The syphilis of the mammary glands is an infectious, specific, rarely occurring venereal disease, which belong to a group of sexually transmitted diseases. The disease flows for a long time and affects the body systemically. Syphilis is caused by pale spirochete (trepal), it is manifested by three stages of the damage to the mammary glands. Through the slightest microcrain on the cover of the breast, the pathogen with ease penetrates, multiplies and diverges throughout the body. At any stage of the disease, the patient is contagious, especially if there are skin manifestations. Men this kind of syphilis are not infected.
Causes of the syphilis of the breast
The main method of infection with the syphilis of the breast is sexual contact with infected, you can also get infected by the child infected with sifilis with breastfeeding. Nuting someone else's unsembed clothing or using personal hygiene objects, a woman increases the risk of infection several times. After all, the pale spirochete in a wet warm environment remains viable for another 4 days, even if it is outside the human body, therefore, when skin damaged on the breast, the probability of infection is high enough.
Symptoms of the syphilis of the breast
At each stage of development for syphilis, different manifestations are characterized. In the incubation period lasting about a month, the disease behaves hidden. At the primary stage in the place where the introduction of a microorganism, it is usually a nipple-anorelar complex, and redness appears, then the formation of a solid chancre in the form of ulcerative erosion. This is considered a clinical symptom of the first stage of syphilis. Shankre has a rounded clearly defined form, brilliant red-blue bottom and painless dense infiltrate. Its sizes can vary from 2mm to 5 cm, ulcerations can be as much as it was a wound at the breast. We gradually increase lymphatic nodes, especially approximate to the infection spot. Although they are enlarged, but painless, ulcers are healing without treatment, the disease subsides, but does not pass.
At the second stage of syphilis, the symptoms of colds or influenza appear from 2 to 5 years: the head is often hurting, indisposition, elevated body temperature, patients are lost in weight, the appetite worsens.
For this stage, cyclic pink polymorphic rashes (Papulas, Roseolas, Pustules) on the chest and throughout the body, skin modifications, scaly spots or ulceration, can fall out throughout the body. The nervous system and internal organs are affected. At this stage, injuries of the epidermis are greatly contagious.
A few years after the start of the disease, the third, little contagious stage of syphilis comes, during which disfiguring, the damage to the spine and brain, may be followed by severe mental illness, paralysis, complete blindness, multiple organ failure. Milk iron itself in the tertiary stage is affected in a gummamine form or resembling chronic mastitis, as diffuse infiltration of the gland. Gumma usually appears near the nipple of the breast and is felt like a dense low-skinned knot, size from walnut. If purulent melting of the gum is happening, it breaks through and the formation of painless syphilitic ulcers, which resembles a lesion with tuberculosis or breast cancer. The tertiary stage of the syphilis of the breast occurs, if not treated for several years after infection, it is the most severe and irreversible stage, leads the patient before disfiguring and disability.
Diagnosis of breast syphilis
To form an accurate diagnosis, an inspection of mammologist and venereologist is needed, collection of anamnesis and results of laboratory research. First of all, serological study of the presence of syphilis in the blood is carried out. If the breast's skin is lesions in the form of erosion ulcers, jerseys, bubbles, carry out a microscopic study of specific elements to identify the pathogen and exclude tuberculosis or an actinomycosis of the chest. Mazz-imprint and biopsy from the edge of ulcers give a cytological and histological conclusion to eliminate breast cancer. Research with ultrasound, MRI and mammography will be nonspecified during breast syphilis.
Treatment of breast syphilis
Modern medicine successfully treats syphilis, including in the breast. But the main thing is to turn to the doctor in time, since the launched stage of the disease will not allow the woman to be completely healthy, since the processes of defeat are irreversible. In addition to the reception of the prescribed drugs, the woman will have to listen to the recommendations of the doctor: to conduct a certain lifestyle, for a while, exclude sexual contacts, drinking alcohol, baby breastfeeding. It is necessary to conduct a survey of sexual partners and family members. A woman is considered completely recovered if for five years after treatment, tests for the presence of Treponama causative agent in the body were negative.
