Symptoms and treatment of ductal ectasia of the breast. Causes, diagnosis and treatment of milk duct ectasia Milk duct ectasia symptoms treatment

Content:

Milk duct ectasia (duct ectasia) is the expansion of the milk ducts. The condition is not considered pathological if there is a periodic return to the previous forms. If there is a constantly present expansion, they speak of a symptom of one of the serious pathologies of the female breast, which must be diagnosed as early as possible. Ectasia is mainly observed in women aged 40-47 years, but can be diagnosed in both young and older age groups.

Status Description

Milk is produced in the female body constantly, regardless of whether breastfeeding is in progress or has long been completed. It’s just that its amount is negligible and it doesn’t reach the nipple - it dissolves “along the way”. In this regard, with unintentional squeezing of the lactiferous duct, the secret may stagnate in some place, expanding the channel. When his permeability is restored, everything returns to normal.

The condition refers to benign changes occurring in the breast. Ectasia can be both a harbinger of aging (age-related changes) and a sign of a serious illness.

Pathological expansion of the milk ducts is observed in the following cases:

1. Intraductal papilloma. A dangerous condition that is characterized by discharge of various colors from the nipple, often with an admixture of blood. Considered as a precursor.
2. Mastopathy. Pathology occurs due to an excess of estrogen in the body of a woman. The hormone provokes the growth of glandular tissue responsible for the production of milk. Expanded in this case, the ducts are one of the symptoms of mastopathy.
3. Ectasia. The condition is accompanied by a constant increase in the width of the milk ducts, inside which inflammatory processes can begin in parallel. Discharge of contents from nipples is characteristic.
4. Intraductal cyst. Unlike papilloma, it is not considered as a precancerous condition, however, it causes the expansion of the milk ducts. This happens due to the clamping of the channels through which the milk leaves. As a result of stagnation, a cavity filled with a secret is formed. Then it closes with a fibrin membrane, turning into a cyst. The lack of timely diagnosis becomes the impetus for the onset of the cystic form of mastopathy.

Useful information! The milk ducts expand and return to normal within one monthly cycle. In the second phase, the woman's body actively produces progesterone. It causes the expansion of the milk channels (the same thing happens during pregnancy). By the beginning of menstruation, the amount of this hormone gradually decreases and the milk ducts inside the breast return to normal.

Causes of ectasia of the mammary glands

The condition may occur due to one provoking factor or due to several at once. The main causes of ectasia:

1. Breast trauma. They can be obtained both independently (chest impact on a corner, hard surface), and during surgery (installation of implants, removal of a neoplasm).
2. Failure of the hormonal background. Occurs due to malfunction of the ovaries (dysfunction), pituitary gland.
3. Inflammation of the mammary gland. Lactostasis or stagnation of milk in the milk ducts can cause them to expand, and then develop into mastitis. The result is a pronounced swelling of the breast tissue, fever, chest pain.
4. Menopausal changes in the body. The restructuring of the hormonal background during this period often provokes the expansion of the milk ducts.

Useful information! Ectasia can also occur due to neoplasms in the mammary gland. If they are large, there is a clamping of the lactiferous duct in one place and its expansion due to the accumulation of a secret in another.

Symptoms of ectasia of the mammary glands

The condition can be asymptomatic and only be detected during a routine physical examination by a mammologist. You need to be alert if the following symptoms occur:

• discharge from the nipples - a typical sign of ectasia of the mammary glands;
• the presence of seals, painful when palpated, often in the area under the areola;
• discomfort in the nipples - tickling, burning;
• change in the appearance of the nipples - redness, swelling, granularity, displacement to the side, elongated shape;
• poor general condition - weakness, chills, subfebrile temperature indicators;
• regular disruptions in the menstrual cycle;
• redness on the skin of the chest, engorgement of the glands on certain days of the cycle.

It's important to know! By itself, the expansion of the ducts goes unnoticed for a woman. If no other signs are observed, and a regular physical examination is not carried out, ectasia can be asymptomatic for a long time. It is found in connection with some other disease.

Types of breast ectasia

The milk ducts may be dilated in both breasts or only one. In the first case, they talk about bilateral ectasia, in the second about local. If the condition is stable, does not worsen, there are no other symptoms, treatment is not indicated.

However, bilateral ectasia in 50% of cases turns out to be pathological, which means that a thorough diagnosis of the patient is necessary. Differentiation from possible malignant processes is required.

Diagnosis of ectasia of the mammary glands

An appointment with a doctor begins with a conversation with the patient and fixing complaints (if any). This is followed by examination and palpation of the mammary glands. Ultrasound and mammography are used as the main methods of hardware examination.

Ultrasound is informative for the diagnosis of breast ectasia. Mammography allows you to see the ducts as if from the inside, to determine if there are neoplasms (cysts, papillomas). A variation of this method is ductography. This is the same X-ray of the breast, only with the introduction of a contrast agent into the ducts. With the help of ductography, the patency of the channels is determined, the presence of neoplasms in them.

