Syphilis of the mammary gland. Benign diseases of the breast anatomical and physiological information

Syphilis of the mammary gland is an inflammatory disease that is quite rare, but it is severe and at the same time gives a complication to other human organs and systems. You can become infected with the disease if the skin of the mammary gland has been damaged and there has been contact with the carrier of the disease, treponema, which is the causative agent of syphilis, easily penetrates the woman's body, multiplies and diverges to other areas. Men do not get sick with this type of syphilis.

Causes of the disease

There are several ways of infection of this form of the disease:

sexual contact with an infected person
breastfeeding a child with syphilis
any wet personal hygiene items (washcloth, towel)
wearing the patient's clothes

It must be said that in a warm, humid environment, the pale spirochete retains its viability for 4 days, even when outside the patient's body. That is why, for the purpose of prevention, it is better not to use common bath accessories, not to wear clothes that were worn before you without washing them first, and if necessary, to feed someone else's child, it is better not to breastfeed, but to express the right amount of milk into a bottle.

Symptoms of breast syphilis

Of course, the manifestations depend on the stage of development of the disease. So, during the incubation period (up to 3 weeks from the moment of infection), no signs appear at all, the primary stage is characterized by the appearance of a hard chancre on the mammary gland, and later there is an increase in lymph nodes, general malaise, which already indicates a secondary stage of mammary lesion. glands. Since the period of the secondary stage itself can last several years, it is important for a woman to pay attention to the fact that the signs of syphilis can be disguised as well-known and more harmless diseases: colds, flu, allergies. In the third stage, the patient develops ulcers, and although this form of the disease is not contagious, irreversible damage to the internal organs will no longer allow the woman to remain fully healthy after the end of treatment.

Treatment

Modern medicine does not see any difficulties in the treatment of any type of this disease, including on the mammary gland. The most important thing in this matter is a timely visit to a doctor, since in an advanced stage it will be much more difficult to cope with the disease. In addition, in addition to taking the prescribed drugs, a woman should adhere to a number of recommendations given by the doctor: lead the necessary lifestyle, give up sexual intercourse for a while, and stop breastfeeding. A fully recovered woman is considered to be a woman whose tests for five years after the end of treatment did not show the presence of treponema in the body.

Breastfeeding for syphilis

The question of whether breastfeeding is allowed with syphilis, if the mother herself is undergoing treatment, is very relevant. In medical practice, it is customary to isolate the child and not allow breastfeeding until research confirms that the baby has a mother's disease. From the point of view of benefits for the child, this should not be done, since treponema is transmitted with the placental bloodstream, which means that the baby is already infected and requires treatment. Therefore, you should not deprive him of the additional immunity obtained with breastfeeding. An obstacle to breastfeeding may be the fact of the second generation of syphilis, i.e. an extremely rare case when treponema was transmitted through the generation. In this case, it is likely that a woman can become infected during breastfeeding.

Malformations. There is insufficient development of the mammary gland (aplasia), very rarely its complete absence (amastia). Overdevelopment of the mammary gland can manifest itself in the form of polymastia - the presence of additional mammary glands with nipples (Fig. 1) and without nipples - or the presence of additional lobules of the gland, located more often in the axillary region.

Rice. 1. Accessory mammary gland. Rice. 2. Symptom of skin retraction. Rice. 3. Symptom of "orange peel".

Cracked nipples often occur in the first days after childbirth, especially in primiparas due to improper feeding and non-compliance with the rules for caring for the nipples.

Cracks are formed when the nipple is sucked vigorously, the baby bites it, or when the nipple is abruptly removed from the baby's mouth. This leads to the appearance of superficial abrasions, and sometimes very deep lesions with ulceration. Especially deep cracks in the nipple can lead to its deformation, partial separation from the areola. Cracks quickly become infected, there is a sharp soreness of the nipples, which greatly complicates feeding. If untreated, the infection can penetrate into the tissues of the mammary gland, leading to the development of acute mastitis (see).

Prevention of cracks should begin during pregnancy (see Pregnancy, pregnancy hygiene). After childbirth, it is necessary to wash the breasts and nipples with boiled water before each feeding of the child and wipe the nipples with 60-70% alcohol or cologne. If the skin is dry, the nipple should be lubricated with vaseline oil.