The syphilis of the mammary glands is a healing disease, but the length of therapy depends on the stage. Comprehensive treatment is carried out by a course, the destination of the dermatovenerologist is strictly individual, the control of the doctor and clinical and serological analyzes are mandatory until complete recovery. Antibiotics of a penicillin group, erythromycin, tetracyclines, cephalosporins are prescribed for the treatment of breast syphilis, erythromycin, tetracycles, cephalosporins. In addition, anti-silicite drugs with iodine and bismuth, biogenic stimulants, immunomodulators are used.
Prevention and forecast for the syphilis of the breast
With a prophylactic goal, you cannot use joint bath accessories, use someone else's clothes, without having wrapped it before, not allow random sexual bonds. If there is a need for a breastfeeding of someone else's child, it is better not to breastfeed, and to see the milk needed for feeding, in a bottle. In the event that the mother itself is treated, whether it is possible to feed the baby with breasts - this question is considered very relevant. Usually a child is isolated from the mother before confirming the baby's baby. However, it is not worth doing this, as Treplemama has already been passed to the child through placental blood flow, it means that he has already infected from the mother and needs treatment. Therefore, it should not be deprived of its additional immunity, which the baby gets through the mother's milk.
After contacting with sifilis, preventive treatment and treatment with bactericidal means of sections of possible infection, including the breast.
The prediction of the treatment of breast syphilis will be favorable under the condition of timely and proper treatment. Within 5 years after the treatment, patients consist of dispensary accounting, regularly undergo serological diagnostics and are considered to be cured, if there are no signs of the disease for a long time.
In medical practice, such a disease is very rarely encountered as a mammary syphilis. However, all the same individual cases with this disease are recorded.
Syphilis Breast is extremely dangerous disease. Since the developing inflammatory process in the mammary gland can go to other organs and vital systems of the body.
The discovery of the syphilis of the mammary glands is carrying a woman to reduce the quality of life in the absence of proper treatment. In addition, syphilis can become a deadly disease if therapeutic measures will not be held in a timely manner.
The syphilis of the breast is an infectious disease, whose causative agent is a pale treponem. If you get into the chest, this infectious pathogen multiplies very quickly. At the same time, the patient's states are worse rapidly.
Ways of infection with syphilis
Syphilis of the thoracic glands can significantly leak in a hidden form.
That is, syphilis infections proceed without pronounced symptoms. The danger of this disease is that it is diagnosed already in the later, launched stages.
The causative agent of syphilis can be amazed first one milk gland, and then go to another. Therefore, both one-sided and double-sided (cover both mammary glands).
Syphilis is considered a very dangerous disease as, on absolutely at all stages it is contagious. The greatest danger to the people surrounding the patient, syphilis bears when it is on the skin.
Men are not subject to syphilis of the thoracic glands, but Pale Treponama may affect them with other organs. The syphilis causative germet has a systematic impact on the body as a whole, so it is impossible to think that if the male floor is not subject to syphilis of the mammary glands, then the Treplema does not carry any danger to them.
Syphilis can be transmitted as basic ways. It:
- Gender transmission
- From mother to child at birth
- Infection
Pale Treplema has the ability to survive outside the human body around the 4th day.
Like other viral diseases, syphilis has a high degree of contagious. Therefore, healthy people need to be avoided personal contacts with an infected patient.
Each person must beware of direct and indirect paths of infection with syphilis. Cure from this disease is very hard. In addition, absolutely all patients with syphilis can not lead a full life. Their quality of life is significantly limited and worsening.
What symptoms has syphilis of the chest glands
As already noted on the initial incubation period, the presence of treponam in dairy glands is not accompanied by any external manifestations. The incubation period can last from one to several months.
- a specific infectious disease caused by pale spirochete, manifested by primary, secondary and / or tertiary damage to the chest glands. Symptoms of the syphilis of the breast depend on the period of the disease and may include a variety of skin manifestations (syphilides), specific lymphadenitis, violation of the general condition, damage internal organs. The diagnosis is confirmed by the results of serological reactions and cytological studies of smears from the edges of ulcers. The main in the treatment of breast syphilis is adequate antibacterial therapy.
