Parametrium is a common type of breast development border in women, it is often an underdeveloped tissue, mostly resembling a baby’s breast, or only a little skin pigmentation is seen, and there can be a little skin gain in the center that resembles a tiny nipple. Some have only mammary glands and some have only nipples, but there are also complete breast bodies (nipples, areolas, and glands) that are visible in the axillae and are larger. The parametrium is also painful and swollen before menstruation, and increases significantly during pregnancy, and even produces milk during breastfeeding. The incidence is 1% to 6%. They can occur in both men and women, more in women than in men (5U1), and are often hereditary. The parametrium can occur anywhere in the breast line between the upper and lower extremities, and is mostly located in the lower part of the breast and around the axilla, generally near the normal breast, but also in the face, neck, buttocks and other parts of the vulva of the groin.
Etiology and pathology
Parametrium is brought from the fetus. In the sixth week of embryonic life, when the embryo is only a little more than 1 cm, the ectodermal cells on both sides of the ventral surface of the trunk thicken to form ridges, which are equivalent to the curved line from the axilla to the groin.
Since people generally have only one or two children, they do not need many mammary glands, so only the pair of mammary primordia on the chest continue to develop and form nipple buds. By the third month of embryonic life, the mammary ducts are formed. The rest of the mammary primordia usually gradually regress after the ninth week of embryonic life. If the regression is incomplete, an extra breast is formed after birth, which is medically known as paramecium or polymecium.
In addition to being the result of incomplete regeneration, the formation of parametrial breasts can also be the result of external forces that deform the breasts. Wearing improper undergarments or tight clothing for a long time can cause pressure on the breasts. For example, tight tops that are sharpened or underwear that is too small and does not cover well can easily push out the flesh that belongs to the breasts, thus forming side breasts.
Classification
There are three types of side breasts.
1. There is breast tissue without nipple.
2. There are nipples but no breast tissue.
3. There are nipples and mammary tissue. Any parametrium with glandular tissue is affected by the same sex hormones as the normal breast.
They are subject to cyclical changes, premenstrual swelling and pain, and can also suffer from the same common diseases as the normal breast, such as hyperplasia, cysts, and parametrial adenocarcinoma
In congenital parametrium, the inside is hard to the touch, and some will have a small white dot, called a degenerative nipple. Acquired parametrium, pseudo-parametrium, is mostly caused by acquired obesity or improper dressing, for example, wrong way of dressing, wrong size of underwear, or often using strapless or half-cover underwear in pursuit of fashion, all these reasons may prevent the chest from concentrating, the underwear is too small or the straps of underwear are too tight, which will cause local fat in the outer chest or underarm in the long run.
Formation
Congenital human mammary glands originate from the ectoderm. During the second month of embryonic development, six to eight pairs of mammary gland primordia are formed on the ventral surface of the embryo, from the axilla to the groin. Normally, by the 9th week of embryonic development, all of them have degenerated and disappeared, except for the pair of mammary primordia in the anterior thoracic region between the 5th ribs, which are preserved and continue to develop. If one or more of the remaining pairs of mammary primordia do not disappear, they will develop into extra breasts or nipples after birth, which is called an epigynum (multiple breasts or nipples).
It is common for acquired women to have parametrium, and this is related to the choice of lingerie. Due to the wrong perception in the past, there is a preference for smaller size in the choice of lingerie, hoping to achieve the effect of squeezing out the cleavage. Because of the small size of the bra, the steel ring and cups are not enough to cover the breasts and squeeze for a long time, the breast fat around the breasts will be squeezed out and the mammary glands will develop towards the armpits which are not covered, and the side breasts will come out.
Most of the time, the formation of parametrium occurs during the teenage years of women. This stage of teenage girls is partly due to the development of breasts began to feel shy and want to hide, so try to choose underwear so that their breasts do not look obvious, accompanied by incorrect posture, hunchback and other situations. In addition, because women at this time are still young, a lot of knowledge comes from their mothers, and underwear is also chosen by their mothers, while I usually do not know the type of underwear, size is not suitable for themselves, and the formation of side breasts over time.