The most rational method of treating superficial cracks is to lubricate the nipples with a 1% alcohol solution of methylene blue or a 2% alcohol solution of gentian violet. After feeding, a napkin with synthomycin or penicillin is applied to deep cracks, and with severe pain with anesthesin ointment. Before feeding, the ointment is washed off. Strict adherence to the feeding regime is necessary.

Tuberculosis of the mammary gland observed very rarely, characterized by the appearance of an infiltrate with foci of softening, in place of which stubbornly non-healing with purulent discharge is formed. The diagnosis is established after a biopsy. Treatment (, etc.).

breast syphilis can occur in all (three) of its stages. Hard chancre is usually located in the area of the nipple and areola, gumma - in the tissues of the gland in the form of a dense limited node. Both types of lesions must be differentiated from cancer (). With the diagnosis established, antisyphilitic treatment is carried out (see).

Mastopathy(synonym: dyshormonal hyperplasia, fibroadenomatosis, Reclus disease) is a group of hormonally dependent breast diseases that are very common and can serve as a background against which in some cases it occurs. Mastopathy occurs nodular and diffuse. With a nodular form in the mammary gland, a limited area of \u200b\u200bdensification is constantly determined (less clearly in the horizontal position of the patient), sometimes painful (with or on its own). This form of mastopathy should be considered as a precancerous condition, and if this pathology is detected, patients should be sent to the hospital for the affected area of the mammary gland, followed by a histological examination of the excised tissue.

With diffuse mastopathy, swelling, heaviness, and soreness of the mammary gland are observed, which increase before menstruation; there are discharges from the nipples of a serous nature or type of colostrum. Patients with diffuse mastopathy should be under medical supervision. Prevention of mastopathy: normalization of sexual life, repeated childbearing, prevention of abortion.

The most common benign breast tumors are fibroadenomas. They are clearly demarcated from the tissues of the mammary gland, have a dense texture, a bumpy surface.

Surgical treatment. Lipomas are relatively rare, located outside the glandular tissue of the mammary gland, have a soft texture, sometimes lobular in nature. Surgical treatment (mandatory!), the removed tumor should be histologically examined. (see) - racemose formation due to milk retention. Treatment: surgical removal of the cyst. Sometimes - a puncture with suction of contents. Feeding the child should be stopped. Other benign tumors - angiomas, fibroids, chondromas, osteomas - are extremely rare.

CLASSIFICATION
^ I. Congenital diseases of the mammary gland.

Amastia - complete absence of both mammary glands, monomastia - unilateral absence of the gland. With aplasia of one gland, compensatory hyperplasia of the second can be observed - anisomastia.
An increase in the number of nipples  polythelia or mammary glands  polymastia. In some cases, additional mammary glands or additional nipples are observed.
Hypomastia - symmetrical underdevelopment of the mammary glands - occurs with endocrine diseases of childhood.
Hypermastia - enlargement of the mammary glands. If hypermastia is observed in girls under 10 years old, then it is due to a disease of the endocrine system that causes premature puberty. In boys, hypermastia can be observed with hormonal feminizing tumors of the gonads. This phenomenon is called gynecomastia and usually requires surgical treatment.

^ II. Acquired diseases of the breast.

Inflammatory diseases: cracked nipples; mastitis; tuberculosis; syphilis; actinomycosis.
Injuries.
Fibrocystic disease.
Tumors: benign (adenomas; fibromas; fibroadenomas; cystoadeno-papilloma; lipomas; angiomas; fibroids) and malignant (cancer and sarcoma)

^ CRACKED NIPPLES
Nipple cracks are observed in approximately 50% of puerperas. Moreover, women who breastfeed for the first time are more likely to suffer. The causes of cracks may be malformations of the nipples, the special tenderness of the skin of the nipple and its slight vulnerability. On the other hand, improper feeding technique, insufficient care for the nipples and mammary glands can also contribute to their occurrence. Nipple injuries can occur as a result of excessive negative pressure created during suckling, forceful sucking of the nipple, or sudden withdrawal by the mother due to biting and maceration of the nipple. Lack of pigmentation of the nipple also appears to be a predisposing factor, as pigmented skin is denser and more resistant to injury.

