What causes breast adenosis with duct ectasia?

Mammary gland disease with duct ectasia is a disease caused by the female breast. It has many causes, such as infection, abnormal hormone secretion, etc. This situation has a great impact on the human body, and may cause breast pain or nipple retraction. If people want to treat it, they must understand what causes it. Here we will introduce how breast adenosis with duct ectasia is caused.

Plasma cell mastitis, abbreviated as plasma cell or ductitis, is also called duct ectasia, and is called comedonal mastitis in traditional Chinese medicine. It is the most common non-bacterial inflammation in the non-lactating period. Over the past few years, we have cured more than 160 cases through surgery, which shows that this disease is not uncommon. However, many people, even some surgeons, do not recognize this disease and treat it as a common small abscess. They perform repeated incisions and drainage. The wounds simply do not heal, or they become repeatedly red and swollen, spontaneously rupture, and form fistulas. Finally, the breasts become riddled with holes, the nipples become inverted, and become twisted and deformed.

There is no consensus on its cause, which may be related to ductal excretion disorders, abnormal hormone stimulation, infection and other factors.

The cause of this disease is unclear, but because it is common in middle-aged and elderly people, it may be a degenerative change related to inverted or deformed nipples, squamous epithelium extending into the inner wall of the duct, causing blockage of keratinized scales, or lipid secretions irritating the duct wall, causing inflammation, scar hyperplasia and secondary infection. Autoimmune disease is also possible, because in the later stages of the disease, it is often accompanied by plasma cell mastitis. In the pathology, a large number of plasma cell infiltrations are common, and the lesions recur repeatedly, so some people believe that it is an autoimmune disease.

Pathogenesis

The pathogenesis of mammary duct ectasia is still controversial in academia. Generally speaking, there are the following views:

Mammary duct dilatation is associated with inflammation

1. Catheter excretion disorder:

(1) Congenital nipple deformity, depression, uncleanness or foreign hair and fibers may cause blockage of the nipple pore, abnormal duct development, poor mammary structure, epithelial hyperplasia, inflammation, injury, etc., which may cause duct stenosis, interruption or occlusion. Poor duct drainage is often the main reason for the progression of the galactorrhea stage to the lump stage.

(2) Secretions accumulate in the duct, causing duct dilatation.

(3) In some middle-aged and elderly women, due to ovarian dysfunction, the mammary ducts undergo degeneration, the duct walls relax, and the contractility of the myoepithelial cells decreases, leading to accumulation of secretions in the ducts and expansion of the duct lumen, causing this disease.

2. Abnormal hormone stimulation:

Abnormal sex hormone stimulation can induce abnormal secretion of the duct epithelium, causing the duct to dilate significantly.

Generally speaking, the presence of obstruction alone without abnormal hormonal stimulation to promote epithelial secretion will not cause duct dilatation.

3. Infection:

It may be related to anaerobic infection or areola infection.

After a more detailed study, Adai (1933) found that in the later stages of the disease, the secretions of the mammary ducts not only stimulate the ductal dilation, but also overflow from the ducts, producing chemical substances after decomposition, which cause chemical stimulation and antigenic reaction of the surrounding tissues, leading to an inflammatory reaction around the ducts characterized by plasma cell infiltration, and named it "plasma cell mastitis".