Ductectasia of the mammary gland and ducts: what is it. Causes and treatment of mammary duct ectasia Breast ectasia

Ectasia of the milk ducts is their pathological expansion. Diagnosed in women aged 40 years and older. At timely treatment does not pose a danger, but the occurrence in some cases serious consequences it is possible.

Reasons for the development of the disease

To the reasons causing disease, experts include:

Hormonal changes. Excessive production of prolactin leads to blockage of the milk ducts by epithelial cells. Failures are caused by contraceptives and certain medications.
Acute or chronic inflammatory process in the body also causes dilation of the milk ducts.
Surgery, chest injuries.
The presence of ductal papillomas and polyps. They are classified as benign neoplasms.
Malignant formations of the mammary glands.

Ectasia of the milk ducts is a progressive inflammation. Hormonal disbalance will negatively affect various systems of a woman’s body, as well as general well-being.

Symptoms

Typically, ectasia (ductectasia) of the mammary gland ducts has a bright severe symptoms:

painful sensations in the mammary glands;
burning and itching in the area around the nipple;
swelling of the nipples;
areola compaction.

The main symptom is fluid discharge from the nipples. They are yellowish or brown with bloody clots.

Breast duct ectasia can be cured successfully, but only with timely consultation with a specialist. A mammologist treats the disease.

Diagnostics

The breast examination is carried out in 3 stages:

Examination of the mammary glands by a mammologist, identifying symptoms and describing the medical history.
Examination under a microscope of fluid released from the nipples to determine the causes of their appearance.
Detection of the malignant nature of tumors, determination of the stage of dilation of the ducts.

As diagnostic methods use:

radiography;
mammography;
ductography;
immunohistochemical examination of a piece of tissue for suspected malignancy of the neoplasm.

If during the examination acute or chronic diseases are identified, then a conservative treatment and a complex aimed at strengthening immune system.

Treatment

Breast ductectasia does not always require treatment.

Only in case of severe discomfort can the mammologist offer the patient:

Antibiotics. Drugs are prescribed to eliminate the source of infection that caused the disease. They are selected individually by the doctor (based on test results). Course - 2 weeks.
Painkillers. They are recommended by the attending physician, but you can get by with your usual medications.

If the cause is hormonal imbalance, then the goal of treatment is to normalize it. This is achieved by taking medications. The doctor selects a set of medications and their dosage. The patient’s age, her general health and the presence of chronic diseases.

Use alone to treat ductectasia hormonal agents contraindicated. May cause harm to health. Surgical treatment is indicated in case of unsuccessful drug therapy. The incision is made at the border of the nipple areola. If the case is complex, the nipple will be removed completely.

An operation to rid a woman’s gland of ectasia is excision. It has a certain number of contraindications. The surgeon must inform the patient and provide detailed consultation.

Contraindications to surgery may include accompanying illnesses. These include heart disease, the patient’s desire to have a child and provide breastfeeding.

The surgery is performed under general anesthesia. A woman should not have diseases infectious nature. Local anesthesia is used very rarely and only for mature women. An atraumatic suture is placed on the incision, so there is no trace left on the mammary gland.

There are 2 types of surgical treatment:

Excision of altered epithelial cells and areas of the milk ducts. The removed material must be immediately sent to the laboratory for histological examination to rule out cancer.
Complete removal milk ducts in case of malignancy.

Prevention

Gland duct ectasia does not require specific prevention.

Problems arising with the expansion of milk ducts can be prevented if:

reduce the risk of injury to the mammary glands;
control hormonal levels;
treat inflammatory processes in a timely manner, preventing them from developing into chronic stage;
strengthening the immune system with physical activity and vitamin complexes;
nipple and breast hygiene;
wearing underwear that does not injure or deform the breasts;
giving up harmful addictions, balanced menu, weight control;
annual visits to a mammologist;
Constant self-examination of the mammary glands for timely detection of lumps.

The list of recovery measures includes warm compresses applied to the chest area. Antibacterial drugs intended to relieve inflammation will also be prescribed to the patient.

Complications and prognosis

Duct ectasia is not a dangerous disease, complications are very rare. It’s just important not to miss endocrine and hormonal problems.

Only discharge with blood is unfavorable in terms of prognosis. This is a symptom of malignant pathology. When treating, the stage, localization and volume of cellular structures involved in the process are important. Constant monitoring is required throughout the entire treatment period.

Video

You will learn the dangers of pain in the chest and discharge from the nipples from our video.

Ductal ectasia is called dilatation of the milk ducts. It can be physiological or pathological - occur during pregnancy, lactation (production of milk in the mammary glands), (against the background of aging processes) or any diseases of the mammary glands.

Some symptoms of pathology may raise suspicion regarding the formation of a malignant pathology - this is pain and compaction in the nipple-areolar area, as well as discharge from the nipple.

Treatment is determined by the underlying disease, against which the milk duct ectasia occurred. Often, the use of hormonal and anti-inflammatory drugs is enough to stop the manifestations of the disease. But if conservative therapy is ineffective, surgical intervention may be indicated - up to (complete removal of the mammary gland).

Ectasia of the mammary ducts has other names - ductectasia of the mammary gland and dilatation of the subareolar canals.

Total information

The described condition as an independent disorder is detected extremely rarely - in fact, it is a complication of a number of pathological processes, which is their unique marker.

