mammography scan breast self-examination breast ductography breast far infrared examination breast ultrasound examination
Laboratory examination
(1) Thyroid function test: blood T3, T4, TSH.
(2) Adrenal function test: ACTH, blood cortisol.
(3) liver and kidney function tests.
(4) Gonadal function tests: E2, T, PRL, LH, FSH and -HCG.
(5) Genetic examination: examination of oral mucosal chromatin and chromosome and karyotype.
(6) Histopathological examination: When the above examination can not confirm the diagnosis of primary lesions, it is feasible to take a fine needle aspiration biopsy or biopsy.
2. Auxiliary inspection
(1) X-ray examination of mammography The shape of the breast is normal. In addition to normal fatty fibrous tissue, hyperplastic glands are seen. After the areola area, the flakes, fan-like or disc-like dense shadows have a uniform density. Most of the gland edges are blurred, and the brush is visible to the surroundings. The shape of the glandular distribution of glands can be clear
(2) MRI examination in the saddle area: MRI examination of the saddle area can be taken when the hypothalamic-pituitary disease or tumor is suspected.
(3) CT examination of the adrenal gland and B-ultrasound of the abdominal organs: suspected adrenal diseases or tumors, feasible CT examination of the adrenal gland and B-ultrasound of the abdominal organs.
(4) B-ultrasound examination of thyroid or testis: suspected thyroid, testicular dysfunction, thyroid or testicular B-ultrasound.
Diagnosis
Differential diagnosis
Calcification of the breast: At present, mammography is still one of the important means for early detection and early diagnosis of breast cancer. The high rate of calcification in the mammary gland is a major advantage of mammography, especially digital molybdenum target photography. Different types of calcification are of great significance in the diagnosis and differential diagnosis of breast diseases. Careful analysis of the manifestations of calcification is of great value in determining the nature of the lesion. The benign calcified particles are coarse, the number is small, the density is high, and the distribution is limited. Malignant calcification particles are fine, numerous, and low in density, and sometimes calcification can be the only manifestation of breast cancer.
Hypertrophy of the breast tissue: From birth to old age, the breast organs are affected by sex hormones, and undergo changes in infancy, early childhood, adolescence, pregnancy and lactation, menopause, and old age. Premenstrual or menstrual period due to physiological hyperemia of the breast, acinar hyperplasia and ductal dilatation and other tissue changes, so that the breast tissue is hypertrophic. The acinar and lobular ducts in the breast during breastfeeding were significantly increased and dense, the ductal dilatation was enlarged, the interlobular tissue was significantly reduced, the acinar epithelium was actively secreted, and some of the epithelium was changed from cubic to columnar. It also makes the breast tissue thick.
Cystic hyperplasia of the breast: This disease is one of the common and frequently-occurring diseases in women. It is more common in women aged 25-45 years. It is essentially a disorder of the normal structure of the breast caused by physiological hyperplasia and incompleteness. In China, cystic changes are rare, mostly glandular hyperplasia, so it is called "mammary hyperplasia". The World Health Organization (WHO) collectively refers to "benign breast dysplasia." The risk of malignant transformation is 2 to 4 times higher than that of normal women. Clinical signs and symptoms are sometimes mixed with breast cancer.