Another mandatory study is a smear-imprint of nipple secretions. Fluid analysis allows you to determine if there is an inflammatory process. Also, blood is always donated for hormones and a biopsy if neoplasms are found.

Treatment of ductal ectasia of the breast

Therapy can be conservative and operational. Drug treatment is usually complex, aimed at stopping the pathology that caused the ectasia of the mammary gland. Additionally, unpleasant symptoms are always removed, if any, immunity is strengthened.

Surgical treatment is required if neoplasms are found inside the ducts. The complexity of the operation depends on the diagnosis:

1. If the histology did not show the presence of atypical cells, the dilated duct (or part of it) and epithelial cells are removed.
2. If the neoplasm in the breast is determined to be malignant, all milk ducts are removed.

The intervention is performed under full anesthesia. Damage to the chest is minimal due to the imposition of cosmetic stitches. Contraindications to surgical intervention are heart pathologies and the desire of a woman in the future to give birth and feed a child on her own.

Important! With timely seeking medical help, breast ectasia can be completely cured.

Prevention

To prevent ectasia of the mammary glands, the following points must be observed:

1. Control hormone levels.
2. Strengthen immunity.
3. Regularly do screening studies (ultrasound, mammography).
4. Protect your chest from injury.
5. Take care of your breasts and nipples regularly.
6. Choose underwear according to size.
7. Do not smoke or drink alcohol.
8. Eat properly.
9. Watch your weight.

If self-examination reveals a suspicious neoplasm in the breast, make an appointment with a specialist.

It's important to know! In about 25% of cases, ectasia is a concomitant symptom of a disease such as carcinoma. If a woman categorically refuses to do a biopsy, she is at great risk.

Ectasia of the mammary glands at first glance seems to be a benign condition, but this is far from being the case. Usually, the expansion of the milk ducts is a symptom of a more formidable pathology, for example, mastopathy.

Dear readers, how was ectasia discovered in you? Were there any external manifestations, indurations on palpation, pain along the duct? What therapy was prescribed by your doctor? If someone received surgical treatment, tell us if there were scars or scars on the chest, if it was painful after the operation, how was the recovery period.

Hello dear readers. You are over 40, and scary words ductectasis of the mammary gland cause shiver in the card? Let's figure it out what it is and how the condition may threaten your health.

Ectasia and ductectasia or dilatation of the subareolar canals

Oh, that's so crazy, you say? What is it ? All these "terrible" terms describe one single phenomenon - the expansion (stretching) of the milk ducts or passages.

The word ektasis (or ectasia) comes from the Greek "stretching", "stretching" the prefix "duct-" determines exactly where this very expansion occurs. But "dilatatio" or dilatation is already a Latin word for "expansion." And there is a similar expansion:

• as physiological (lactation and involution);
• and pathological (hormonal, neoplastic).

In the first case, you are pregnant, breastfeeding, or your bust, unfortunately, fades (age). In the second case, you need to look for the disease!

Ductectasia can be:

• left chest;
• right chest
• bilateral.

Doctors talk about ectasia only if your ducts have grown (expanded) from a normal 1.5 mm to 3 or even 5 mm, or even more.

Ductectasia is rarely an independent change, more often it is a beacon of other breast diseases.

What is dangerous dilatation of the ducts?

By his incompetence. Often ductectasia accompanies pituitary-hypothalamar diseases or problems of the female genital area (adnexitis, oophoritis, endometriosis, or bulk neoplasia).

With the expansion of the milk passages, both women with (secretory form) and women with, including diseases, face. Symptom called the "secerating gland".

The mechanism of ectasia and its causes

Dilatation of milk passages is a multi-stage process. Moreover, various factors influence its individual stages. But the mechanism for the development of ectasia is always the same:

• liquid: pathological or physiological (milk) enters the lumen of the lactiferous duct, stretching it (compensatory ectasia);
• in the presence of clots, the ducts "clog" or "overlap", the pressure inside the milky passage increases, the walls stretch, constant pressure causes persistent (pathological) dilatation.

This means that with an abundance of prolactin in the blood and excessive milk production, you run the risk of stretching (ectasia) of the ducts.

The same mechanism is triggered by little encouraging reasons:

• with acute inflammation of glandular tissues;
• with the formation of adhesions;
• the influence of scars after injury;
• with the germination of tumors (neoplasia);
• in the formation of papilloma or cysts within the duct.

During menopause, ectasia develops because the gland involutes, is replaced by connective tissue, the breast sags, pulling the ducts along with it.

Signs of dilation

Symptoms dilations are nonspecific. It:

• (nipple + areolar circle);
• soreness;
• edema;
• hyperemia (redness);
• Availability ;
• deformation, displacement to the side or retraction of the nipple;
• discharge from the milky pores (with the development of the disease, they are not associated with lactation),

They can vary in color from yellowish to brown. With the development of the process, the SAH zone turns red, swells and hurts.

