Symptom >> Obstetrics and Gynecology >> Gynecology

Saggy breasts

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction The sagging of the breast after the lactation period, the degree of sagging is related to the number of pregnancy and breastfeeding. This is mainly because the acinar in the breast of the female is atrophied after the lactation, and the fibrous connective tissue in the original interstitial is due to the end of pregnancy and breastfeeding. The period is extended and elongated by the filling of the milk. In this case, after the breast-feeding is stopped, the fibrous connective tissue is incompletely retracted and relatively elongated.

Cause

Cause

The etiology and pathogenesis are not well understood. It is believed that excessive secretion of estrogen and target cells of breast tissue are particularly sensitive to estrogen stimulation and cause hyperproliferation. Others believe that it may be related to some unknown genetic factors in breast tissue such as genetic abnormalities.

Pathogenesis

The pathological changes of adult female breast hypertrophy have the following characteristics:

1. General form: The hypertrophied breast can flatten the umbilicus to the knee, and the weight can reach 5-10kg on each side. The nipple is subsided, the epidermis varicose veins are soft, and sometimes the nodules of different sizes can be touched. The cut surface sees the gray-red hyperplasia of the breast tissue, light yellow, grayish hyperplastic fat, fibrous tissue.

2. Histological morphology: Hypertrophic breasts are mainly composed of hyperproliferative glands, fat, and fibrous tissue. There are few small catheters with few branches. Occasionally, there is a tendency of lobular formation. The epithelial cells proliferate in a papillary structure. Secretory vacuoles can be seen in the cytoplasm of epithelial cells. It has been reported that the development of papillary ductal epithelial hyperplasia can lead to atypical hyperplasia, a few (1 %~2%) can develop into breast cancer.

Examine

an examination

Related inspection

Breast ultrasound examination of breast ductoscopy

1. Symptoms and signs

(1) The breast is huge: the hypertrophic mammary gland is mostly drooping or gourd-shaped, and its nipples are more likely to sag and shift. The big breasts can reach 5000-6000g each, and even tens of kilograms can flatten the umbilical cord.

(2) Skin nipple changes: varicose veins on the surface of the breast, which may have pigmentation, increased areola, and nipples may be invaginated.

(3) Restricted activities: heavy breasts can make patients inconvenient, have a sense of falling when standing, and have chest tightness and shortness of breath when lying down. Neck acid back pain, hunchback belly, posture changes thoracic deformity.

(4) Physical examination: one or both breasts are more than 2 times larger than normal. The quality of the touch is hard and tough, and the elasticity is large. It is generally difficult to reach the obvious mass.

2. Clinical classification

The classification of breast hypertrophy is based on factors such as the shape of the breast, the density of the glands, and the amount of tissue that needs to be removed.

(1) Classification according to the density of glands: There are mainly two types:

1 hypertrophic breast: mild drooping, upper fullness; glandular hyperplasia; breast skin elasticity.

2 drooping breasts: markedly drooping, upper flat; fat hyperplasia; breast skin relaxation.

(2) Volume classification according to the need to remove: 0 ~ 200g: mild hypertrophy. 200 ~ 500g: moderate hypertrophy. 500 ~ 1500g: severe hypertrophy. >1500g: Big breast disease

complication:

Because the skin under the breast area is close to the skin of the chest and abdomen, the sweat can not be emitted, and the local moisture is often caused by eczema, erosion and other skin diseases.

Diagnosis

Differential diagnosis

Multiple breast fibroadenomas of the breast

Frequently, many breasts that have smooth surfaces, large mobility, hard texture, clear edges, and non-sticky skin are generally slow to grow, and the breasts may sometimes increase slightly, but generally there is no obvious excessive increase. If the pregnancy increases rapidly in the short term or in the short term, the possibility of phyllodes cystosarcoma should be considered and surgery should be performed promptly.

2. Breast fat deposition

Caused by pituitary dysfunction, often accompanied by excessive fat deposition in the hip, the near-infrared scan can identify hypertrophic breast tissue and excessive fat deposition.