Breast pain

Introduction Simple epithelial hyperplasia of mammary glands, also known as breast pain, is an early lesion of mammary gland dysplasia. In 1922, Bloodgood first described that in 1928 Semb noticed that the disease manifested as breast pain and a mass, called simple adenoma. In 1931 Beatle called breast simple epithelial hyperplasia; in 1948 Gescnickter called mastodynia. Has been in use ever since.

Cause

(1) Causes of the disease

The occurrence and development of the disease is closely related to the endocrine state of the ovary. A large amount of data indicates that when the ovarian endocrine disorders, excessive secretion of estrogen, and the relative decrease of progesterone, not only stimulates the parenchymal hyperplasia of the breast, but also causes irregular proliferation of the distal ductal epithelium, causing ductal dilatation and cyst formation, and also losing progesterone. The inhibitory effect on estrogen leads to excessive proliferation of interstitial connective tissue and collagenation and lymphocyte infiltration.

(two) pathogenesis

The pathological features of simple breast epithelial hyperplasia are:

1. Gross morphology: The lesion area of mammary gland hyperplasia is tough, without capsule, and the boundary with normal tissue is unclear. The cut surface has a gray-white small granular appearance.

2. Histological morphology: microscopically, the end of the milk duct and acinar epithelial hyperplasia and shedding, causing the milk duct to swell and pain; causing the ductal dilatation of the breast to form a small cyst; the fibrous tissue of the mammary gland is proliferating, and the leaflets are fused together; The interstitial lymphocytes infiltrate.

an examination

Related inspection

X-ray lipiodol angiography mammography nipple discharge examination blood routine whole body imaging

Mainly manifested as breast pain, breast lumps, and has obvious periodicity and self-limiting characteristics.

Breast pain

That is, intermittent breast pain began to appear 3 to 4 days before menstruation, and it was sharply reduced after menstruation. The pain can be diffuse dull pain or a localized sting. Generally, only one side of the breast is involved, and both sides can be involved at the same time, and one side is heavy. The pain is mostly limited to a certain part of the breast, about 50% in the upper part, 20% in the upper part, and tenderness in the pain. The pain is sometimes very intense and radiates to the scapula and ankles, which is aggravated by mood swings, or tired, rainy weather. Most of the patients have short menstrual periods, and the amount is scarce. When the mood is stable or the mood is comfortable, the symptoms can be alleviated, and the emotions will grow and fall. Pain is very sensitive to external stimuli, such as clothing rubbing, walking slightly faster or slightly higher limb activity, can aggravate breast pain.

2. Intramammary mass

Often bilateral breasts occur symmetrically, can be dispersed throughout the breast, can also be limited to a part of the breast, especially in the upper quadrant of the double breast. Palpation is nodular, varies in size, texture is not hard and the surrounding tissue is unclear and can be promoted. The size of the mass changes with menstruation, becomes larger and harder before menstruation, and shrinks and softens after menstruation. Some patients have nipple discharge.

3. Self-limiting and repeatability of the disease

The disease can be cured without healing. Especially after pregnancy, breastfeeding and breastfeeding symptoms disappear on their own, but there are repeated; self-healing after menopause.

Differential diagnosis

The disease should be identified with the following diseases :

1. Breast cancer: Some breast cancers may have similar hyperplasia, but the masses of breast cancer are mostly unilateral, the mass is fixed and there is a growing trend. In the menstrual cycle changes can be increased, without shrinking trend. Acupuncture can confirm the diagnosis.

2. Breast fat necrosis: The disease occurs in women who are more obese after trauma. The mass is superficial, not deep into the mammary gland, and the mass does not change with the menstrual cycle. Needle aspiration cytology and tissue biopsy can confirm the diagnosis.

The diagnosis of this disease should be considered in the following clinical features:

1. Periodic pain and swelling of one or both breasts associated with menstruation in women of childbearing age.

2. The examination can touch a small granular mass, and the texture is not hard.

3. The disease development process has the characteristics of self-limiting and repeatability.

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