The syphilis of the breast is rarely encountered specific inflammatory disease with a long flow and systemic lesion of the body. The causative agent of syphilis - pale spirochete (treponema) easily penetrates through the existing insignificant damage to the skin of the breast, is multiplied and spread throughout the body. The patient with syphilis is infectious in any period of the disease, especially if there are skin manifestations. The syphilis of the breast, as well as other diseases, the diagnosis and treatment of which Mammology is engaged in mainly female patients.
Causes of the syphilis of the breast
Syphilis of the breast can be infected with a patient with direct contacts (from a sexual partner, when feeding a sick child), a domestic path (through wet hygiene objects: wash, towel; clothes).
In the wet discharge of the patient, the pale spirochete can maintain viability up to 4 days and in the presence of microtrams, small wounds, cracks on the skin of the breast (especially in the packer and the range) the probability of infection with syphilis is quite high.
Symptoms of the syphilis of the breast
The manifestations of the syphilis of the breast differ depending on the stage of the disease. During the incubation period (about a month), the syphilis of the breast occurs without any clinical signs of infection. At the primary stage of the syphilis of the breast at the site of the introduction of microorganisms (usually in the field of chest nipple or the range), redness develops with the formation of solid Shankra - a rounded clearly defined ulcerative erosion with a brilliant blue-and-red bottom and dense painless infiltrate. The dimensions of the solid chancre can range from 2-3 mm to 4-5 cm, with multiple damage to the skin of the breast - ulcers can be several.
Gradually, there is a painless increase and sealing of axillary lymph nodes, with the further development of specific polyadenitis. The solid breast chance heals sometimes before the development of signs of secondary syphilis. At the end of the primary stage of the syphilis of the breast, lasting 6-8 weeks, there may be general alert.
The secondary stage of the mammary gland syphilis lasting from 2 to 5 years is manifested by symptoms resembling a cold or flu with generalized painless lymphadenitis and cyclically appearing polymorphic rashes (roselas, papulas, pustulas) in the chest area and throughout the body. There is a loss of skin pigmentation (leukoderma), baldness, decrease in appetite and weight loss, damage to the nervous system and internal organs.
Less frequently, the milk iron is affected by syphilis in the tertiary stage, which can flow in a gummamine form or as diffuse infiltration of the gland resembling chronic mastitis. The gum of the breast occurs usually around the nipple and is detected in the thicker of the gland as a dense, clearly limited low-oral node of the magnitude of the walnut. With purulent melting of the gum and its breakthrough, a syphilitic ulcer is formed, resembling a damage for cancer or tuberculosis of the breast, which is not accompanied by pain. The tertiary syphilis of the breast is little contagious, but is characterized by an irreversible lesion of internal organs, spinal and brain, severe mental disorders, paralysis, blindness. Tertiary breast syphilis occurs in the absence of treatment several years after the infection, is the most severe stage of the disease leading to the disfigure and disability of the patient.
Diagnosis of breast syphilis
When making a diagnosis of breast syphilis, a patient is needed by a mammologist and a venereologist, a detailed collection of anamnesis for the detection of specific symptoms of the disease, as well as laboratory research.
Perform serological diagnosis of syphilis in plasma and blood serum: nonspecific (RPR-test, RW - Vasserman reaction) and specific (reef, RPGA, Ribt). In the presence of skin manifestations in the field of breast (erosion, ulcers, ulcers, bubbles), the microscopy of the specific elements on the pale trepony to identify the pathogen and the differential diagnosis of syphilis, tuberculosis or the actinomicosis of the chest gland is carried out. The fence of fragrance frains and biopsy from the edges of ulcers allows to obtain a cytological and histological conclusion in order to exclude breast cancer.
Mammography, ultrasound and MRI of the mammary glands during syphilis are not specific.
Treatment and forecast of the syphilis of the breast
The syphilis of the breast is a healing disease, the duration of the therapy of which is determined by the stage of syphilitic lesion. Complex course treatment of the syphilis of the breast is prescribed by a dermatovenerologist individually, an outpatient or in hospital with mandatory medical and clinical and serological control is carried out.