The normal lumen of the milk ducts ranges from 1.5 mm at the narrowest part to 2 mm at the widest. It is considered that ectasia of the milk ducts has occurred if the lumen of the ducts increases to at least 3-5 mm or more.

note

The described pathology is most often diagnosed in women in age category over 40 years old. This fact indicates that age-related changes that occur in a woman’s body are of greatest importance in the development of lacteal duct ectasia.

Breast duct ectasia itself is not a critical condition. But it often occurs against the background of diseases of the mammary glands, the prognosis for which is serious or questionable.

Causes

Ectasia of the mammary gland ducts can be equally provoked by both physiological and pathological factors.

Normally, moderate ectasia develops under conditions such as:

second phase of the ovulatory cycle;
pregnancy;
lactation.

In the first two cases, ectasia means normal physiological preparation of the mammary glands for lactation. During lactation itself, the milk ducts are able to expand most often when:

large volumes of produced mother's milk;
– stagnation of milk in the mammary glands, which indicates disturbances in the evacuation of milk from the glands.

If ductectasia of the mammary gland is observed during the development of involutive processes (reverse development against the background of withering and aging), then it can be regarded as both physiological and pathological - this depends on the degree of its manifestations. Normally, this is a slight dilation of the mammary gland ducts, which develops against the background of:

hormonal changes in mammary tissue;
their structural changes.

Pathological expansion of the milk ducts often develops against the background of diseases and pathological conditions such as:

dyshormonal disorders;
hyperprolactinemia. This is a hormone whose function is to stimulate the development of breast tissue;
secerating mammary gland - this is the name of the gland from the nipple of which pathological secretion is constantly secreted;
inflammatory processes;
deforming transformations.

Dyshormonal conditions most often lead to the development of ectasia of the subareolar canals - those that are located under the areola of the mammary gland. This happens when there is a violation of the ratio between the amount of estrogens and gestagens. The reasons for this condition are:

pathologies of female genital organs;
disorders of the hypothalamic-pituitary system, a complex of brain structures that plays a regulatory role.

Of all the pathologies of the female genital organs, the most common cause dyshormonal conditions that lead to ductal ectasia of the mammary gland are:

– inflammatory damage to the ovaries;
– inflammatory process in the uterine appendages (ovaries and tubes);
neoplasms are most often voluminous. They can be either benign or malignant;
– a disease in which endometrial cells (the inner layer of the uterus) appear in extragenital areas.

Hyperprolactinemia plays the following role in the occurrence of ductal ectasia of the mammary gland. Since prolactin is produced in greater quantities, it further stimulates the breast tissue, and this provokes a constant secretion of milk, which puts intense pressure on the milk ducts from the inside and thus contributes to their expansion. Hyperprolactinemia can be caused by diseases and pathological conditions such as:

With a secerated mammary gland, the milk ducts begin to expand due to the fact that pathological secretions enter their lumen, which puts pressure on the walls of the ducts. Most often this pathological process develops in diseases and pathological conditions such as:

secretory - a change in the tissues of the mammary gland that develops against the background hormonal imbalance and is accompanied by pathological secretion from the nipples;
intraductal papillomatosis of the mammary glands - the formation of small short growths of tissue in the ducts;
mammary glands. Most often this is intraductal cancer ( cancer tumor develops inside the milk ducts) and (cancer of the nipple and areola).

Inflammatory processes in the mammary glands lead to changes in the normal structure of their tissues, which entails a change in the structure of the milk ducts. The following components of the inflammatory process play a role in the development of ductal ectasia:

swelling of tissues during an acute process;
proliferation connective tissue in a chronic process.

Ectasia of the mammary gland ducts against the background of its deformation develops practically according to the same “scenario” as ectasia against the background of inflammatory processes. This deformation most often occurs against the background of such pathological conditions as:

traumatic injury to the mammary gland suffered in the recent past;
medical manipulations - diagnostic (puncture) and therapeutic (surgical intervention for a particular disease of the mammary gland);
tissue germination by neoplasms – benign and malignant.

Development of the disease

The process of formation of milk duct ectasia consists of several parts, the development of which can be provoked by various factors. The following changes are observed:

The described changes can occur with local (local) tissue swelling, which develops in such pathological conditions as:

acute inflammation;
adhesive process;
formation of scar tissue after traumatic injuries to the mammary gland;
invasion of the gland by tumors.

In addition to the processes described, in women, the development of ectasia of the milk ducts is played by the fact that the breast tissue is stretched due to its sagging, which, in turn, develops due to a decrease in elasticity, characteristic of involutive processes.

Symptoms

Clinical signs of breast duct ectasia often develop gradually and often appear only with significant progression of the described disease. The main signs of the described disease are:

itching or burning in the areola area;
soreness there;
tissue compaction;
changes in the nipple;
discharge;
skin irritation.

Characteristics of pain:

by localization - in the area of the affected milk ducts;
in terms of distribution – irradiation as such is not observed;
by nature – oppressive;
in terms of intensity - moderate, with the progression of pathology - increasing;
by occurrence - they mainly appear with a significant expansion of the milk ducts.

Often there is no pain, the patient complains of discomfort.

note

With ductal ectasia of the mammary gland, tissue often becomes denser in the subareolar area.

Changes in the nipple appear as:

offsets;
retractions;
deformation.

Characteristics of discharge:

in quantity - scant or in moderate quantities;
by frequency – regular;
by nature – serous or sanguineous;
by color - yellowish or whitish;
The consistency is liquid.

Skin irritation occurs due to contact with the described pathological discharge from the nipple. It manifests itself in the form of skin changes such as:

swelling;
redness;
maceration - wet corrosion.

note

If ectasia of the milk ducts occurs due to dyshormonal disorders, dilation of the ducts is observed in both mammary glands.