Nipple cracks can be radial, transverse and circular, superficial and deep. Often they are multiple and affect both nipples, quickly become infected, the edges become hyperemic, swollen, and the bottom is often covered with a whitish greasy coating.

Treatment of nipple cracks should pursue not only the task of eliminating the infection and healing the skin defect, but at the same time the task of maintaining lactation function. Disinfectants and bacteriostatic agents are used, ointment dressings are applied after feeding.

Prevention of the formation of cracks consists primarily in observing the rules of hygiene, washing the mammary glands and the areola zone alternately with warm and cold water, frequent change of bed and underwear, preparing the nipples for feeding during pregnancy by stretching them.

MASTITIS
Mastitis is inflammation of the breast tissue. Speaking of mastitis, most often they mean acute lactational (due to breastfeeding) mastitis.

There are non-lactational (outside breastfeeding) and lactational mastitis. Non-lactational mastitis is most often observed in newborn girls. Often, such mastitis is associated with previous hyperplasia (enlargement) of the mammary glands and subsequent infection. Lactational mastitis occurs against the background of lactation - breastfeeding. Separately allocate chronic mastitis. Many scientific researchers do not recognize this form, considering it a form of fibrocystic disease.

According to the clinical course, three stages of acute mastitis are distinguished: the stage of serous inflammation; infiltrative stage; abscess stage.

Localization distinguishes: subareolar, antemammary, intramammary (parenchymal, interstitial), retromammary and panmastitis.

The cause of mastitis is infection. Most often it is staphylococci and streptococci. The source of infection is usually the skin, where these microorganisms can live. Entrance gates - the gates through which the infection enters the breast tissue, are nipple cracks.

Predisposing factors are:

cracked nipple;
lactostasis - milk retention. It can occur with a significant formation of milk, a violation of the outflow of milk;
immune disorders

Forms of acute mastitis are actually the stages of its development:

serous mastitis. It is characterized by a deterioration in general well-being, a rise in temperature, a delay in milk in the mammary gland;
infiltrative mastitis is characterized by the appearance of an infiltrate in the mammary gland, which can later be transformed into an abscess. The skin over the infiltrate acquires a reddish tint;
purulent - characterized by the appearance of purulent inflammation. There are several forms of purulent mastitis: abscessing (the occurrence of an abscess - a limited purulent focus); phlegmonous - the spread of purulent inflammation in the breast tissue; gangrenous - the occurrence of massive necrosis in the mammary gland (often leads to the need to remove the mammary gland).

Diagnosis is based on clinical data (clarification of complaints, examination), ultrasound data.

Treatment:

antibacterial therapy;
drainage (with purulent mastitis) - opening the abscess in order to evacuate the pus to the outside;
detoxification therapy.

GALACTOCELE

A galactocele is a cyst in the breast filled with liquid or "condensed" milk, sometimes an oily or cheesy mass.

The disease is rarely seen. The onset of a gelactocele usually refers to the period of lactation, sometimes as a result of blockage of one or more ducts, a retention cyst is formed with the corresponding contents.

^ Treatment consists in surgical excision of the formation.
galactorrhea
The separation of milk outside the lactation period is often observed for a long time after weaning the baby from the breast. One or both mammary glands may produce first milk and then a thickened, creamy or serous secretion. At the heart of persistent galactorrhea lies, apparently, the ongoing production of galactogenic hormone by the pituitary gland on the basis of an imbalance between the functions of the ovaries and the pituitary gland. Treatments this state is not required, except for the observance of hygiene rules.
^ BREAST TUBERCULOSIS
Tuberculosis of the mammary gland most often occurs at the age of 20-40 years. The left and right mammary glands are equally often affected. In 13% of patients, disease of both mammary glands was noted. The process is predominantly localized in the upper outer quadrant.

There are three main clinical forms of breast tuberculosis: disseminated nodular, confluent - abscessed and sclerotic. Other forms - ulcerative, ulcerative-fistulous and miliary - are the result of the further development of the pathological process.