If you find 1 or 2 signs at the same time, this is not ectasia. Contact a mammologist. Maybe your hormones were “bumped up” during frequent flights or you were taking medications that affect the hormonal status.

Treatment

Treatment Methods diseases directly depend on its main the reasons . With dyshormonal disorders, hormonal therapy has proven itself well. Proper selection of drugs will help normalize hormones and metabolism of the mammary glands.

Ectasia of the ducts of the mammary gland has specific symptoms, so it is not difficult to differentiate this disease.

Consider the key features of the disease, what signs it manifests itself and what provokes its development. Separately, we analyze the nuances of the applied diagnostic methods and therapeutic measures.

So, what does breast ectasia mean? By this term, medicine means a physiological or pathological condition in which dilated ducts of the mammary gland are observed. In mammology, ectasia is also called duektasia or plasmacytic mastitis (ICD-10, code - N60.4).

The expansion of the lumen of the milk canals has a local character and is observed in the subareolar region of the chest, which is most often due to:

• Pregnancy.
• Climax.
• Breastfeeding.
• The beginning of menstruation.
• Breast diseases.
• Pathological changes in the breast.

Doctors talk about ectasia as a pathology only when an increase in the width of the thoracic ducts is not associated with bearing a child, lactation, and the onset of menopause.

Dilatation of the mammary ducts of the mammary glands as an independent disease is rare, mainly its presence indicates the development of other pathological processes in the breast. The lumen of the ducts increases to 3-5 mm or more (the norm is 1.5-2 mm).

An abnormal phenomenon in most episodes is diagnosed in women aged 40-45 years, which is due to the age-related processes of the body.

Development features

The pathogenesis of the disease is characterized by a complex process:

1. With hormonal abnormalities, hypertrophy of the intraductal tissues occurs, which provokes the expansion of the milk ducts.
2. A physiological or pathological secret, when it penetrates into the lactiferous channels, provokes their compensatory dilatation.
3. If the viscosity of the intraductal fluid is increased or there are clots in it, then an excessively thick substance can clog the ducts, which leads to a pressure jump in the distal sections, thereby causing a steady expansion of the milky ways.

The manifestation of ductectasia is largely identical to the symptoms of mastitis. Ectasia has several forms and types of its manifestation, depending on what reasons it was caused by:

• Hormonal - due to hormonal imbalance.
• Physiological - pregnancy and lactation.
• Oncological - the presence of a malignant tumor in the tissues of the breast.

The milk ducts in the chest can expand in one or both glands, so ectasia can be:

• Unilateral.
• Double-sided.

In this case, it can occur in different areas of the mammary glands:

• On the left side of the chest.
• Right breast.

If ductectasia is present in only one in one breast, for example, in the right breast, while the woman's health is consistently good and there are no other symptoms, special treatment is not prescribed.

With its bilateral manifestation, it most often has a pathological character (50%).

Causes of breast ectasia

Ectasia of the milk ducts can be caused by both natural and pathological mechanisms of the body, therefore, in order to clarify the provoking factor, a woman needs to undergo a complete diagnosis of the body.

Among the most common causes, doctors call:

Breast ectasia is characterized by the manifestation of pronounced symptoms, especially common signs of the disease are:

1. Unpleasant discomfort in the breast.
2. Itching and burning in the nipples.
3. Pain in the chest.
4. Swelling of the nipples.
5. Redness of the nipple tissues.
6. Displacement of the nipples.
7. On certain days of the menstrual cycle, one or both breasts increase in size, become hard.
8. Discharge from the nipples of unknown origin.
9. On palpation, breasts are felt in the areola area.

The release of third-party fluid from the nipples is the main sign of the development of breast ectasia, while the watery substance may have a different color. A particularly alarming symptom is discharge interspersed with blood fluid, which indicates the development of a tumor of a benign or malignant form.

As mentioned above, the physiological ductectasis of the mammary gland is not capable of causing particular harm to a woman's health, but its presence can lead to the appearance of:

• Mastitis.
• Breast deformities.
• Inflammation of the milk channels.

If ectasia developed as a result of a secerating breast, then the constant discharge of fluid from the dilated milk ducts can provoke the development of dermatosis or dermatitis on the tissues of the areola.

Excessive expansion of the breast ducts is a clear sign of inflammation, hormonal abnormalities, or the presence of a tumor in the mammary glands. Such anomalous processes cannot be ignored:

• Disturbances in the hormonal system negatively affect the general condition of the body.
• Due to the accumulation of milk, the ducts can become clogged, which is dangerous for inflammation of the breast.
• The development of mastopathy due to changes in the structure of breast tissue.
• The manifestation of seals may have a malignant form.