The ducts are affected in only one mammary gland, most often in such pathological conditions as:

inflammatory processes;
consequences of traumatization;
volumetric processes (formation of tumors).

Diagnostics

The first task of the diagnostic process is to determine whether breast ductal ectasia is physiological or pathological. Hasty conclusions should be avoided, since sometimes physiological ectasia can develop into pathological one. The main thing in the diagnostic process is to identify not only the pathology being described, but the reasons that provoked its appearance. To do this, it is necessary to use all available information - the patient’s complaints (if any), age characteristics and features of obstetric and gynecological history, results additional methods examinations (physical, instrumental, laboratory).

A physical examination of the breast takes into account:

upon examination - size, symmetry, visible changes (or lack thereof) of the mammary glands, skin changes, presence of discharge;
upon palpation (palpation) - consistency of breast tissue, soreness, presence or absence of lumps.

Instrumental research methods used in the diagnosis of ductal ectasia of the mammary gland are as follows:

– a set of methods for examining the mammary gland;
– X-ray examination mammary gland ducts with preliminary introduction of a contrast agent into them. Allows you to evaluate the milk duct system, identify areas of dilatation (expansion) and analyze its severity. The method is valuable in identifying intraductal (intraductal) neoplasms;
radioisotope - the patient is intravenously injected with pharmaceuticals containing radioisotopes; when examining the mammary gland with a special tomograph, they create color picture. It is used to determine changes in the mammary gland - in particular, areas of dilated milk ducts;
– sampling of breast tissue for subsequent examination under a microscope.

Mammography includes examination methods such as:

X-ray mammography is plain radiography mammary glands in two or three projections;
ultrasound mammography - using ultrasound, areas of dilatation (expansion) are identified in the thickness of the mammary gland - this is a sign of ectasia of the milk ducts;
tomosynthesis - using a two-dimensional image of the mammary gland, which is created during this method, the structure of the gland tissue is assessed;
magnetic resonance (MRI) mammography – a method of tomographic examination of the mammary gland;
optical mammography – breast tissue is studied using optical equipment.

Laboratory methods used in the diagnosis of the described disease are as follows:

Since ductal ectasia of the mammary gland in the majority of cases develops as a complication of other diseases, consultations with related specialists - a gynecologist, endocrinologist, oncologist, dermatologist, and surgeon - may be necessary.

Differential diagnosis

Differential diagnosis of mammary duct ectasia is often carried out with such diseases and pathological conditions as:

galactophoritis - inflammatory lesion of the milk ducts;
subareolar abscess - a limited abscess that develops in the tissues under the areola area;
neoplasms - benign and malignant (including Paget's disease - cancer of the nipple and areola).

Complications

Physiological ectasia of the mammary gland ducts does not pose any risk to the health and life of a woman. But in some cases it may be accompanied by complications such as:

galactophorite;
deformation of the mammary gland - can develop with a significant expansion of the milk ducts.

With the development of the pathological form of the described pathology, complications such as:

– inflammatory lesions of the skin (most often in the alveolar zone);
– non-inflammatory lesions (most often in the alveolar zone).

Both of these complications develop with ectasia of the lacteal ducts in patients with secerated mammary glands - their development is provoked by the constant secretion of secretions from the dilated ducts.

It is also possible to develop another pathological condition, which is not a complication of lacteal duct ectasia, but develops against its background - this is cancerophobia (fear of getting cancer).

Treatment of milk duct ectasia

If ductal ectasia of the mammary gland has formed due to physiological reasons, no treatment required. However, regular monitoring by a mammologist is indicated.

If the dilation of the mammary ducts is determined to be pathological, treatment is based on the elimination of the underlying disease that led to the appearance of the described pathology. Treatment methods can be conservative and surgical.

Conservative therapy is based on the following:

for dishormonal disorders - hormonal drugs;
for inflammatory processes - taking into account the sensitivity of the pathogen and anti-inflammatory drugs (non-steroidal anti-inflammatory drugs, or NSAIDs, are often used);
at malignant neoplasm– cytostatics.

The following purposes are common:

immunocorrectors;
vitamins and minerals (often in the form of complexes).

If ductal ectasia of the mammary gland occurs due to hormonal disorders, patients are recommended to:

reduce weight;
adjust your diet - the consumption of fatty foods should be reduced and simple carbohydrates(buns, pastries, cakes and other sweet products are rich in them).

Surgical treatment for breast duct ectasia is indicated in the following cases:

lack of effect from conservative therapy;
steady progression of pathology and development of complications;
expressed pain syndrome, which is difficult to relieve;
severe deformation of the mammary gland;
cancerous lesion.

The type and extent of surgical intervention depends on the type of pathology and the degree of its development. The following operations are carried out:

selective ductolobectomy – excision of part of the mammary gland with affected milk ducts;
desquamation of a benign neoplasm from its bed;
sectoral resection of the mammary gland - removal of a section of it;
mastectomy – complete removal of the mammary gland.

In the presence of oncopathology that provoked the development of ductal ectasia of the mammary gland, radiation therapy is indicated.

Prevention

The set of preventive measures to prevent the development of duct ectasia of the mammary gland is very wide, since ectasia can occur against the background of many diseases of the mammary gland. To reduce the risk of morbidity, important measures are:

Sometimes a woman notices that her nipple and areola of the mammary gland look unusual, and some fluid is discharged. The cause is often a condition called ductal ectasia (ductectasia). Its symptoms are quite characteristic, so it is not difficult to recognize it. Laboratory and instrumental diagnostics definitely needed. You may only need to adjust your hormonal levels, but sometimes more drastic treatment is required and cannot be delayed.