With a diffuse nodular form, there is a slight increase in the mammary gland, its deformation and soreness. In the thickness of the gland, dense and densely elastic nodules are palpable, with fuzzy boundaries, the skin in most cases is fused with the tumor, sometimes hyperplastic, cyanotic. Regional lymph nodes are enlarged, slightly painful, dense. In the future, individual nodules are interconnected and form a tumor-like formation, which is caseously reborn, softens, suppurates and turns into a tuberculous abscess. The abscess is opened, one or more fistulas are formed, releasing liquid pus. Sometimes the fistula takes the form of a superficial ulcer with a bluish tint, the skin in the circumference is thinned and pigmented, the axillary lymph nodes enlarge and merge into a single conglomerate.

The sclerotic form is characterized by the formation of dense tuberous nodes, with indistinct boundaries, immobile in relation to the underlying tissues and to the skin. When the nodes are located near the nipple, the latter is retracted.

The clinical picture of the disease depends on the phase of development of the pathological process and the biological characteristics of the organism. Of the common phenomena, subfebrile temperature, general weakness, and a history of tuberculosis attract attention. From laboratory data, it should be noted a slight leukocytosis and an acceleration of ESR. Often the Pirquet and Mantoux reactions help the diagnosis. One should strive to establish a primary focus in the lungs and bronchial nodes, as well as in the nearby ribs and sternum. To this end, the patient must undergo a comprehensive x-ray examination.

Treatment. The question of the treatment of tuberculosis of the mammary gland should be decided together with a phthisiatrician. Initially, antibacterial drugs are used: PASK, streptomycin, cycloserine, etc. At the same time, they use heliotherapy, irradiation of the gland with a quartz lamp. Of great importance are general strengthening methods of treatment in sanatorium conditions.

The literature describes many cases of cure after the use of conservative and specific treatment of tuberculosis of the mammary gland, however, the vast majority of surgeons prefer surgical treatment, resecting or amputating the gland. After the operation, specific antibacterial and strengthening treatment should be taken.
^ SYPHILIS OF THE BREAST
Breast syphilis is rare and can affect the gland in all three of its stages. In the primary stage, the disease manifests itself in the form of a hard chancre, on the basis of non-sexual infection, most often due to the transfer of infection to a nursing mother by a sick child. In this case, there is a significant increase in regional lymph nodes. The secondary stage is characterized by the formation of papules. Tertiary syphilis of the mammary gland manifests itself in two forms: in the form of diffuse syphilitic mastitis and solitary gummy tumor. The gumma of the mammary gland usually develops “near the nipple, in the depths of the glandular tissue. It is determined in the form of an insensitive, rounded formation with a bumpy surface. In the future, purulent fusion of the node may occur and its breakthrough to the outside with the subsequent formation of an ulcer; sometimes enlarged regional lymph nodes.

Diagnostics. When recognizing gummy tumors of the breast, there is a high percentage of diagnostic errors. The anamnesis and clinical picture of the gumma are quite characteristic: a history of syphilis, the presence of other signs of syphilis, characteristic night pains, a positive Wasserman reaction, rapid growth and decay of the gummatous tumor with the formation of necrotic and caseous masses; sometimes there is partial scarring of the ulcer.

Treatment. With syphilis of the mammary gland, specific therapy is carried out.

actinomycosis
Actinomycosis of the mammary glands is rare, it can be primary and secondary. In primary actinomycosis, the pathogen enters the mammary gland through the skin or through the excretory ducts; in the secondary - by the lymphogenous route from the ribs, pleura, and lungs affected by actinomycosis.

The disease begins with the appearance of small nodules and abscesses at the site of the introduction of the fungus, which subsequently merge into dense infiltrates with areas of softening. After the opening of the abscesses, long-term non-healing fistulas are formed.

Diagnosis put on the basis of anamnesis (actinomycosis of other organs) and the detection of accumulations of drusen of the radiant fungus in the discharge from the fistula.

Treatment. With actinomycosis of the mammary gland, a resection of the affected area is performed. Drug treatment consists in the use of antibacterial drugs, immunotherapy, restorative therapy.

^ FIBROCYSTIC DISEASE
In recent years, there has been a trend towards an increase in the number of benign diseases of the mammary glands, which are diagnosed in every 4th woman under the age of 30 years. In patients older than 40 years, various pathological conditions of the mammary glands are detected in 60% of cases. At the same time, every 2nd woman of late reproductive age has a diffuse form of fibrocystic mastopathy (54%), nodular forms of mastopathy are diagnosed in 26% of patients, fibroadenomas in 18% of cases, breast cancer in 2% of women. Thus, about 75-80% of women of late reproductive age suffer from various diseases of this organ, often combined under the general term "mastopathy", and now the term "fibrocystic disease" (FCD).