The further success of the treatment of pathology depends on how quickly diagnostic measures are carried out. It is much easier to get rid of ectasia at the beginning of its development, preventing the disease from worsening, so you should not start the pathological process, hoping that the problem will be solved by itself.

If a woman suspects ductectasia in herself, it is necessary to contact narrow-profile specialists:

• Gynecologist.
• Mammologist.

To confirm the diagnosis, it will be necessary to undergo laboratory and hardware diagnostics.

Laboratory examination of the body involves the delivery of the following tests:

1. Blood test for prolactin or other hormones.
2. Analysis of nipple secretions (the study of a smear allows you to determine the presence of inflammation or tumors).
3. A biopsy is prescribed in case of detection of seals of suspicious origin.

In order to accurately diagnose the present disease, an instrumental examination is prescribed:

If the echo signs detected by ultrasound are not enough for the final diagnosis, while the ectasia is characterized by a complex course, the following is prescribed:

1. Establishment of tumor marker CA 15-3.
2. Radioisotope scintigraphy of the breast.
3. Computed tomography of the chest.
4. Magnetic resonance imaging.

Additional instrumental studies make it possible to differentiate the disease from other serious diseases:

• Paget's disease.
• malignant formations.
• Subareolar abscess.
• Galactophorite.

In addition, a woman will need to consult an endocrinologist, surgeon and oncologist.

If the diagnostic results confirmed the presence of the disease in both mammary glands, then in this case a diagnosis of bilateral ectasia is established.

Directions for the treatment of ductectasia of the mammary glands

The main direction of the therapeutic scheme:

• symptomatic treatment.
• Elimination of the root cause of the disease.

Based on the results of the examination, the patient's state of health, how extensive the symptomatic picture is, as well as the presence of other factors, a method of treating the pathology is determined, which can be:

• Medical.
• Surgical.

As a rule, ductal ectasia is treated with different drugs, depending on the underlying cause of the disease:

1. In the presence of inflammation, antibiotics, non-steroidal anti-inflammatory drugs are recommended in combination with drugs of complex action that help strengthen the body's immune abilities.
2. If the pathological expansion of the ducts is caused by a hormonal imbalance, hormonal medications are prescribed. Doctors warn against self-administration of drugs in this group, which can be dangerous for the body.
3. With severe pain, analgesics are prescribed.
4. In cancerous neoplasms, cytostatics and antitumor drugs are recommended.

The above drug therapy is supplemented by:

• Sedatives.
• Immunomodulatory drugs.
• Vitamins and minerals.
• Physiotherapy.

Of the drugs used, it should be noted:

If drug therapy is ineffective, a decision is made on surgical intervention, especially if large papillomas or polyps are present in the ducts of the gland, and also if:

• Severe pain syndrome.
• Significant deformation of the breast.
• Tumors of malignant etiology.
• Another disease that led to ductectasia.

With ectasia, the following types of operations are practiced:

1. Selective duct lobectomy.
2. Sectoral resection of the gland.
3. Enucleation of a benign formation.
4. Mastectomy (complete removal of the breast).

In oncological course of the disease, surgical treatment is supplemented with radiation therapy.

However, surgical treatment is contraindicated for those women who have heart defects or in the future the patient plans pregnancy and breastfeeding.

With regard to the use of folk recipes, according to official medicine, herbal remedies for plasmacytic mastitis are absolutely inappropriate. Doctors believe that traditional methods are not able to fully eliminate the causes of the disease, but only temporarily stop its signs, which is completely insufficient to completely get rid of the pathology.

Recipes of an unconventional clinic are suitable only as a prevention of possible complications and only with the permission of a doctor, for example:

• Burdock compress. Rinse a fresh burdock leaf well and apply to the chest.
• Herbal infusion. Mix in equal proportions: nettle, burdock root, peony and leuzea. From the resulting mixture, take 1 tsp. raw materials and steamed with 1 liter of boiling water, leave for 8 hours. Take 100 ml 3 times a day. The duration of the course is 1 month.
• Cabbage leaf with honey. It is good to beat off a cabbage leaf, grease it with honey and apply it to the place of the chest where there is pain.

Estimated Forecast

It is almost impossible to predict further consequences from the presence of ductectasia in advance. It all depends on how timely the patient sought medical help, diagnostic results and other factors.

If the disease was stopped at the beginning of its development, then the woman has a good chance of a full recovery. A particularly important role is played by the nature of the present discharge from the nipples:

To avoid the appearance of ectasia, every woman should be attentive to her health. It is enough to follow simple preventive measures:

1. Avoid situations in which trauma to the mammary glands may occur.
2. It is not recommended to resort to plastic surgery on the breast without an urgent need.
3. Control the state of the hormonal background, especially prolactin, while taking into account that some drugs can upset the balance of hormones in the body.
4. Strengthen and support the immune system through physical activity and vitamins.
5. Timely treat any manifestations of inflammation, preventing their transition to a chronic form.
6. Eat right, avoid obesity, give up bad habits.
7. Wear a comfortable bra, adhere to hygiene.
8. Women over 45 have regular mammograms.
9. Systematically visit a mammologist and gynecologist.
10. If ductectasia is suspected, do not delay a visit to a specialist.