In the treatment of syphilis of the breast, antibiotics of a group of penicillins (benzylpenicillin and its analogs), erythromycin, cephalosporins, tetracyclines are used. Additionally, anti-acidic preparations containing iodine and bismuth, immunomodulators, biogenic stimulants are prescribed.
After contact with the patient syphilis, during the first 2 hours, preventive treatment with processing of possible infection (including breast occasion) is necessary for bactericidal agents. During the treatment of the syphilis of the breast, it is necessary to exclude sexual life, alcohol, conduct a survey of sexual partners and family members.
With proper and timely therapy, the forecast treatment for the syphilis of the breast is favorable. Patients are subject to dispensary observation with serological diagnostics and in the absence of signs of the disease for five years - are considered to be cured finally.
And we have
CLASSIFICATION
^ I. Congenital breast diseases.
Amastry Full absence of both mammary glands, monomastia one-sided absence of glands. In the aplasia of one gland, a compensatory hyperplasia of the second anise is observed.
Increase the number of nipples Flutchiy or mammary glands polymisty. In some cases, additional dairy glands or supplement nipples are observed.
Goloralism Symmetric underdevelopment of the dairy glands happens with endocrine diseases of children's age.
Hypermisty increase the mammary glands. If hypermatia is observed in girls up to 10 years, then it is due to the disease of the endocrine system, causing premature puberty. In boys, hypermarines can be observed with hormonal feminizing, germ tumors. This phenomenon is called gynecomastia and, as a rule, requires surgical treatment.
Inflammatory diseases: Cracks of nipples; mastitis; tuberculosis; syphilis; Aktinomycosis.
Injuries.
Fibrozno-cystic disease.
Tumors: benign (adenoma; fibromes; fibroadenomes; cystandaenopapilloma; lipoma; angioma; moma) and malignant (cancer and sarcoma)
^ Cracks of Nipples
Cracks of nipples are observed in approximately 50% of the parents. Moreover, women suffer more often, nursing for the first time. The causes of the occurrence of cracks may be vices for the development of nipples, the special tenderness of the skin of the nipple and the slight vanity of it. On the other hand, the wrong feeding technique, lacking care for the nipples and milk glands can also contribute to their occurrence. Damage to the nipple may occur as a result of an excessive negative pressure, creating during sucking, energetic suction of a nipple or a sharp extraction of its mother, due to the boning and maceration of the nipple. Insufficient pigmentation of the nipple, apparently, is also a predisposing factor, since pigmented leather is more dense and better opposed the injury.
Cracks of nipples can be radial, transverse and circular, surface and deep. Often they are multiple and affected by both nipples are rapidly infected, the edges become hypereminated, edema, and the bottom is often covered with a whitish rail.
Treatment of Pacific cracks must pursue not only the task of eliminating infection and healing of the defect of the skin, but also at the same time the task of preserving the lactation function. Apply disinfectants and bacteriostatic agents, after feeding, we apply ointment bandages.
The prevention of the formation of cracks consists primarily in compliance with the rules of hygiene, kneading the mammary glands and the zone of the area alternately with warm and cold water, frequent change of bed and underwear, preparing nipples to feed during pregnancy by pulling them.
MASTITIS
Mastitis - inflammation of the fabric of the breast. Speaking of mastitis, most often implies a sharp lactation (arising against the background of breastfeeding) mastitis.
There are nobotational (outside breastfeeding) and lactation mastitis. Nobotational mastits are most often marked with newborn girls. Often, such mastits are associated with the preceding hyperplasia (increasing) of the mammary glands and the subsequent addition of infection. Lactomatic mastits arise against the background of lactation - breastfeeding. Separately highlight chronic mastitis. Many scientific researchers do not recognize this form, considering it a form of fibrous-cystic diseases.
For clinical flow, three stages of acute mastitis are distinguished: the stage of serous inflammation; Infiltrative stage; Absoed Stage.
The localization is distinguished by: subareolar, antemmmar, intramammmar (parenchymal, interstitial), retromammar and poleastitis.