Asian breast shape itself is on the flared side, so it is important for women to educate their teenagers correctly and pay attention to protection from an early age.
Location
They are mostly located on the lower inner side of the normal breast, or above the normal breast near the armpit, while a few are found on the abdomen, groin, inner thighs, and occasionally on the cheeks, ears, neck, upper limbs, shoulders, buttocks, back, and vulva. Most of the parametrial breasts appear in pairs and are symmetrically distributed, and most patients have only one pair, but there are also single or more than one pair.
They are usually smaller than normal breasts, and there are three common conditions: the first is only nipples without breast tissue, which is often mistaken for warts or superfluous; the second is no nipples, but only breast tissue in the deeper layers of subcutaneous tissue; these two are medically known as incomplete parametrium. The third type is the nipple and breast tissue together, called complete parametrium, commonly found in the armpit, the volume is also larger.
Effects
The impact of parametrium on well-being varies depending on the species. Incomplete parametrium, especially those with only nipple and areola but no glandular tissue, has little impact on the body and has no risk of evolving into breast cancer. They are affected by female hormones, such as estrogen, progesterone and prolactin, and present swelling and pain during the menstrual cycle, pregnancy or breastfeeding, and a small amount of milk is secreted during breastfeeding.
A few of these breasts are connected to the normal breast by dark channels, which can drain the milk to the normal breast, while those that are not connected to the normal breast or do not have nipples can accumulate milk because they cannot be emptied and are prone to swelling and pain, inflammation and even pus. In addition, the normal breast may face diseases, such as mastitis, lobular hyperplasia, breast fibroids, breast cancer, etc., can also come to the head of the secondary breast, and the possibility of victimization than the normal breast is higher.
The worst thing is that the paramount breast is often clothed in various pretenses, leading the patient and even the doctor elsewhere, leading to misdiagnosis. If the inflammation of the parametrium is mistaken for lymph node inflammation, or the lobular hyperplasia of the parametrium is misdiagnosed as a lipoma, it is still common, because the first two are inflammatory and the treatment criteria are more or less the same, and anti-inflammatory drugs are used; the latter two are benign lesions that do not cause a life crisis.
If the cancer of the parametrium is recognized as a common inflammatory disease, it is a directional mistake that directly affects the life of the patient.
It is not a chronic disease, but it is not a minimal disease, so it is necessary to deal with it correctly. For those who are not menstruating, pregnant or breastfeeding, the possibility of breast cancer is very high. To deal with it once and for all
Clinical manifestations
1. Having breast tissue without nipple.
2.Having nipple without breast tissue.
3. nipple and breast tissue.
The parametrium is due to the incomplete development of the embryonic primordial mammary primordium. Parametrium can occur in the axillae, chest wall, abdomen, outer thighs, etc. However, they have also been reported in the face, neck, buttocks, etc. The paramammary gland with glandular body is made up of breast tissue, which is a sex organ affected by sex hormones. Part of it can have clinical symptoms such as swelling and pain, lumps, premenstrual pregnancy and lactation, and even lactation. Any factor that can cause breast cancer can cause the onset of parametrial tumor, which can also be benign or malignant. Parammary tumors can occur in any part of the parametrial area, such as the axilla and chest wall, but the axilla is the most common, and can also grow in the abdomen or perineum.
Parametrial diagnosis
1. a localized bulge or subcutaneous swelling near the axilla or around the normal breast.
2. soreness and swelling of the swelling, especially if it is obvious before menstruation
3. a tough tissue that can be pinched up with the fingers during palpation, is soft, has indistinct borders, and has a glandular lobe feeling within touch.
4. a fat-like lobulation visible under the taut skin after pinching with the fingers.
5, the lump has grayscale images of the breast on NIR scan.
The possibility of fibroids should be thought of if movable hard nodes are palpated in the above masses. If the above mentioned hard nodes or obvious hard masses are present in the parametrial masses, if they are fixed with skin or basal adhesions, or if there are orange peel-like skin changes on the surface, the possibility of cancer should be considered. Parametrial breast should be differentiated from lipoma and sebaceous cyst, etc. When differentiated from lipoma, it is easier to differentiate because of the high penetration of near-infrared light to fat. Sebaceous cysts are well-defined and mostly round. Near-infrared scans also show images of different shades of gray, but the images disappear when the skin is pinched.