Milk secretion occurs in the alveoli of the mammary gland lobes. It is carried through ducts to the nipples. During lactation, the amount of milk secreted depends on the individual characteristics of the woman’s body.

Milk is produced in the breast not only after childbirth, but throughout reproductive period, however, in the absence of stimulation its amount is negligible. Therefore, before reaching the nipples, it dissolves.

If for some reason the patency of the duct deteriorates or the elasticity of the walls is impaired, then its pathological expansion occurs in some area. This condition in itself is not dangerous. If, after detecting symptoms and mammological examination, it is determined that the disorders are minor and are not associated with the formation of tumors, most often only periodic monitoring of the condition of the glands or drug elimination of the causes of the pathology is carried out.

Complications of ectasia may include:

the formation of cysts in the walls of the duct due to uneven stretching of the epithelium lining the milky duct from the inside;
dangerous accumulation of milk as a result of blocked passages, which can lead to infectious inflammation breast (mastitis);
a change in the state of glandular tissue, provoking the development of mastopathy.

Video: What is the danger of ectasia. Diagnosis and treatment

Causes of ectasia

The main factors contributing to the occurrence of this disease are changes in hormonal levels, leading to increased content prolactin, as well as diseases that result in a narrowing of the lumen of the milk passages.

More often similar condition occurs in women aged 40-45 years (beginning of menopause). It is at this age that estrogen levels decrease and prolactin levels in the blood increase. In this regard, milk production increases slightly, which causes the ducts to dilate. At the same time, tissue elasticity decreases due to age-related changes metabolism and reduction of collagen content. As a result, after the milky duct expands, the walls do not return to their original state.

Menopause and associated hormonal disorders create an increased risk of benign and malignant diseases of the mammary glands. Therefore, women of this age require special attention treat the slightest signs of trouble in their condition.

The occurrence of ductal ectasia of the mammary gland is also possible in younger women if they have ovarian diseases, thyroid gland or other organs endocrine system. In postmenopause, ectasia occurs due to involution (tissue aging, changes internal structure glands).

Another cause of ectasia is the formation of obstructions in the path of milk. Blockage of the ducts can occur in the following cases:

squeezing by tight underwear or squeezing the chest when uncomfortable position bodies;
damage to the ducts due to injuries or as a result of operations on the mammary glands;
inflammation in any part of the gland;
epithelial proliferation due to abnormal cell development (glandular mastopathy);
the formation of polyps on the walls of the milk duct;
the occurrence of intraductal papillomas (growths caused by the human papillomavirus);
compression of the ducts by benign or malignant tumors of the mammary glands.

Video: Signs, diagnosis and treatment of intraductal papillomas

Symptoms of ectasia

The first thing a woman notices is the change in the shape of the nipple. It becomes wider and flatter, and when the peripapillary area is compressed, the nipple is retracted. White or colored discharge appears, which may indicate inflammation or other pathology. Thus, spotting occurs in the presence of polyps and papillomas, which are easily injured even with light pressure on the chest. Greens and yellow discharge speak of the presence of a cyst or inflammatory process. Dark and red discharge - with breast carcinoma.

Swelling appears in the area of the nipple and areola. The skin in the area around the nipple becomes rougher. Red spots appear above the dilated ducts. A woman experiences a burning and itching sensation in the nipple area. There is pain in the chest.

Diagnosis of ectasia and its causes

After an external examination, the doctor, taking into account the patient’s age and existing symptoms, suggests the presence of ductectasia. To clarify the diagnosis and establish the causes of the pathology, examinations are carried out using various methods.

Mammography- This is an x-ray of the breast using weak radiation. Usually used after 40 years. This method can determine the presence and nature of changes in tissues, the shape of the ducts.

Ultrasound. This method is especially suitable for examining young women. It allows you to accurately determine the presence of compactions and the location of tumors.

Ductography– X-ray of the milky passages filled with a contrast agent. The picture gives a picture of their location and changes in shape.

Biopsy. Using a special needle, a tissue sample is taken from the area of the expanded milky duct. Typically, this method is used if there are suspicions about the nature of the tumors.

Histology analysis. Examination under a microscope of fluid released from the nipple. The smear determines the presence and type of neoplasms in the ducts of the mammary glands.

Blood analysis on the content of various hormones. Such an analysis is done if there are assumptions about hormonal disorders in a woman’s body, that they were the cause of changes in the milk ducts.

Video: When and how ductography is performed

Treatment

Pathologies discovered during the examination are eliminated mainly with the help of medications of various effects.

If a hormonal imbalance is detected, replacement drugs are used hormone therapy to reduce prolactin levels and suppress the production of excess estrogen. If the cause of ectasia is an inflammatory process, antibiotics and anti-inflammatory drugs are prescribed. To increase the body's resistance, vitamin preparations and immunomodulators are used.

Cysts of the milk ducts are usually not removed, but they are punctured and the contents are sucked out, followed by injection antiseptic solutions. If dilatation of large ducts is detected, the affected area is large, a tumor, polyps, papillomas or neoplasms are detected, the nature of which could not be accurately determined, then surgical method treatment (excision). Excision of damaged ducts and tissues is performed. After surgery, the excised material undergoes a histological examination, which allows us to say for sure whether the cause of ectasia was breast cancer.

