Mammary gland hyperplasia refers to the proliferation of epithelial and fibrous tissue in the breast, structural degenerative lesions of the ducts and lobules of the breast tissue and the growth of progressive connective tissue. It is the most common breast disease in women and should be prevented in advance.
I. Etiology
1, mental tension, emotional excitement and other adverse mental factors, may make the original should be recovered mammary hyperplasia tissue is not recovered or incomplete recovery, over time, the formation of mammary hyperplasia, and these adverse mental stimulation will aggravate the existing symptoms of mammary hyperplasia.
2, multiple abortions are prone to mastopexy.
3, endocrine factors. Most scholars believe that it is related to the endocrine imbalance of the ovaries. The absolute or relative increase of estrogen and the absolute or relative decrease of progesterone cause disorders of the breast structure.
4.Essential fatty acids. Women with mastalgia have abnormal fatty acids and low plasma essential fatty acid levels.
5, long-term use of estrogen-containing health products, birth control pills, may also trigger breast enlargement.
6, lifestyle habits such as high fat, high protein diet, may also play a part.
Second, classification
There are many types of mammary hyperplasia, some of which are completely physiological and can subside on their own without special treatment, such as simple mammary hyperplasia, while others are pathological and require active treatment, especially the cystic hyperplasia type, which cannot be taken lightly because of the possibility of cancer.
1.Breast pain syndrome
It is also known as simple breast hyperplasia. It is most common in teenage girls and young patients, and its cause is due to the high secretion and fluctuation of gonadal hormones. It is characterized by obvious periodic breast swelling and pain, and the pain disappears on its own after menstruation. The pain is mainly localized to the breast, but sometimes it can radiate to the ipsilateral axilla and chest wall. This type of hyperplasia is a normal physiological phenomenon, and patients should not be overly anxious and anxious in the first place, as long as they adjust their emotions and maintain a balance, generally elevated endocrine hormones can slowly be corrected, and various symptoms can disappear on their own.
2.Mammary gland adenopathy
The basis of this type of lesion is the expansion of both breast lobules and ducts and hyperplasia of periglandular tissues in the breast, mostly occurring between 30 and 45 years old, with serious symptoms and belonging to stage II of breast hyperplasia. It is easy to attract attention, often difficult to cure, and prolonged treatment causes mental depression, leading to aggravation of symptoms. Seriously lead to endocrine disorders, such as menstrual disorders, insomnia and dreaminess, dull complexion and other series of reactions.
3.Cystic hyperplasia
It takes the proliferation of epithelial cells in the milk ducts as the main lesion, and the lumps appearing in the breast are mostly diffuse thickening, with some patients showing limited performance and mostly oval-shaped sacs, which are easily confused with fibers. They mostly occur at the age of 40 to 55 and require active treatment and regular checkups. Stage III breast enlargement often brings mental depression and fear to patients. Such enlargement may develop into cancer, which often causes worry and panic among patients.
Third, the optimal means of examination.
The imaging examination for patients with mastocytosis is recommended: ① color ultrasonography is preferred because of the abundance of glands in this disease and the fact that most patients are less than 40 years old. The resolution of ultrasonography for nodules and cystic and solid masses in dense glands is much better than that of mammography. For older patients who are not rich in glands, mammography should be preferred, and if necessary, a combination of both is feasible. In some cases, it is not easy to distinguish the mass or nodule from fibroadenoma and breast cancer, so it is necessary to combine with necessary pathological histological examination (hollow-core needle aspiration biopsy, fine needle aspiration cytology or surgical biopsy) to confirm the diagnosis.
The relationship between mastocytosis and breast cancer
In 1997, the Chinese Society of Pathology classified breast hyperplasia into cyst-based type, adenopathy-based type, fibroadenoma-based type, intraductal papillomatosis-based type and atypical hyperplasia, and the first four types are collectively called general hyperplasia, while ductal atypical hyperplasia is common and lobular atypical hyperplasia is rare. Non-proliferative lesions include cysts, papillary apocrine changes, epithelial-related calcifications, and mild hyperplasia of the general type. 70% of biopsies are non-proliferative lesions, and the risk of secondary breast cancer does not increase compared to women who do not have a breast biopsy, and only atypical hyperplasia is a precancerous breast lesion.
V. Breast enlargement is not a disease and breast cancer is a major disease
Most of the breast enlargement is not a disease, but a normal physiological condition, mostly seen in women of childbearing age, when they are preparing for breastfeeding and due to changes in hormone levels. In fact, menstruation, development, pregnancy, degeneration, menopause and menopause can cause fluctuations in endocrine levels and structural and functional disorders of the thyroid and breast in a woman’s life, and mammary gland hyperplasia is one of the common triggering results. Breast cancer, on the other hand, is one of the common malignant tumors in women and is extremely threatening. In conclusion, breast hyperplasia cannot be collectively referred to as precancerous lesions. The risk of breast cancer does not increase significantly in most cases of breast hyperplasia, and the risk of breast cancer in patients with breast pain is not different from that of normal people.
Some common misconceptions about the treatment of mastocytosis
The diagnosis and treatment of mastocytosis are still very irregular, and there are many misconceptions. Commonly, (1) the diagnosis of mastocytosis is made only by history taking and physical examination, without imaging. This phenomenon occurs most often among non-breast specialists in primary care hospitals and is the most common reason for missing early breast cancer diagnosis. (2) Mammography is routinely performed on all patients regardless of their age. This is mainly due to the lack of understanding of the advantages and disadvantages of breast ultrasound and mammography. (3) Common wrong treatments for breast hyperplasia include anti-inflammatory treatment (application of antibiotics), local injection of drugs, external application of Chinese herbs, massage, physiotherapy, etc.. These treatments are basically ineffective or even harmful, especially before the diagnosis of breast cancer is ruled out. (4) Exaggerating the risk of malignant transformation of breast hyperplasia increases the psychological burden of patients. (5) Minimally invasive surgery or excisional examinations are routinely performed for changes such as /nodules0 found during imaging examinations of breast hyperplasia (breast ultrasonography and mammography). This is a huge waste of medical resources. According to the American Society of Imaging’s breast imaging grading criteria, those with Ò grade imaging are benign and most do not require active management (need to be observed), while those with Ó grade imaging need to be followed up and reviewed by imaging in six months.