The breast is an organ that changes from birth to the end of life. During the birth, she has grown a little thanks to the estrogen hormone from the mother. Then, during puberty, with the eggs (ovaries) starting to work, estrogen and progesterone hormones are secreted and the breast begins to grow. With premenstrual edema, it becomes tense, sore and tender. Sometimes these complaints may be too much (premenstrual syndrome) and treatment may be required. During and after pregnancy, the breast continues to grow, prepares for lactation, produces milk and helps the baby to be fed. It shrinks again after breastfeeding. After the menopause (menstruation cessation), the breast shrinks, sags, and the breast tissue begins to be replaced by adipose tissue.
What are the Common Breast Changes and Benign Breast Diseases?
The symbol of motherhood and femininity. The breast is under the influence of a total of 7 hormones. Among these, the hormones that affect the breast the most are; estrogen and progesterone hormones. Stress, extreme fatigue, changes in nutrition, climate and environment cause differences in the levels of these hormones in the blood and thus changes in the breast. Meanwhile, edema, fluid accumulation and cell differentiation occur in the milk-producing and milk-carrying structures of the breast.
What are Fibrocystic Changes and Cysts of the Breast?
Changes in blood levels of hormones affecting the breast cause fibrocystic structures in the breast. These occur in almost every woman at some point in her life. It may present with swelling, edema, soreness and a mass whose borders are not completely clear, and it is more common in women between 30-50 years of age. The best method of recognizing these cysts is ultrasonography. There may be cysts (microcysts) that are difficult to detect on ultrasonography, and macrocysts that can be easily identified. Macrocysts of the breast are usually benign formations filled with gray-green fluid. They may be in one or both breasts. They mostly disappear after menopause. Cysts are often felt as a tender mass with indistinct borders during monthly breast self-exams that women should do after the age of 20. Rarely, it may be limited. The presence of these masses reduces the risk of breast cancer in women. they cause fear. Simple breast cysts do not require drainage or surgical treatment. Women should be followed at regular intervals.
What are the Symptoms of a Breast Cyst?
- A palpable mass, usually with indistinct borders, rarely smooth-sided, slippery, round or oval,
- Very rarely, gray-green discharge from the nipple and when squeezing the nipple · Painting, pain and or tenderness in the area where the mass is located,
- Mass size enlargement or breast tenderness, especially before menstruation
- menstruation There may be a reduction in the size of the mass and a decrease in breast tenderness after the period.
After the physical examination of the breast by the doctor, ultrasonographic examination guides the diagnosis. Enlargement into the cyst can be seen very rarely (intra-cystic papilloma) and ultrasound-guided biopsy is required. Evacuation of simple cysts is unnecessary. Some herbal remedies are helpful in women with severe complaints.
Is Fibrocystic Breast Change a Disease?
- Fibrocystic breast change is not a disease and has nothing to do with cancer. It is more common in women with menstrual irregularity, overexertion, stress, obesity, smoking and anti-depressant use, and in women who are in the period of transition to menopause (peri-menopause). Swelling, pain, tenderness, and a palpable mass in the breast are among the most common symptoms. may be requested. The aim is to reveal whether there is cancer in the breast in addition to fibrocystic breast change. Women can be followed up with ultrasonography every 6 months.
What is Fibroadenoma?
It is the most common benign tumor of the breast. It is usually seen in women between the ages of 15-35, and it can rarely occur in older ages. Palpable fibroadenomas are well-circumscribed, round or oval in shape, easy to move. able masses. The ones that are not palpable are also noticed on ultrasonography in a similar way. They can occur in both breasts. Although the cause of its occurrence is unknown, it is thought to be related to reproductive hormones. Fibroadenomas are checked every 6 months by ultrasonography, biopsy and removal are recommended for those with a diameter of more than 3 cm, rapidly growing and deforming. They are unlikely to develop into cancer, but very rarely, breast cancer may develop within fibroadenomas.
What is Ductal Ectasia?