Prevention of ectasia

Proper breast self-examination is of great importance. It is necessary to pay attention to the appearance of compacted areas, changes skin, shape of the breasts and nipples, the appearance of discharge. If there is the slightest sign of trouble, you need to go to the doctor. Mammological examination should also be carried out for preventive purposes, even in the absence of external signs pathology. Women aged 35 years and older should especially carefully monitor the condition of the mammary glands.

In order to maintain correct hormonal levels, you must avoid excessive use of hormonal drugs, monitor your weight, and treat on time endocrine diseases, inflammatory and infectious diseases genitals. It is necessary to protect the chest from bruises and compression.

It is especially important to monitor the condition of the glands during breastfeeding (to prevent cracked nipples and stagnation of milk in the breast).

Ectasia of the milk ducts is their pathological expansion. Diagnosed in women aged 40 years and older. With timely treatment there is no danger, but in some cases serious consequences cannot be ruled out.

The causes of the disease, according to experts, include:

Hormonal changes. Excessive production of prolactin leads to blockage of the milk ducts by epithelial cells. Failures are caused by contraceptives and certain medications.
Acute or chronic inflammatory process in the body also causes dilation of the milk ducts.
Surgery, chest injuries.
The presence of ductal papillomas and polyps. They are classified as benign neoplasms.
Malignant formations of the mammary glands.

Ectasia of the milk ducts is a progressive inflammation. Hormonal imbalance will negatively affect various systems of a woman’s body, as well as her overall well-being.

Symptoms

Typically, ectasia (ductectasia) of the mammary gland ducts has pronounced symptoms:

pain in the mammary glands;
burning and itching in the area around the nipple;
swelling of the nipples;
areola compaction.

The main symptom is fluid discharge from the nipples. They are yellowish or brown with bloody clots.

Breast duct ectasia can be cured successfully, but only with timely consultation with a specialist. A mammologist treats the disease.

Diagnostics

The breast examination is carried out in 3 stages:

Examination of the mammary glands by a mammologist, identifying symptoms and describing the medical history.
Examination under a microscope of fluid released from the nipples to determine the causes of their appearance.
Detection of the malignant nature of tumors, determination of the stage of dilation of the ducts.

The following diagnostic methods are used:

radiography;
mammography;
ductography;
immunohistochemical examination of a piece of tissue for suspected malignancy of the neoplasm.

If during the examination acute or chronic diseases are identified, conservative treatment and a complex aimed at strengthening the immune system will be prescribed.

Treatment

Breast ductectasia does not always require treatment.

Only in case of severe discomfort can the mammologist offer the patient:

Antibiotics. Drugs are prescribed to eliminate the source of infection that caused the disease. They are selected individually by the doctor (based on test results). Course - 2 weeks.
Painkillers. They are recommended by the attending physician, but you can get by with your usual medications.

It is contraindicated to use hormonal drugs to treat ductectasia on your own. May cause harm to health. Surgical treatment is indicated in case of unsuccessful drug therapy. The incision is made at the border of the nipple areola. If the case is complex, the nipple will be removed completely.

An operation to rid a woman’s gland of ectasia is excision. It has a certain number of contraindications. The surgeon must inform the patient and provide detailed consultation.

Concomitant diseases may be a contraindication to surgery. These include heart disease, the patient’s desire to have a child and provide breastfeeding.

The surgery is performed under general anesthesia. A woman should not have infectious diseases. Local anesthesia is used very rarely and only for mature women. An atraumatic suture is placed on the incision, so there is no trace left on the mammary gland.

There are 2 types of surgical treatment:

Excision of altered epithelial cells and areas of the milk ducts. The removed material must be immediately sent to the laboratory for histological examination in order to exclude an oncological tumor.
Complete removal of the milk ducts in case of malignancy.

Prevention

Gland duct ectasia does not require specific prevention.

Problems arising with the expansion of milk ducts can be prevented if:

reduce the risk of injury to the mammary glands;
control hormonal levels;
treat inflammatory processes in a timely manner, preventing them from entering the chronic stage;
strengthening the immune system through physical activity and vitamin complexes;
nipple and breast hygiene;
wearing underwear that does not injure or deform the breasts;
giving up bad habits, balanced menu, weight control;
annual visits to a mammologist;
Constant self-examination of the mammary glands for timely detection of lumps.

The list of recovery measures includes warm compresses applied to the chest area. Antibacterial drugs intended to relieve inflammation will also be prescribed to the patient.

Complications and prognosis

Duct ectasia is not a dangerous disease, complications are very rare. It’s just important not to miss endocrine and hormonal problems.

Video

You will learn the dangers of pain in the chest and discharge from the nipples from our video.