Ectasia of the mammary ducts is the expansion of the milk ducts. It can be physiological or pathological - occur against the background of pregnancy, lactation (milk formation in the mammary glands), (against the background of aging processes) or any diseases of the mammary glands.

Some symptoms of pathology can cause alertness regarding the formation of malignant pathology - this is soreness and induration in the nipple-areolar region, as well as discharge from the nipple.

Treatment is determined by the underlying disease, against which the ectasia of the milk ducts occurred. Often, the use of hormonal and anti-inflammatory drugs is enough to stop the manifestations of the disease. But with the ineffectiveness of conservative therapy, surgery can be indicated - up to (complete removal of the mammary gland).

Milk duct ectasia has other names - it is mammary duct ectasia and dilatation of the subareolar canals.

common data

The described condition as an independent disorder is extremely rare - in fact, this is a complication of a number of pathological processes, which is their kind of marker.

The normal lumen of the milk ducts ranges from 1.5 mm at its narrowest point to 2 mm at its widest. It is believed that ectasia of the milk ducts has occurred if the lumen of the ducts increases to at least 3-5 mm or more.

note

The described pathology is most often diagnosed in women in the age category over 40 years. This fact indicates that age-related changes that occur in a woman's body are of greatest importance in the development of ectasia of the milk ducts.

By itself, ductal ectasia of the breast is not a critical condition. But it often occurs against the background of diseases of the mammary glands, the prognosis for which is serious or doubtful.

The reasons

Ectasia of the ducts of the mammary gland is equally capable of provoking both physiological and pathological factors.

Normally, moderate ectasia develops in conditions such as:

• the second phase of the ovulatory cycle;
• pregnancy;
• lactation.

In the first two cases, ectasia means the normal physiological preparation of the mammary glands for lactation. During lactation itself, the milk ducts are able to expand most often with:

• large volumes of produced mother's milk;
• - stagnation of milk in the mammary glands, which indicates violations of the evacuation of milk from the glands.

If ductectasia of the mammary gland is observed during the development of involutive processes (reverse development against the background of wilting and aging), then it can be regarded both as physiological and as pathological, depending on the degree of its manifestations. Normally, this is a slight expansion of the ducts of the mammary gland, which develops against the background of:

• hormonal changes in breast tissue;
• their structural changes.

Pathological expansion of the milk ducts often develops against the background of such diseases and pathological conditions as:

• dishormonal disorders;
• hyperprolactinemia. This is a hormone whose function is to stimulate the development of breast tissue;
• secerating mammary gland - this is the name of the gland, from the nipple of which a pathological secret is constantly secreted;
• inflammatory processes;
• deforming transformations.

Dishormonal conditions most often lead to the development of ectasia of the subareolar canals - those that are under the areola of the mammary gland. This happens when the ratio between the amount of estrogens and gestagens is violated. The reasons for this condition are:

• pathology of the female genital organs;
• disorders of the hypothalamic-pituitary system - a complex of brain structures that performs a regulatory role.

Of all the pathologies of the female genital organs, the most common cause of a dishormonal condition that leads to ectasia of the ducts of the mammary gland is:

• - inflammation of the ovaries;
• - inflammation in the uterine appendages (ovaries and tubes);
• neoplasms are most often voluminous. They can be both benign and malignant;
• - a disease in which endometrial cells (the inner layer of the uterus) appear in extragenital areas.

Hyperprolactinemia plays a further role in the occurrence of ductal ectasia in the breast. Since prolactin is produced in greater quantities, it stimulates the breast tissue even more, and this provokes a constant secretion of milk, which strongly presses from the inside on the milk ducts and thus contributes to their expansion. Hyperprolactinemia can be provoked by such diseases and pathological conditions as:

With a secerating mammary gland, the milk ducts begin to expand due to the fact that pathological secretions enter their lumen, which put pressure on the walls of the ducts. Most often, this pathological process develops in such diseases and pathological conditions as:

• secretory - a change in the tissues of the mammary gland, which develops against the background of hormonal imbalance and is accompanied by the release of a pathological secret from the nipples;
• intraductal papillomatosis of the mammary glands - the formation of small short outgrowths of tissue in the ducts;
• mammary glands. Most often it is intraductal cancer (a cancerous tumor develops inside the milk ducts) and (cancerous lesions of the nipple and areola).

Inflammatory processes in the mammary glands lead to the fact that the normal structure of their tissues changes, which entails a change in the structure of the milk ducts. The following components of the inflammatory process play a role in the development of ductal ectasia:

• swelling of tissues in an acute process;
• proliferation of connective tissue in a chronic process.