FCD, as defined by WHO (1984), is a complex of processes characterized by a wide range of proliferative and regressive changes in mammary gland tissues, with the formation of abnormal ratios of epithelial and connective tissue components and the formation of fibrous, cystic, proliferative changes in the mammary gland, which often, but not necessarily, coexist. There are non-proliferative and proliferative forms of FCD. At the same time, the risk of malignancy in the non-proliferative form is 0.86%, with moderate proliferation  2.34%, with pronounced proliferation  31.4%. According to histological studies of the surgical material, breast cancer is combined with FCD up to 50% of cases.

In the literature, you can find many terms denoting various forms and stages of dyshormonal hyperplasia: mastalgia, mastoplasia, mastodynia, Mintz's disease, fibroadenomatosis, mastopathy, etc. Breast diseases outside of pregnancy, united by the general term "mastopathy", are also called "dyshormonal dysplasia". Mastopathy is a dishormonal benign disease of the mammary glands, characterized by hyperplasia of its tissue.

If there are no significant disagreements among specialists regarding the classifications of nodular formations, then with respect to diffuse forms there are certain difficulties that do not allow a fairly wide range of changes to be introduced into a rigid classification framework. In recent years, a clinical and radiological classification has been proposed that is convenient for use in clinical practice and makes it possible to distinguish diffuse and nodular forms that are diagnosed using radiography, ultrasound scanning, and morphological examination.

1. Diffuse form of fibrocystic mastopathy:

diffuse mastopathy with a predominance of the cystic component;
diffuse mastopathy with a predominance of the fibrous component;
mixed form of diffuse mastopathy;
sclerosing adenosis.

2. Nodal form.

The severity of these processes is determined conditionally, according to the ratio of connective tissue, glandular components and adipose tissue: not pronounced fibrocystic mastopathy; fibrocystic mastopathy of moderate severity; severe degree of fibrocystic mastopathy.

Etiology. FCD is a benign disease. However, in some cases, this pathology can be an intermediate stage in the development of a malignant process. Since benign diseases and breast cancer have much in 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 for the development of this disease has been identified, since mastopathy is a multifactorial disease associated with both genetic and environmental factors.

In the occurrence and development of dyshormonal diseases of the mammary glands, a huge role is given to the state of the hypothalamic-pituitary system. Violation of the neurohumoral component of the reproductive cycle leads to the activation of proliferative processes in hormone-dependent organs, including mammary gland tissues, which are the target for ovarian steroid hormones, prolactin, placental hormones, and indirectly hormones of other endocrine glands of the body.

Numerous clinical observations confirm that benign diseases of the mammary glands in 70% of cases are combined with various disorders in the neuroendocrine and reproductive systems.

The commonality of dyshormonal pathology of the mammary glands and a number of gynecological diseases is indicated by many authors who are unanimous in the fact that among the variety of exogenous and endogenous factors, the determining factor in the pathogenesis of benign diseases of the mammary glands is a violation of the rhythm of the secretion of gonadotropic hormones, and the resulting hormonal imbalance is expressed in absolute or relative hyperestrogenism and lack of progesterone.

Thus, the decisive role in the development of diseases of the mammary glands is assigned to progesterone deficiency conditions, in which an excess of estrogen causes the proliferation of all gland tissues.

However, mastopathy is often observed in women with ovulatory cycles and unimpaired reproductive function. In this case, the decisive role in the occurrence of breast pathology is assigned not to the absolute value of hormones in the blood plasma, but to the state of sex steroid receptors in the gland tissue, since the state of the receptor apparatus determines the occurrence of the pathological process.

In unchanged breast tissue, the number of receptors is minimal. Against the background of hormonal imbalance in some women, changes in the mammary glands may not go beyond the physiological norm, while in others, subject to the activation of the receptor apparatus, they can go into a pathological process with the subsequent development of proliferative processes.