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grud.guru

N60.4 Mammary ductal ectasia

Mastitis is characterized by the following symptoms: fever; increase axillary lymph nodes; sharp pain in the chest; formation of suppuration. This disease can be eliminated conservatively only with initial stage. Without properly prescribed treatment, it can cause an abscess, which can only be gotten rid of surgically. Another disease of the mammary glands that occurs very often in women is mastopathy. This is a benign inflammatory change, usually developing as a result of hormonal disorders. Its signs are lumps in the chest, pain, and discharge from the nipples. Breast diseases Nodular mastopathy is considered more dangerous than diffuse mastopathy; it quite often requires surgical treatment. Mammologists advise being as attentive as possible to the prevention of hormonal disorders, especially if mastopathy has already been identified before. There is a hypothesis according to which oncological diseases mammary glands, as a rule, appear with mastopathy. A form of breast disease called a mammary cyst is also quite common. This disease also usually occurs due to hormonal imbalance, strong factor risk, in particular, is misuse oral contraceptives. As a result, fluid-filled cavities form in the chest. Treatment consists of removing fluid from the affected area using a special needle, but it does not exclude recurrence of the disease. It is not surprising that the most feared disease of the mammary glands is cancer. The situation is complicated by the fact that in the first stages the disease may either not manifest itself at all, or produce symptoms reminiscent of signs of the development of mastopathy. That is why, at the slightest suspicion of the presence of cancer cells, it is necessary to undergo additional research: blood test, mammography, ultrasound biopsy. This will help make a correct diagnosis.

symptomd.ru

Ductectasia (ectasia of the mammary glands)

Pathological dilation of the canals and ducts of the glands is called ductectasia or ectasia. The second name of the ducts is subareolar canals; they expand mainly due to age-related changes that are characteristic of women aged 40 to 45 years. With timely treatment, the disease is not life-threatening, but if the disease is ignored, it can lead to other, more serious consequences. serious pathologies. Ductectasia is treated by a mammologist; the method of treatment is purely individual, depending on the specifics of the individual patient and the characteristics of his body.

Causes

It is not always possible to accurately determine the root cause that caused ductectasia (ectasia) of the mammary gland ducts, but most often it is one of the following factors.

Hormonal changes in the female body, characterized by the production of excess sex hormone called prolactin. Excess prolactin leads to blockage of the ducts with foreign cells that should not be there normally.
Hormonal imbalance caused by hormones and certain other medications.
Inflammation causing pathological changes in the breast.
Changes in the shape and structure of the ducts at the stage of premenopause, menopause and postmenopause (which is considered normal).
Traumatic injuries glands.
Consequences of surgical interventions.
Papilloma or polyp in the duct. Both of these neoplasms are benign, but lead to pathological changes in the duct.
Oncological tumors of the gland.

Most of the above reasons are benign and do not threaten the patient’s life. But ductectasia (ectasia) of the mammary gland ducts always causes the doctor’s caution, since in a small percentage of cases it may indicate oncology.

Consequences of pathology and health hazards

Usually ectasia is considered as a disease that does not cause special harm body, but there are some nuances. The doctor understands that too dilated ducts indicate an inflammatory process, hormonal problems or tumors in the gland. All these processes cannot be left to chance - inflammation can progress, hormones affect all body systems and overall well-being, and the tumor sometimes turns out to be malignant (although this rarely happens).

Particular emphasis is placed on diagnosing the nature of the tumor. Timely detection of oncology contributes to effective treatment. The use of techniques such as mammography, ultrasound and biopsy significantly increases the chances early diagnosis oncological formations. The required scope of examinations is determined by the attending physician, based on the symptoms and results of the initial examination.

Symptoms

Ductectasia refers to diseases with obvious symptoms. The characteristic signs of the disease are following symptoms.

Pain and discomfort in the gland area.
Seals on palpation - halos.
The nipples itch and there is a burning sensation.
Swelling and redness of the nipple.
The nipple is inverted.
The nipple is displaced relative to its usual position.
A substance of unknown etymology released from the nipple.

Discharge is considered the main symptom of ectasia. The gland almost constantly secretes a small volume of milk, not only in nursing mothers, but also in other women. If a woman does not feed her baby, milk usually does not reach the nipple. With ductectasia, the discharge varies in color: from the usual white and yellow to the unpleasantly striking brown and bloody red. Especially bad sign are discharge mixed with blood - they may indicate a neoplasm (both benign and oncological).

Diagnostics

With ductectasia, the success of treatment largely depends on the speed of diagnosis. It is much easier to get rid of the disease in the early stages, so the need for prompt and accurate diagnosis is a top priority. When found the slightest symptoms The disease should not hope that everything will return to normal on its own, but immediately consult a mammologist.

The symptoms of ductectasia are in many ways similar to those of other glandular diseases. Therefore, it is important to differentiate ectasia from other diseases and find out why the dilation of the ducts occurred. The choice of treatment method depends on the answers received.

According to the doctor's decision, the diagnosis includes the following procedures.

Mammography - helps to evaluate the ducts, identify polyps, tumors, papillomas.
Ultrasonography glands (ultrasound) – clarifies the information available after mammography about the condition of the ducts.
A smear of nipple discharge shows the presence or absence of inflammation; based on the result, it can be assumed whether there is a tumor in the gland.
A blood test for prolactin or other hormones shows existing hormonal disorders in the body.
Biopsy is performed if formations of unknown etiology are found.
Ductography is an x-ray of ducts with the obligatory introduction of a contrast agent into the channels. This technique is a special, more accurate type of mammography.

Treatment of ductectasia

If diagnostic studies confirmed the initial diagnosis of ectasia of two or one mammary gland. If the pathology affects both breasts, then a diagnosis of bilateral ductectasia is made. The treatment regimen prescribed by the mammologist is aimed at eliminating the symptoms of the disease and the causes that led to the disease.

