Parametrium is a common type of breast development borders in women, it is often an underdeveloped tissue, mostly like a baby’s breast, or only a little skin pigmentation is seen, and there can be a little skin gain back in the center, similar to 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 armpits and are larger.
Before menstruation, the parametrium is also swollen and painful, and it is obviously enlarged when expecting, and there are nipples and even secretion of milk during the prolapse. 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. They are mostly located on the lower inner side of the normal breast, or above the normal breast near the armpit, and a few are found on the abdomen, groin, inner thighs, and occasionally on the cheeks, ears, neck, upper limbs, shoulders, buttocks, back, vulva, etc. They are easily mistaken for subcutaneous nodes, lymph nodes or tumors.
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 of parametrial breasts in the axilla.
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, if you wear tight fitting tops or undergarments that are too small and do not cover your breasts well, they can easily push out the flesh that belongs to your breasts, thus forming a side breast.
Overview
There are three types of side breasts.
(1) There is breast tissue without nipples.
(2) Nipple without breast tissue.
(3) With nipple and breast tissue. All parametrial breasts with glandular tissue are affected by the same sex hormones as normal breasts, with cyclical changes, premenstrual swelling and pain, and the same common diseases as normal breasts, such as breast hyperplasia, breast cysts, and parametrial adenocarcinoma.
Congenital Parametrial Breast
The human mammary gland originates 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 inguinal “breast line”. Under normal circumstances, by the 9th week of development, the embryo has 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 pairs of the remaining mammary gland primordia do not disappear, they will develop into extra breasts or nipples after birth, and this is called an appendage (multiple breasts or multiple nipples).
They are hard to the touch inside and some will have a small white dot, called a degenerative nipple.
Acquired Parametrium
It is very common for women to have parastomastia, mostly caused by acquired obesity, or improper clothing. Due to the wrong perception in the past, they prefer to choose a smaller size in their underwear, hoping to achieve the effect of squeezing out the cleavage. As a result of the small bra, the steel ring and cups are not enough to cover the breasts and squeeze them 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.
Effects
Incomplete breasts, especially those with nipples and areolas but no glandular tissue, do not affect the body much and do not have the 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 pretensions, 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. If you have an intact parametrium or an incomplete parametrium with glandular tissue, it is better to remove it as soon as possible to eliminate the hidden danger, especially those who are secretly “expanding their power” and presenting swelling and pain even during non-menstrual period, pregnancy or breastfeeding, the possibility of evolving into breast cancer is very high, so you should seek medical attention in time and use a scalpel to deal with it once and for all. It should be treated once and for all with the help of a scalpel.
Para-breast diagnosis
1.A localized bulge or subcutaneous swelling near the armpit or around the normal breast;
2.Soreness and swelling of the swelling, especially if it is obvious before menstruation;
3.Tender tissue that can be pinched up with fingers during palpation, with soft texture and unclear borders, and a sense of glandular lobe within touch;
4.After pinching up with fingers, a fat-like lobulated mass can be seen under the taut skin;
5, the lump has grayscale images of the breast on NIR scan.
The above mentioned masses should be thought of as fibroids if there are movable hard nodes. If there are hard nodes or hard masses in the parametrial lump, if they are adherent to the skin or the base, 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, which are easier to differentiate from lipoma because of the high penetrating power of near-infrared light on fat. Sebaceous cysts have clear borders and are mostly round in shape, and images of different shades of gray can be seen on NIR scans, but they disappear when the skin is pinched.
Treatment
”It is estimated that one out of every four women has a parametrial breast, so the chance is so high that you should check your armpit to see if you have an 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. The protruding part: Use your hand to make a fist to 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 equipment, the use of negative pressure will be sucked into the cups, converted into positive pressure and then push out the breast, the side breast in the breast cups for shaping, the breast in repeated suction and release into the cups, will gradually become the cups of the round shape, fatty side breast continued to operate repeated mechanical massage after a month will have shaping effect, if there are nipples of the side 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 surgery can be designed in the front of the armpit, after the skin incision to separate the subcutaneous tissue; remove all the breast tissue of the parametrium, as if there is a nipple areola, should also be removed together, after the parametrium surgery need pressure bandage 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. The parametrial breast is a multiple breast deformity that affects the appearance; for larger anterior axillary parametrial breast that affects the aesthetics and dressing, the patient can undergo surgery if he or she has an urgent request for surgery. If there are obvious hard nodes inside the breast, if there are fibroids of the parametrium, nipple overflow, obvious swelling and pain of the lump, 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.