The adipose tissue of the mammary gland contains much fewer receptors and is used as a depot for estrogens, progesterone and androgens. Under the influence of aromatase, androgens are converted into estradiol and estrone. This process increases with age, which is one of the factors that increase the risk of developing breast diseases.

In the occurrence of dyshormonal pathology of the mammary glands, liver diseases play an indirect role. As is known, enzymatic inactivation and conjugation of steroid hormones occur in the liver. Maintaining a constant level of hormones in the circulating blood is due to their enterohepatic metabolism. An unfavorable effect of an excess of sex hormones on liver function was revealed. Diseases of the hepatobiliary complex most often initiate the development of chronic hyperestrogenism due to delayed utilization of estrogens in the liver. These data are confirmed by the high frequency of hyperplastic processes in the mammary glands in liver diseases.

Thyroid hormones (thyroxine, triiodothyronine) play an important role in the morphogenesis and functional differentiation of breast epithelial cells. The action of thyroid hormones on the mammary gland can be realized in various ways, directly or through action on receptors for other hormones, in particular for prolactin. In 64% of patients with various forms of mastopathy, thyroid pathology was detected. Hypofunction of the thyroid gland increases the risk of mastopathy by 3.8 times.

A specific infectious disease caused by pallidum spirochete, manifested by primary, secondary and / or tertiary lesions of the mammary glands. Symptoms of breast syphilis depend on the period of the disease and may include a variety of skin manifestations (syphilides), specific lymphadenitis, a violation of the general condition, damage to internal organs. The diagnosis is confirmed by the results of serological reactions and cytological examination of smears from the edges of the ulcer. The main thing in the treatment of breast syphilis is adequate antibiotic therapy.

General information

Breast syphilis is a rare specific inflammatory disease with a long course and systemic damage to the body. The causative agent of syphilis - pale spirochete (treponema) easily penetrates through the existing minor damage to the skin of the mammary gland, multiplies and spreads throughout the body. A patient with syphilis is contagious at any stage of the disease, especially in the presence of skin manifestations. Breast syphilis, like other diseases diagnosed and treated by mammology, concerns mainly female patients.

Causes of breast syphilis

Breast syphilis can be contracted from a patient through direct contact (from a sexual partner, while feeding a sick child), by household means (through wet hygiene items: a washcloth, towel, clothes).

In the wet secretions of the patient, the pale spirochete can remain viable for up to 4 days, and in the presence of microtraumas, small wounds, cracks in the skin of the breast (especially in the nipple and areola), the probability of infection with syphilis is quite high.

Symptoms of breast syphilis

Manifestations of breast syphilis vary depending on the stage of the disease. During the incubation period (about a month), breast syphilis occurs without any clinical signs of infection. At the primary stage of breast syphilis, at the site of the introduction of microorganisms (usually in the region of the breast nipple or areola), redness develops with the formation of a hard chancre - a round, well-defined ulcerative erosion with a shiny bluish-red bottom and a dense, painless infiltrate. The size of a hard chancre can vary from 2-3 mm to 4-5 cm, with multiple lesions of the skin of the mammary gland, there may be several ulcers.

Painless thickening and enlargement of the axillary lymph nodes are gradually observed, with the further development of specific polyadenitis. Hard chancre of the mammary gland sometimes heals before the development of signs of secondary syphilis. At the end of the primary stage of breast syphilis, which lasts 6-8 weeks, there may be a general malaise.

The secondary stage of breast 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 (roseola, papules, pustules) in the breast area and throughout the body. There is a loss of skin pigmentation (leukoderma), baldness, loss of appetite and weight loss, damage to the nervous system and internal organs.

Least of all, the mammary gland is affected by syphilis in the tertiary stage, which can occur in a gummy form or in the form of a diffuse infiltration of the gland, resembling chronic mastitis. Gumma of the mammary gland usually occurs near the nipple and is found in the thickness of the gland as a dense, clearly limited, slightly painful node the size of a walnut. With purulent melting of the gum and its breakthrough, a syphilitic ulcer is formed, resembling a lesion in breast cancer or tuberculosis, which, however, is not accompanied by pain. Tertiary syphilis of the mammary gland is slightly contagious, but is characterized by irreversible damage to the internal organs, spinal cord and brain, severe mental disorders, paralysis, and blindness. Tertiary syphilis of the breast occurs in the absence of treatment several years after infection, is the most severe stage of the disease, leading to disfigurement and disability of the patient.