Most often prescribed for ectasia therapeutic treatment, depending on the reasons that caused ectasia. If inflammation of any form is detected during the diagnosis, the patient is prescribed special anti-inflammatory drugs. Additionally, the doctor prescribes complex medications that should strengthen the immune system.
In case of hormonal disorders, the disease is treated in such a way as to normalize the level of hormones in the body. The goal is achieved by taking hormonal medications. The choice and dose of medications is prescribed by a doctor, who will take into account the patient’s age, her state of health, and the presence of concomitant diseases. It is dangerous to prescribe hormonal drugs on your own; they are taken only after consultation with a doctor.
If therapeutic treatment does not bring the desired result, the disease is treated with surgical intervention. The operation is especially often used when polyps or large papillomas are detected in the ducts.

Modern medicine offers two methods of performing operations for ductectasia.

Only pathological areas of the canals are removed and cellular material. The material obtained during the operation is necessarily sent for histological examination to confirm or refute oncology.
Complete removal of the ducts - this technique is usually chosen if the patient’s tumor is confirmed to have a malignant nature.

Both types of operations are performed when general anesthesia. Today's surgical techniques so jewelry-like and precise that they practically leave no traces. For some patients, surgical treatment is contraindicated: usually due to heart disease or the desire to give birth to a child and feed him breast milk.

Only the attending specialist can make a decision about surgery or refuse it. In complex cases of oncology, the decision is made at a medical consultation. The results and outcomes of treatment depend on timely diagnosis, the causes of the disease. In the vast majority of cases, recovery is not difficult to achieve if the patient came to the doctor on time and the examination did not reveal cancer.

Prevention

To avoid problems that arise when expanding channels, you need to adhere to some preventive measures. Ductectasia (ectasia) of the mammary gland ducts is much easier to prevent than to treat. To avoid contracting this disease, it is advisable to adhere to the following recommendations.

Reduce the risk of breast injury by avoiding unnecessary surgical operations.
Control your hormonal levels, prolactin in the blood - this is especially important for women after forty, but young girls also need to monitor their hormones. Please note that some medications disrupt the balance of hormones in the body.
Treat inflammation promptly and correctly before it becomes chronic.
Strengthen your immune system through exercise and take vitamins as prescribed by your doctor.
Maintain hygiene and sanitation: wear comfortable underwear that does not compress the glands.
Eat right and control overweight, give up cigarettes and alcohol.
Come on in preventive examination see a gynecologist or mammologist annually.
After 40-45 years, do an annual mammogram of the glands to detect tumors and lumps in a timely manner.

If you have symptoms of dilated ducts or suspect any breast disease, make an unscheduled visit to the doctor for a full examination.

Forecast

It is impossible to predict in advance how ductectasia will end for each specific patient. Much depends on preventive measures, correctness and timeliness of diagnosis. When a patient monitors her own health and pays attention to discomfort and pain in the chest, she comes to the doctor on time. The mammologist will conduct an examination, make a diagnosis, and prescribe adequate treatment - in this case, we can confidently speak about a positive prognosis for the disease.

If the discharge is white or transparent, then adequate drug treatment will lead to complete recovery. When the discharge is yellow, green or brown, more detailed diagnostics and powerful medications will be needed. The success of the prognosis for unhealthy-colored discharge depends on the timeliness of help and competent medical intervention.

The most unfavorable prognosis is considered to be discharge with blood - they are called hemorrhagic. Similar symptoms are inherent in oncological tumors (but sometimes there are exceptions). The prognosis of treatment here depends on what stage of development the tumor is in, whether metastases are present and how widespread they are. Based on the diagnostic results, a decision is made on the possibility of surgery.

Breast consists of glandular cells, the natural function of which is to produce the substance necessary for the nutrition of small children. If milk is released outside the lactation period, then it is very unwise for a woman to dismiss this fact. It is even more dangerous to independently diagnose and receive treatment over the Internet. By visiting a doctor on time, you can quickly receive treatment at low financial cost. More importantly, such treatment will help preserve beautiful breasts. Sometimes a visit to a doctor can save a woman’s life (the rarity of such situations should not reassure the patient; it is better to be safe).

Today medicine can cure the most dangerous diseases, which was not the case just a few years ago. If there have been cases of cancer in a woman’s family, she should visit the doctor even more often so as not to miss the first stage of tumor development (predisposition to cancer is inherited). A visit to the doctor, faith in healing and the knowledge of qualified specialists guarantees a cure in unadvanced cases of the disease. Preventive measures V Everyday life significantly reduce the risk of getting sick. Love your body, take care of its condition, and it will serve you for many more years!

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Milk duct ectasia

Milk duct ectasia is a chronic inflammatory disease, affecting the subarolar or periductal (around the nipple or milk ducts) area of the breast. If left untreated, ectasia can eventually lead to obliteration of the breast ducts, but early stages On the contrary, the ducts are dilated (stretched). Dilated ducts often contain cholesterol crystals, calcifications, proteinaceous secretions, and polyps containing histiocytes. This is the result of an inflammatory reaction, which results in discharge from the nipple.

Plasma cell mastitis can cause nipple retraction.

Nipple discharge

With duct ectasia, sticky, multi-colored discharge from the nipples is often observed, sometimes resembling toothpaste. The affected area hurts, itches, and the nipple may swell. In the early stages, the disease is not dangerous.

If the affected tissue grows or there is blood in the nipple discharge, your doctor will likely suggest surgical removal. The nipple will most likely be removed during surgery. This is, of course, an unpleasant cosmetic result, but the disease will not go away on its own and refusal of treatment can lead to shortening of the main ducts of the mammary gland and its deformation.

Diagnostics

When screening for breast cancer on clinical examination, ductal ectasia may be found as a tubular mass (tube-like) under the nipple.