Ectasia of the ducts of the mammary gland against the background of its deformation develops almost according to the same "scenario" as ectasia against the background of inflammatory processes. Such a deformation is most often formed against the background of such pathological conditions as:

• traumatic lesion of the mammary gland, suffered in the recent past;
• medical manipulations - diagnostic (puncture) and therapeutic (surgical intervention for a particular disease of the mammary gland);
• germination of tissues by neoplasms - benign and malignant.

Development of the disease

The process of formation of ectasia of the lactiferous ducts consists of several links, the development of which can be triggered by various factors. The following changes are observed:

The described changes can occur with local (local) tissue edema, which develops under such pathological conditions as:

• acute inflammation;
• adhesive process;
• the formation of scar tissue after traumatic injuries of the mammary gland;
• germination of the gland by tumors.

In addition to the processes described, in women in the development of ectasia of the lactiferous ducts, the fact that the breast tissue is stretched due to its sagging, which, in turn, develops due to a decrease in elasticity characteristic of involutive processes, plays a role in the development of ectasia of the lactiferous ducts.

Symptoms

Clinical signs of ductal ectasia of the breast often develop gradually and often appear only with a significant progression of the described disease. The main signs of the described disease are:

• itching or burning in the areola;
• soreness in the same place;
• tissue compaction;
• changes in the nipple;
• discharge;
• skin irritation.

Pain characteristics:

• by localization - in the area of ​​​​the affected milk ducts;
• by distribution - irradiation as such is not observed;
• by nature - pressing;
• by intensity - moderate, with the progression of pathology - increasing;
• by occurrence - mainly appear with a significant expansion of the milk ducts.

Often there is no pain, the patient complains of discomfort.

note

With ectasia of the ducts of the mammary gland, the tissues are often compacted in the subareolar region.

Changes on the part of the nipple are manifested in the form of it:

• offsets;
• retractions;
• deformation.

Discharge characteristics:

• in quantity - scarce or in moderation;
• by frequency - regular;
• by nature - serous or sanious;
• in color - yellowish or whitish;
• by consistency - liquid.

Irritation of the skin occurs due to the described pathological discharge from the nipple on them. It manifests itself in the form of changes in the skin, such as:

• puffiness;
• redness;
• maceration - wet corrosion.

note

If the ectasia of the milk ducts has arisen due to dishormonal disorders, the expansion of the ducts is observed in both mammary glands.

The ducts are affected in only one mammary gland, most often in such pathological conditions as:

• inflammatory processes;
• consequences of trauma;
• volumetric processes (formation of tumors).

Diagnostics

The first task of the diagnostic process is to determine whether breast ductal ectasia is physiological or pathological. Hasty conclusions should be avoided, since sometimes physiological ectasia can flow into pathological. The main thing in the diagnostic process is to identify not only the described pathology, but the reasons that provoked its appearance. To do this, it is necessary to use all available information - the patient's complaints (if any), age characteristics and features of the obstetric and gynecological history, the results of additional examination methods (physical, instrumental, laboratory).

Physical examination of the breast includes:

• on examination - size, symmetry, visible changes (or lack thereof) of the mammary glands, skin changes, the presence of secretions;
• on palpation (palpation) - the consistency of breast tissue, soreness, the presence or absence of seals.

Instrumental research methods used in the diagnosis of ectasia of the ducts of the breast are as follows:

• - a set of methods for examining the breast;
• - X-ray examination of the ducts of the mammary gland with a preliminary introduction of a contrast agent into them. Allows you to evaluate the system of the milk ducts, identify areas of dilation (expansion) and analyze its severity. The method is valuable in identifying intraductal (intraductal) neoplasms;
• radioisotope - the patient is intravenously injected with pharmaceutical preparations with radioisotopes, when examining the breast with a special tomograph, they create a color picture. It determines changes in the mammary gland - in particular, areas of dilated milk ducts;
• - sampling of breast tissue for subsequent examination under a microscope.

Mammography includes examination methods such as:

• x-ray mammography is a survey radiography of the mammary glands in two or three projections;
• ultrasound mammography - with the help of ultrasound in the thickness of the mammary gland, areas of dilation (expansion) are detected - this is a sign of ectasia of the milk ducts;
• tomosynthesis - according to a two-dimensional image of the mammary gland, which is created during this method, the structure of the gland tissues is assessed;
• magnetic resonance (MRI-) mammography - a technique for tomographic examination of the mammary gland;
• optical mammography - breast tissue is examined using optical equipment.

The laboratory methods involved in the diagnosis of the described disease are as follows:

Since ectasia of the ducts of the mammary gland in the maximum majority of cases develops as a complication of its other diseases, it may be necessary to consult related specialists - a gynecologist, endocrinologist, oncologist, dermatologist, surgeon.