Methods of elimination
”According to the estimation, one in four women on average has a parametrial breast, so the chance is so high that you should check your armpit to see if you have this unwanted guest.
Sports massage
You can expand the chest exercise, thin arm exercise, the use of pectoralis major muscle and arm muscle group contraction, driven to improve the situation of parametrium. Every morning and evening, you can massage the parametrium, hands naturally hanging down, you can see the concave and convex part between the armpit and the chest. Inner concave part: repeatedly and softly knead with appropriate strength of middle finger and thumb, 30 times each on the left and right. Protruding part: Make a fist with your hand and push the protruding side breast from outside to inside with the force of your knuckles, 30 strokes each on the left and right. (Note: the right breast with the left hand action, and vice versa, the left breast with the right hand action)
Mechanical repetitive massage
Western use of mechanical suction and release massage apparatus, the use of negative pressure will be sucked into the cups of the breast breast, converted into positive pressure and then push out the breast, the secondary breast in the breast cups for shaping, breast in repeated suction and release into the cups, will gradually become the cups of the round shape, fatty secondary breast continued to operate repeated mechanical massage after a month will have shaping effect, if there are nipples of the secondary breast, you must be diagnosed by a physician, for surgery Treatment.
Liposuction
If the raised tissues of the parametrium are too large, or if they rub against the skin frequently, causing recurrent eczema or inconvenience in life, removal can be considered.
There are two ways to remove the parametrial breast. If the pseudo-parametrial breast is formed by improper dressing or simple fat hoarding, liposuction can be used to remove it with a wound of about 0.5 cm; if there is breast tissue inside the parametrial breast and the parametrial breast needs to be removed, the excision surgery is chosen.
Surgical treatment
1.Usually performed under continuous epidural or intravenous anesthesia, only a few are performed under local anesthesia. Local anesthesia is not conducive to freeing the flap with the electric knife, nor is it conducive to distinguishing between fat and parametrial glandular tissue.
2. The selection of incision will take into account the aesthetics and concealment.
3.Side breast has no envelope, so the flap should be free to the edge of the lump and the resection area should be sufficient to ensure the surgical treatment effect.
4.For the treatment of parametrial cancer, the excision range should be at least 5cm from the edge of the lump, and the muscle tissue should be removed at the same time, and the axillary lymph nodes on the same side should be cleared.
5.Rubber drainage tube and negative pressure absorption are placed on the trauma surface to facilitate the growth of skin flap, and the drainage tube is removed after 72 hours according to the drainage flow. If the tube is removed too early, subcutaneous fluid and blood accumulation will occur.
These are not rigid, because the surgeons who perform the parasthesia surgery are clinically experienced experts, and they have their own set of steps on how to do the parasthesia surgery, and they are constantly improving to help patients solve their problems in the best way possible. So the actual parasthesia surgery procedure needs to be seen in conjunction with the specific doctor and hospital.
How you will feel after the surgery
Para-mastectomy surgery is not complicated and can usually be done under partial anesthesia. The incision can be designed in the front of the armpit, after the skin incision to separate the subcutaneous tissue, remove all the mammary tissue of the parametrial breast, as if the nipple areola exists, should also be removed together, after the parametrial mastectomy surgery need to be pressure bandaged seven days after the removal of stitches. There will be no great impact on the daily work.
There are obvious painful conditions; painful conditions affect the patient’s life. Surgery should be performed for those with parametrial fibroids or nipple overflow. Parametrial breast as a multiple breast deformity, affecting the appearance. For larger anterior axillary parametrium that affects aesthetics and dressing, patients who have urgent requests for surgery can undergo surgery. If there are obvious hard nodules inside the breast; if there are fibroids of the parametrium, nipple overflow, obvious swelling and pain of the lump, or if there is a certain possibility of malignant change; if the lump has increased significantly recently, surgery can be considered. If the diagnosis is unclear and other tumors cannot be excluded.