The cause of mastitis is a nfection. Most often it is staphylococci and streptococci. The source of infection is usually skin covered, where these microorganisms can dwell. The entrance gate - the gate through which the infection falls into the tissue of the breast is the cracks of the nipple.
The predisposing factors are:
cracks of a nipple;
lactostasis - milk delay. May occur with the significant formation of milk, violation of milk outflow;
immunity violations
serous mastitis. It is characterized by a deterioration in general well-being, a temperature rise, a milk delay in the breast;
infiltrative mastitis is characterized by the appearance of infiltration in the mammary gland, which may be converted into an ulcome. The skin over infiltrate acquires a reddish hue;
purulent is characterized by the appearance of purulent inflammation. There are several forms of purulent mastitis: an abscess (the occurrence of an abscess - limited purulent focus); phlegmonous - the propagation of purulent inflammation on the fabric of the breast; Gangrenous - the occurrence of massive necrosis in the mammary gland (often leads to the need to remove the mammary gland).
Treatment:
antibacterial therapy;
drainage (with purulent mastitis) - the opening of an ulcer in order to evacuate the pus outward;
disinfecting therapy.
Galactocele
Galactocele is a cyst in the mammary gland filled with liquid or "condensed" milk, sometimes an oily or raw-like mass.
The disease is rarely observed. The beginning of the gelactocele usually refers to the lactation period, sometimes as a result of blockage of one or more ducts, a retention cyst with relevant content is formed.
^ Treatment lies in the operational excision of education.
Galactere
The separation of milk outside the lactation period is often observed for a long time after the child from the chest. One or both of the dairy glands can first produce milk, and then a condensed, creamy or serous secret. The presence of a persistent galactorye is based on the continued production of the hylocto hormone hypophysia on the basis of the equilibrium interference between the ovarian and pituitary function. Treatment This state is not required, in addition to compliance with the rules of hygiene.
^
Tuberculosis of the breast
The tuberculosis of the breast is most often found at the age of 20-40 years. The left and right milk iron is equally affected. 13% of patients have a disease of both mammary glands. The process is primarily localized in the upper-outer quadrant.
There are three main clinical forms of breast tuberculosis: a scattered nodal, merging absced and sclerotic. Other forms are ulcerative, ulcerative-fiscal and miliary - are a consequence of the further development of the pathological process.
With a scattered noded form, some increase in the breast, its deformation and pain is noted. In the thickness of the gland, dense and tightly elastic nodules, having fuzzy boundaries, the skin in most cases is fought with a tumor, sometimes hyperplasted, cyanotic. Regional lymph nodes are increased, slightly painful, dense. In the future, individual nodules are connected to each other and form a tumor-like formation, which encourageously reincines, softened, caculate and turns into tuberculous abscess. The abscess is revealed, one or more fistulas emitting liquid pus are formed. Sometimes, the fistula takes the shape of surface ulcers with a bluish tint, the skin in the circumference is thinned and pigmented, the axillary lymph nodes increase and merge into a single conglomerate.
The sclerotic form is characterized by the formation of dense burgter nodes, with fuzzy boundaries, fixed with respect to the underlying tissues and to the skin. When the nodes are located near the nipple, the latter is drawn.
The clinical picture of the disease depends on the phase of the development of the pathological process and the biological characteristics of the body. Subfebrile temperature, general weakness, presence in the history of tuberculosis attracted from the overall phenomena. Laboratory data should be noted by small leukocytosis and the acceleration of the ROE. Often the diagnosis helps the reaction of the pirk and mantu. It should be striving to establish a primary hearth in lungs and bronchial nodes, as well as in nearby ribs and sternum. To this end, the patient must be subjected to a comprehensive radiological examination.
Treatment. The question of the treatment of breast tuberculosis should be solved in conjunction with the phthisiare. Initially, antibacterial drugs are used: Pask, Streptomycin, cycloserine, etc. At the same time, they use heliotherapy, iron irradiation with a quartz lamp. Great importance acquires general strengthening methods of treatment in sanatorium conditions.