Differential Diagnosis

Differential diagnosis of ductal ectasia of the mammary gland is often carried out with such diseases and pathological conditions as:

• galactophoritis - an inflammatory lesion of the milk ducts;
• subareolar abscess - a limited abscess that develops in the tissues under the areola area;
• neoplasms - benign and malignant (including Paget's disease - cancer of the nipple and areola).

Complications

Physiological ductal ectasia of the mammary gland does not pose any risk to the health and life of a woman. But in some cases, it can be accompanied by complications such as:

• galactophorite;
• deformation of the mammary gland - can develop with a significant expansion of the milk ducts.

With the development of the pathological form of the described pathology, complications such as:

• - inflammatory lesions of the skin (most often in the alveolar zone);
• - a non-inflammatory lesion (most often in the alveolar zone).

Both of these complications develop with ectasia of the lactiferous ducts in patients with a secerating mammary gland - their development provokes a constant secretion from the dilated ducts.

It is also possible to develop another pathological condition, which is not a complication of lactiferous duct ectasia, but develops against its background - this is carcinophobia (fear of getting cancer).

Treatment of milk duct ectasia

If the ductal ectasia of the mammary gland has formed due to physiological causes, treatment is not required. However, regular follow-up with a mammologist is indicated.

If the expansion of the ducts of the mammary gland is defined as pathological, the treatment is based on the elimination of the underlying disease, which led to the appearance of the described pathology. Treatment methods can be conservative and surgical.

Conservative therapy is based on the following appointments:

• with dyshormonal disorders - hormonal drugs;
• in inflammatory processes - taking into account the sensitivity of the pathogen and anti-inflammatory drugs (non-steroidal anti-inflammatory drugs, or NSAIDs are often used);
• with a malignant neoplasm - cytostatics.

The following appointments are common:

• immunocorrectors;
• vitamins and minerals (often in the form of complexes).

If ectasia of the ducts of the mammary gland occurs against the background of hormonal disorders, patients are recommended:

• reduce weight;
• adjust nutrition - while the consumption of fatty foods and simple carbohydrates should be reduced (they are rich in buns, cakes, cakes and other sweet products).

Surgical treatment for ductal ectasia of the breast is indicated in the following cases:

• lack of effect from conservative therapy;
• steady progression of pathology and development of complications;
• severe pain syndrome, which is stopped with difficulty;
• severe deformity of the mammary gland;
• cancerous injury.

The type and extent of surgical intervention depends on the type of pathology and the degree of its development. Operations such as:

• selective ductolobectomy - excision of a part of the mammary gland with affected milk ducts;
• husking a benign neoplasm from its bed;
• sectoral resection of the mammary gland - removal of its section;
• Mastectomy is the complete removal of the breast.

In the presence of oncopathology that provoked the development of ectasia of the ducts of the mammary gland, radiation therapy is indicated.

Prevention

The complex of preventive measures that prevent the development of ductal ectasia of the mammary gland is very wide, since ectasia can occur against the background of many diseases of the mammary gland. To reduce the risk of morbidity, important measures are:

Sometimes a woman notices that the nipple and areola of her breast look unusual, there is a release of some kind of liquid. The cause is often a disease such as duct ectasia (ductectasia). His symptoms are quite characteristic, so it is not difficult to recognize him. Laboratory and instrumental diagnostics is a must. You may only have to correct the hormonal background, but sometimes more cardinal treatment is required, which is urgent.

The secretion of milk occurs in the alveoli of the lobules of the mammary gland. Through the ducts, it is brought to the nipples. During lactation, the amount of milk secreted depends on the individual characteristics of the woman's body.

Milk in the breast is formed not only after childbirth, but also throughout the entire reproductive period, however, in the absence of stimulation, its amount is insignificant. Therefore, before reaching the nipples, it resolves.

If for some reason the patency of the duct worsens or the elasticity of the walls is disturbed, then its pathological expansion occurs in some area. By itself, this condition is not dangerous. If, after the detection of symptoms and a mammological examination, it is established that the violations are small and not associated with the formation of tumors, most often only periodic monitoring of the state of the glands or medication elimination of the causes of the pathology is carried out.

Complications of ectasia can be:

• the formation of cysts in the walls of the duct due to uneven stretching of the epithelium lining the lactiferous passage from the inside;
• dangerous accumulation of milk as a result of overlapping passages, which can lead to infectious inflammation of the mammary gland (mastitis);
• a change in the state of the glandular tissue, provoking the development of mastopathy.

Video: What is the danger of ectasia. Diagnosis and treatment

Causes of ectasia

The main factors contributing to the onset of this disease are changes in the hormonal background, leading to an increased content of prolactin, as well as diseases that result in a narrowing of the lumen of the lactiferous passages.