- Expansion of the milk ducts located behind the nipple, obstruction of the duct with fluid Sometimes, a white appearance and a light-colored liquid appear on the nipple. It is usually seen in women between the ages of 45-55.
- While it may not show any symptoms on physical examination, it may be felt as a hard mass under the nipple.
- The exact cause of its formation is unknown. However, it is thought that changing breast tissue as we age and smoking may be the cause.
- Mostly, no treatment is required. In cases where infection is added (mastitis), antibiotic and cold compress application may be required. If the complaints persist, the resulting mass is surgically removed.
What is Fat Necrosis?
- Even though it is not cancer, in terms of signs and symptoms It is a breast change that is very similar to breast cancer.
- Symptoms include a mass in the breast and bruising around it, tenderness in the mass, collapse and shrinkage in the skin or nipple. related traumas or infections.
- Sometimes, biopsy is required to distinguish it from breast cancer.
What is a hamartoma?
- It is a benign breast tumor that occurs as a result of excessive growth and proliferation of cells in the breast tissue. The average age of onset is 45. It is rarely seen in young women. They can be soft or hard.
- Mammography, ultrasonography and biopsy should be performed for diagnosis. If they overgrow and cause pain, they are surgically removed.
What is Intraductal Papilloma (IDP)?
- They are small and benign tumors that develop in the ducts that carry milk in the breast. It is most commonly seen in middle-aged (35-55 years) women.
- They may cause light-colored or bloody discharge from the nipple and a palpable mass when enlarged.
- Physical examination, ultrasonography and mammography can be diagnosed with Papillomas, which are only one, are less likely to turn into cancer, and when they are in large numbers, the possibility of transforming into cancer increases.
- Surgical method is used to remove papillomas with surrounding healthy tissues. Cancer risk is determined by biopsy, additional treatment is applied if there is evidence of cancer.
What is a Lipoma?
- They are slow-growing, soft and mobile benign tumors that develop from fat tissues in the body, are located just under the skin or in the breast. These glands can occur in any body region containing adipose tissue. It is generally detected in obese women between the ages of 40-60.
- They may rarely be painful and grow rapidly.
- They do not need to be removed unless they cause any complaints. If necessary, the treatment is done by surgical method.
What are Infections in the Breast (Mastitis)?
Infections such as mastitis, cellulitis or abscess are frequently seen in the breast. These ailments in the breast can sometimes be confused with skin diseases and cancer. It is most common in women between the ages of 18-50.
Mastitis seen in lactating women (postpartum mastitis-puerperal mastitis): Bacteria that enter through the cracks in the nipple due to the sucking of the baby easily cause infection and abscess in the breast in postpartum breastfeeding women. They can be (contraceptive mastitis-puerperal mastitis). Breast redness, severe pain, fever, chills and weakness are seen. It is treated with antibiotics and cold compresses. It causes widespread abscess in the breast in some patients and may need to be drained surgically in the operating room environment. Factors such as clogged milk ducts, cracked nipples, wrong breastfeeding techniques, poor nutrition, and clothes that put pressure on the breast are among the causes of puerperal mastitis. And It is a difficult condition to treat. Physical examination and radiological findings mimic breast cancer. Therefore, a biopsy is required. Treatment includes cortisone, evacuation of the abscess, and surgical cleaning. It is frequently seen in women between the ages of 30-45.
Post-areolar mastitis (Sub-areolar mastitis): Symptoms include redness, pain, redness, tenderness, stiffness and fever behind or around the nipple. It occurs mostly in smokers and women between 30-45 years old. Its treatment includes antibiotics and surgical drainage, surgical removal of inflamed tissues.
Is Nipple Discharge Always Dangerous?
If nipple discharge occurs spontaneously, not when squeezed by hand, only If it comes from a breast and a duct, is white or bloody then this discharge should be considered significant. This symptom occurs as a result of a tumor in the breast ducts (intra-ductal papilloma) or a cancer that develops from the mammary ducts. In the presence of serous-bloody discharge from the nipple, diagnosis should be made by ultrasonography, mammography and, if necessary, biopsy.
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