In the literature, many cases of cure after the use of conservative and specific treatment of breast tuberculosis, but the overwhelming majority of surgeons prefer surgical treatment, producing resection or ammputation of the gland. After the operation, specific antibacterial and strengthening treatment should be taken.
^
Syphilis of the breast
The syphilis of the breast is rare and can hit the gland in all three stages. In the primary stage, the disease is manifested in the form of a solid Shankra, on the soil of the out-of -olest infection, most often due to the transfer of infection to the nursing mother sick child. At the same time, there is a significant increase in regional lymph nodes. The secondary stage is characterized by the formation of Papul. The tertiary syphilis of the breast is manifested in two forms: in the form of diffuse syphilitic mastitis and solitary gummime tumor. The gum of the breast is usually developing "Right from the nipple, in the depths of the iron fabric. It is determined in the form of a low-sensitive, rounded form of formation with a buggy surface. In the future, the purulent melting of the node can occur and the breakthrough of it with the subsequent formation of ulcers; Sometimes regional lymph nodes increase.
Diagnostics. When recognizing gummime breast tumors, there is a high percentage of diagnostic errors. Anamnesis and clinical picture of Gumma are quite characteristic: syphilis in history, the presence of other signs of syphilis, characteristic night pain, the positive reaction of vasserman, the rapid growth and decay of the gummime tumor to form necrotic and caseaseous masses; Sometimes there is a partial scarring of ulcers.
Treatment. During the syphilis of the breast, they spend specific therapy.
Actinomycosis
The actinomycosis of the mammary glands is rare, it can be primary and secondary. In the primary actinomycosis, the causative agent enters the milk gland through the skin or by output flows; With a secondary lymphogenic path from the ribs affected by the actinomycosis, pleura, lungs.
The disease begins with the appearance of the fungus of small nodules and abscesses at the site of the introduction, which are subsequently merged into dense infiltrates with sections of softens. After the openness of the jets are formed a long-venting fistula.
Diagnosisthey put on the basis of anamnesis (actinosis of other organs) and the discovery of the cluster of the rays fungus in the fistula separated from the fistula.
Treatment.With the actinomyosis of the breast, resection of the affected area is made. Medicase treatment is to use antibacterial drugs, immunotherapy, soiling therapy.
^
Fibrozno-cystic disease
In recent years, there has been a tendency to increase the number of benign diseases of the mammary glands, which are diagnosed with each 4th woman under the age of 30. In patients over 40 years old, various pathological conditions of the mammary glands are detected in 60% of cases. At the same time, each 2rd woman of late reproductive age is observed a diffuse form of fibrous-cystic mastopathy (54%), nodal forms of mastopathy are diagnosed in 26% of patients, fibrotenomes in 18% of cases, breast cancer in 2% of women. Thus, about 75-80% of women of late reproductive ages suffer from various diseases of the authority, often united by a general term "mastopathy", and at present the term "fibrous-cystic disease" (FKB).
FCB, according to WHO (1984), is a complex of processes characterized by a wide range of proliferative and regressive changes in the tissues of the mammary glands, with the formation of abnormal ratios of the epithelial and connecting components and the formation of changes in fibrous, cystic, proliferative changes in breast, which often, but not necessarily coexist. There are unpoliferative and proliferative forms of FKB. At the same time, the risk of malignancy in the non-proliferative form is 0.86%, with a moderate proliferation of 2.34%, with a sharply pronounced proliferation 31.4%. According to histological studies of operational material, breast cancer is combined with FKB to 50% of cases.
In the literature, we can meet a lot of terms denoting various forms and stages of the dormactive hyperplasia: Mastalgia, Mazoplasia, Mastodynium, Mint's disease, fibroadenomatosis, mastopathy, etc. The diseases of the breast outside pregnancy, combined by the general term "mastopathy", are also called "dormricious dysplasia". Mastopathy These are the dormsal benign diseases of the mammary glands, characterized by the hyperplasia of its fabric.
