Is breast duct dilatation serious?

Some middle-aged and elderly women are troubled by breast duct ectasia all year round. Initially, the breast is just red, swollen and painful. When the nipple is squeezed, there is brown or purulent discharge, and hard lumps of varying sizes can also be felt. Because patients are not examined and treated in time, the acute disease develops into a chronic disease, which is often clinically similar to breast cancer. So, is breast duct ectasia a serious disease?

1. Concept

Mammary duct ectasia is the most common benign nonbacterial inflammatory disease in the non-lactating period. It is common in middle-aged and elderly women, with the peak age of onset being 50-60 years old. Due to its complex and changeable clinical manifestations, it is easily misdiagnosed as breast cancer.

2. Symptoms

1. Acute phase

The early symptoms are not obvious. There may be spontaneous or intermittent nipple discharge when squeezed. The discharge is brown or bloody and purulent. The areola skin is red, swollen, hot and tender. Swollen lymph nodes and tenderness can be felt in the axilla. The whole body may experience symptoms such as chills and high fever.

2. Subacute phase

A slightly painful and tender lump forms on the areola with unclear edges, similar to a breast abscess lump, and varies in size. Puncture of the tumor can often extract pus. Sometimes the tumor ruptures naturally and forms a pus fistula.

3. Chronic stage

One or more hard nodules with unclear boundaries appear on the areola. They feel firm to the touch and are adhered to the surrounding tissues. If they are adhered to the skin, the local skin will appear orange peel-like, the nipple will retract, and in severe cases, the breast will be deformed. Serous or bloody discharge may be seen. Axillary lymph nodes may be palpable.

3. Causes

1. Ductal drainage disorder

For example, congenital nipple deformity, depression, uncleanness or foreign hair and fibers may cause blockage of the nipple pores, abnormal duct development, and poor mammary structure, which may lead to accumulation of secretions in the ducts and cause duct dilatation. In some middle-aged and elderly women, due to ovarian dysfunction, the breast ducts undergo degeneration, leading to accumulation of secretions in the ducts and expansion of the ductal lumen.

2. Abnormal hormone stimulation

Some scholars have found that the levels of sex hormones in patients' blood are abnormal. The levels of estradiol (E2) and luteinizing hormone (LH) in the blood before ovulation are lower than normal, while the level of prolactin (PRL) is higher than normal. Abnormal sex hormone stimulation can induce abnormal secretion of the duct epithelium, causing the duct to dilate significantly.

3. Infection

The disease is accompanied by anaerobic infection or areola infection, which invades the subcutaneous tissue and affects the milk ducts, forming fistulas after penetrating the milk ducts. Or on the basis of duct obstruction, a large amount of shed epithelial cells and lipid secretions accumulate in the duct, escape from the duct wall and decompose to produce chemical substances, causing chemical stimulation and antigenic reaction of the surrounding tissues, causing inflammation dominated by plasma cells.

IV. Hazards

Long-term treatment without cure will cause mental depression and aggravate the symptoms. It can cause serious endocrine disorders, such as irregular menstruation, insomnia, dark skin color, etc. A large number of mammary duct cells and epithelial cells accumulate and die, and once a cystic mass is formed, it is easy to become cancerous.

5. Diagnosis

The diagnosis can be confirmed by X-ray breast ductography, fine needle aspiration cytology of the tumor, and pathological examination after tumor removal.

6. Treatment

The treatment plan at different stages is determined according to different clinical manifestations. The common point of treatment is to remove the dilated mammary ducts in order to achieve the goal of radical cure.

VII. Prevention

1. Women should have regular breast examinations every year to achieve early treatment.

2. Pay attention to personal hygiene. Care should be taken to keep the nipple and areola area clean, appropriate assistance should be provided to clear secretions, and tight underwear should be avoided.

3. Strengthen your physical fitness, pay attention to the combination of work and rest, exercise more, and eat more fruits and vegetables.