Diagnosis of breast syphilis

When making a diagnosis of breast syphilis, it is necessary to examine the patient by a mammologist and venereologist, a detailed history taking to detect specific symptoms of the disease, as well as laboratory tests.

Perform serological diagnosis of syphilis in plasma and serum: non-specific (RPR-test, RW - Wasserman reaction) and specific (RIF, RPHA, RIBT). In the presence of skin manifestations in the area of the mammary gland (erosions, ulcers, abscesses, vesicles), microscopy of specific elements is carried out for pale treponema to identify the pathogen and differential diagnosis of syphilis, tuberculosis, or actinomycosis of the mammary gland. Smear-prints and biopsy from the edges of the ulcer allows obtaining cytological and histological conclusions in order to exclude breast cancer.

Mammography, ultrasound and MRI of the mammary glands for syphilis are not specific.

Treatment and prognosis of breast syphilis

Syphilis of the mammary gland is a curable disease, the duration of therapy of which is determined by the stage of the syphilitic lesion. Complex course treatment of breast syphilis is prescribed by a dermatovenereologist individually, carried out on an outpatient basis or in a hospital with mandatory medical and clinical and serological control.

In the treatment of breast syphilis, antibiotics of the penicillin group (benzylpenicillin and its analogues), erythromycin, cephalosporins, tetracyclines are used. Additionally, antisyphilitic drugs containing iodine and bismuth, immunomodulators, and biogenic stimulants are prescribed.

After contact with a patient with syphilis, during the first 2 hours, preventive treatment is necessary with the treatment of places of possible infection (including the breast) with bactericidal agents. During the treatment of breast syphilis, it is necessary to exclude sexual life, alcohol, conduct a survey of sexual partners and family members.

With proper and timely therapy, the prognosis for the treatment of breast syphilis is favorable. Patients are subject to dispensary observation with serological diagnostics, and in the absence of signs of the disease for five years, they are considered cured completely.

In medical practice, such a disease as syphilis of the mammary glands is very rare. However, still isolated cases with this disease are recorded.

Breast syphilis is an extremely dangerous disease. Since the developing inflammatory process in the mammary gland can go to other organs and vital systems of the body.

The detection of syphilis of the mammary glands for a woman reduces the quality of life in the absence of proper treatment. In addition, syphilis can become a deadly disease if treatment is not carried out in a timely manner.

Breast syphilis is an infectious disease caused by Treponema pallidum. When it enters the mammary gland, this infectious agent multiplies very quickly. In this case, the patient's condition is rapidly deteriorating.

Ways of contracting syphilis

Syphilis of the mammary glands can proceed in a latent form for a sufficiently long period. That is, syphilis infections occur without pronounced symptoms. The danger of this disease lies in the fact that it is diagnosed already in the late, advanced stages.

The causative agent of syphilis can first affect one mammary gland, and then move on to another. Therefore, both unilateral and bilateral (cover both mammary glands).

Syphilis is considered a very dangerous disease because, at absolutely all stages, it is contagious. The greatest danger to the people around the patient, syphilis carries when it is on the skin.

Men are not susceptible to syphilis of the mammary glands, however, pale treponema, when infected, can affect other organs in them. The microbe-causative agent of syphilis has a systemic effect on the body as a whole, so it cannot be thought that if the male sex is not susceptible to syphilis of the mammary glands, then treponema does not pose any danger to them.

Syphilis can be transmitted in these main ways. It:

sexual transmission
From mother to child at birth
Infection

Pale treponema has the ability to survive outside the human body for about 4 days.

Like other viral diseases, syphilis is highly contagious. Therefore, healthy people must avoid personal contact with an infected patient.

Each person must beware of direct and indirect ways of contracting syphilis. It is very difficult to recover from this disease. In addition, absolutely all patients with syphilis cannot lead a full life. Their quality of life is significantly limited and deteriorates.

What are the symptoms of breast syphilis

As already noted in the initial incubation period, the presence of treponema in the mammary glands is not accompanied by any external manifestations. The incubation period can last from one to several months.