Most often, this condition occurs in women aged 40-45 years (the onset of menopause). It is at this age that there is a decrease in the level of estrogen and an increase in the content of prolactin in the blood. In this regard, the production of milk increases slightly, which causes the expansion of the ducts. At the same time, tissue elasticity decreases due to age-related changes in metabolism and a decrease in collagen content. As a result, after the expansion of the Milky Way, the walls do not return to their original state.

Menopause and associated hormonal disorders create an increased risk of benign and malignant diseases of the mammary glands. Therefore, women of this age are required to pay special attention to the slightest signs of trouble in their condition.

The occurrence of ectasia of the ducts of the mammary gland is also possible in younger women if they have diseases of the ovaries, thyroid gland or other organs of the endocrine system. In postmenopause, ectasia occurs due to involution (aging of tissues, changes in the internal structure of the glands).

Another cause of ectasia is the formation of obstacles to the passage of milk. Blockage of ducts can occur in the following cases:

• pinching with tight linen or squeezing the chest with an uncomfortable body position;
• damage to the ducts due to injuries or as a result of operations on the mammary glands;
• inflammation in any part of the gland;
• proliferation of the epithelium due to abnormal cell development (glandular mastopathy);
• the formation of polyps on the walls of the milk duct;
• the occurrence of intraductal papillomas (growths caused by the human papillomavirus);
• compression of the ducts by benign or malignant tumors of the mammary glands.

Video: Signs, diagnosis and treatment of intraductal papillomas

Symptoms of ectasia

The first thing a woman pays attention to is a change in the shape of the nipple. It becomes wider and flatter, with squeezing of the peripapillary region, the nipple is retracted. White or colored discharge appears, which may indicate inflammation or other pathology. So, spotting occurs in the presence of polyps and papillomas, which are easily injured even with light pressure on the chest. Green and yellow discharge indicates the presence of a cyst or an inflammatory process. Dark and red discharge - with breast carcinoma.

There is swelling in the area of ​​the nipple and areola. The skin in the peripapillary region becomes rough. Red spots appear above the dilated ducts. A woman has a burning sensation and itching in the nipple area. There is pain in the chest.

Diagnosis of ectasia and its causes

After an external examination, the doctor, taking into account the age of the patient and the existing symptoms, suggests the presence of ductectasia. To clarify the diagnosis and establish the causes of the pathology, an examination is carried out using various methods.

Mammography- This is an x-ray of the breast using weak radiation. It is usually used after 40 years. This method can determine the presence and nature of changes in tissues, the shape of the ducts.

ultrasound. This method is especially suitable for examining young women. It allows you to accurately determine the presence of seals and the location of neoplasms.

Ductography- X-ray of the milky passages filled with a contrast agent. The picture gives a picture of their location and change in shape.

Biopsy. With the help of a special needle, a tissue sample is taken in the area of ​​​​the enlarged milky passage. Usually this method is used if there are suspicions about the nature of the neoplasms.

Histological analysis. Examination under a microscope of fluid released from the nipple. The smear determines the presence and type of neoplasms in the ducts of the mammary glands.

Blood analysis for various hormones. Such an analysis is done if there are assumptions about hormonal disorders in the woman's body, that it was they who caused the changes in the milk ducts.

Video: When and how is ductography performed

Treatment

Pathologies detected during the examination are eliminated mainly with the help of drugs of various effects.

When a hormonal failure is detected, hormone replacement therapy drugs are used to reduce the level of prolactin, suppress the production of excess estrogen. If the cause of ectasia is an inflammatory process, antibiotics and anti-inflammatory drugs are prescribed. To increase the body's resistance, vitamin preparations and immunomodulators are used.

Cysts of the milk ducts are usually not removed, but they are pierced and the contents are aspirated, followed by the introduction of antiseptic solutions. If an expansion of large ducts is detected, the lesion is large, a tumor, polyps, papillomas or neoplasms are found, the nature of which could not be accurately determined, then a surgical method of treatment (excision) is used. Excision of damaged ducts and tissues is performed. After the operation, the excised material is subjected to a histological examination, which allows you to say for sure whether the cause of the ectasia was breast cancer.

Prevention of ectasia

Proper self-examination of the breast is of great importance. It is necessary to pay attention to the appearance of compacted areas, changes in the skin, the shape of the breast and nipples, the appearance of discharge. If there are the slightest signs of trouble, you should go to the doctor. Mammological examination should also be carried out for preventive purposes, even in the absence of external signs of pathology. A woman aged 35 years and older should especially carefully monitor the condition of the mammary glands.

In order to maintain the correct hormonal background, it is necessary to avoid the excessive use of hormonal drugs, monitor your weight, treat endocrine diseases, inflammatory and infectious diseases of the genital organs in time. It is necessary to protect the chest from bruises and squeezing.

It is especially important to monitor the condition of the glands during breastfeeding (to prevent the appearance of nipple cracks, stagnation of milk in the breast).