If there are no significant differences about the classifications of nodal formations of significant differences, then there are certain difficulties with respect to diffuse forms that do not allow to introduce a fairly wide range of changes to the rigid classification framework. In recent years, a clinical and radiological classification has been proposed, convenient for use in clinical practice and allowing to distinguish diffuse and components that are diagnosed with radiography, with ultrasound scanning and morphological examination.
1. Diffuse form of fibrocystic mastopathy:
diffuse mastopathy with the predominance of the cystic component;
diffuse mastopathy with the predominance of the fibrous component;
mixed form of diffuse mastopathy;
sclerosing adenosis.
The degree of severity of these processes is determined conditionally, according to the relationship of the connective tissue, ferruginous components and adipose tissue: not sharply pronounced fibrocystic mastopathy; fibrocystic mastopathy of the average degree of severity; The pronounced degree of fibrocystic mastopathy.
Etiology.FKB is a benign disease. However, in some cases, this pathology may be an intermediate stage in the development of a malignant process. Since benign diseases and breast cancer have many common in etiological factors and pathogenetic mechanisms, the risk factors for the development of mastopathy and breast cancer are largely identical. To date, no specific risk factor has been revealed for the development of this disease, since mastopathy multifactorial disease associated with both genetic factors and environmental factors.
In the occurrence and development of dormricial diseases of the mammary glands, a huge role is given to the state of the hypothalamic-pituitary system. The violation of the neurohumoral component of the reproductive cycle leads to the activation of proliferative processes in hormonally dependent organs, including in the tissues of the mammary glands, which are the target for steroid hormones of ovarian, prolactin, placental hormones and indirect hormones of other endocrine organism.
Numerous clinical observations are confirmed that the benign diseases of the mammary glands in 70% of cases are combined with various disorders in neuroendocrine and reproductive systems.
Many authors are indicated on the commodity of the dormonic disease of the dairy glands and a number of gynecological diseases, which are unanimous in the fact that among the variety of ex- and endogenous factors determining in the pathogenesis of benign diseases of the mammary glands is the violation of the rhythm of the secretion of gonadotropic hormones, and the hormonal imbalance arising in the absolute or relative hyperstroy and disadvantage of progesterone.
Thus, the decisive role in the development of diseases of the dairy glands is given by progesteronderate states, in which excess estrogen causes the proliferation of all tissues of the gland.
At the same time, mastopathy is often observed in women with ovulatory cycles and an undisturbed reproductive function. In this case, the decisive role in the occurrence of the pathology of the mammary glands is given not to the absolute value of hormones in the blood plasma, but the condition of the receptors of the genital steroids in the gland tissue, since the state of the receptor apparatus determines the occurrence of the pathological process.
In constant breast tissue, the number of receptors is minimal. Against the background of violation of hormonal equilibrium in some women, changes in lactic glands may not go beyond the scope of the physiological norm, while others, subject to activation of the receptor apparatus, are able to move into a pathological process with the subsequent development of proliferative processes.
The fatty tissue of the breast contains much less receptors and is as depot of estrogen, progesterone and androgen. Under the influence of aromatase androgens turn into estradiol and estrone. This process with age is enhanced, which is one of the factors of increasing the risk of developing diseases of the mammary glands.
In the emergence of the dormriconal pathology of the mammary glands, the mediated role is played by the liver disease. As you know, enzymatic inactivation and conjunction of steroid hormones occurs in the liver. Maintaining a constant level of hormones in circulating blood is due to their enterogeptic exchange. The adverse effect of excess sex hormones on the liver function has been revealed. The diseases of the hepatobiliary complex most often initiate the development of chronic hyperstroyment due to the slow motion utilization of estrogen in the liver. These data are confirmed by the high frequency of hyperplastic processes in mammary glands in diseases of the liver.
Thyroid hormones (thyroxine, triiodothyronine) play an important role in morphogenesis and functional differentiation of breast epithelial cells. The effect of thyroid hormones on the milk gland can be realized in various ways, directly or through the action to receptors to other hormones, in particular to prolactin. In 64% of patients with various forms of mastopathy, the pathology of the thyroid gland is revealed. The pitpofunction of the thyroid gland increases the risk of mastopathy by 3.8 times.