An X-ray will most likely not “see” the disease.
Ultrasound is used in addition to mammography and helps differentiate between benign and malignant lesions.
Ductography: Sometimes used as an adjunct to mammography in women who have given birth - a contrast agent is injected into the breast stream before the mammogram is performed.
Duct lavage (washing) and content cytology.
And if a puncture biopsy shows nothing, an excisional biopsy (removal of a pathological formation or organ) may be prescribed.

Treatment

Breast duct ectasia does not always require treatment. However, if uncomfortable symptoms progress, treatment options may include the following.

The role of the mammary ducts is very important, because they are responsible for lactation. But if these elements of the breast structure do not function correctly or change their structure, then such disorders can lead to unpleasant consequences.

To understand the importance of the functions of the mammary ducts, you need to understand anatomical structure breasts It is quite complex and can change almost throughout a woman’s life, as it strongly depends on hormonal levels. The mammary gland contains different tissues, namely connective, adipose and glandular (and their ratio depends on individual characteristics and may undergo some changes).

The mammary gland is divided into lobes, the total number of which can vary from 8-10 to 25-30. These structural elements, in turn, are divided into smaller lobules. Each lobule contains separate alveoli (about 40-80). A small duct leads from each alveoli, which then connects with others and forms larger elements. Thus, a whole branched complex network is formed, and its final parts are the largest ducts leading directly to the nipple (it contains approximately 5-8 small holes through which milk is released).

There are several types of mammary ducts, and they all differ in function and structure:

The first type is less developed and is typical for girls who have not gone through puberty. The structure of such elements includes no more than 8-10 milk ducts.
The second type is formed after puberty, and such lobules can contain up to 35-40 ducts.
The third type is formed during pregnancy from the second type, characterized by the number of ducts reaching 70-80.
The last type is the fourth, and these lobes are formed during lactation, and after its completion they regress again to the third type (the number of ducts can reach 100-120).

Dilation of the ducts: normal or pathological

If the milk duct of the breast is dilated, then in medicine this condition is called ectasia. First, it’s worth finding out how much the diameter of one structural element should be. Normally, it varies from 1.5-2 to 3 mm. But in some cases the figure may increase. Sometimes, if the milk ducts are dilated, this is a variant of the norm and is caused by natural processes occurring in the body physiological processes. But sometimes an increase (especially up to 5-8 mm or more) is regarded as a pathology, is provoked by certain disorders or diseases and requires medical attention.

Acceptable and normal ectasia may be due to the following reasons:

Hormonal changes observed in the second phase menstrual cycle. On at this stage female body begins to produce increased amount progesterone, thus, as if preparing for possible pregnancy. And this hormone triggers a number of processes, including the expansion of the milk ducts, but, as a rule, it is insignificant.
Pregnancy. In that important period progesterone continues to be produced by the woman’s body, and in increased volumes compared to the normal state. And due to the increased synthesis of this hormone, the ducts expand, preparing for the upcoming breastfeeding.
Lactation. At this stage, the ducts perform very important functions, namely, they ensure the transportation of milk produced in the gland to the holes located in the nipples. And if milk is synthesized in increased volumes or does not have time to leave the breast, this can provoke ectasia. Dilation is usually observed immediately during breastfeeding and some time after its completion, then the breast structure gradually becomes the same as it was before pregnancy.
Menopause or menopause. During these periods, hormonal changes are inevitable and irreversible, so dilation of the ducts often occurs in women over 45 years of age.

Pathological causes of dilation of the milk ducts:

The ducts can dilate due to mastopathy, in which there is often an increased synthesis of progesterone, which has a direct effect on the structure and diameter of the ducts.
An increase in diameter to 8 mm or more can be caused by neoplasms localized in the ducts. Usually they are benign in nature, and these include cysts, papillomas, and polyps. But there is such a disease as intraductal cancer, and with it ectasia also occurs.
Inflammatory processes affecting the milk ducts. Thus, expansion can develop with mastitis - inflammation of the glandular tissue.
Various chest injuries.
Previous operations on the mammary glands.

How to detect dilated ducts

An increase in the diameter of the ducts to 8 mm or more usually does not go unnoticed and makes itself felt.

Symptoms of lacteal duct ectasia may include the following:

tenderness, bloating or discomfort in the mammary glands
change in the shape of the nipples, for example, their enlargement or, on the contrary, retraction
burning and itching localized in the papillary area
discharge from nipples outside of lactation
Sometimes hyperemia and redness of the skin are observed (if there is an inflammatory process)

If you suspect dilation of the milk ducts, you should contact a mammologist who will prescribe an examination to determine the causes of ectasia. These may be recommended diagnostic procedures such as mammography, ductography (a study with the introduction of a contrast agent into the breast tissue), x-rays, blood tests for hormones, ultrasound, puncture (if neoplasms are suspected), microscopic examination of nipple discharge.

How to eliminate pathology

In some cases, the expansion is normal and reversible, and then only monitoring of the condition will be required, involving regular examinations by a mammologist. If the diameter is increased to 8 mm or more, and ectasia is caused by pathologies, then medical attention will be required.

Therapy, depending on the causes of the problem, may include the following:

Antibiotics may be recommended for tissue infections.
In case of hormonal imbalances, doctors often prescribe hormonal drugs, not only for oral administration, but also local ones, for example, creams or gels applied directly to the chest.
For neoplasms, surgery will be required, which may involve removal of the tumor or complete excision of the affected duct.

Dilatation of the mammary ducts can be either normal or pathological condition, but in any case you should consult a doctor to avoid unwanted consequences.