Under the mysterious term "galactocele"( the word is formed by the fusion of two Greek roots: "gala" - milk and "target" - tumor), a rare enough benign fatty cyst is hidden, the cavity of which is filled with curdled milk.
Most often, a galactocele develops in the mammary gland of a woman who has stopped breastfeeding, although there have been cases of similar formations in pregnant women and nursing mothers. Sometimes a fatty cyst can occur eight to ten months after the cessation of lactation, and it is very rare cases of its formation in children and men.
What is galactocele?
So, in the vast majority of cases, galactocele is formed during lactation, and the main cause of the pathology is a scarring obstruction that clogs one or more of the milk ducts of the mammary gland.
The culprit of scar formation can be an inflammatory process, an anomaly of development or a trauma of the mammary gland.
Since the resulting obstruction leads to stagnation and accumulation of breast milk in the cystic cavity, the galactocele is a typical retention( from Latin "retentio" - retention) cyst.
The site of the localization of the cystic cavity( in the case of a multi-compartmental galactocele there may be several of them), consisting of the glandular tissue of the lobules of the mammary gland and the epithelial cells lining the lacteal duct, is the nasal zone.
Photo galactocele of breast on ultrasound
The content of the cystic cavity depends on the time elapsed since the onset of the pathological process.
Inside it may be:
- curdled breast milk;
- an oily, moistish mass;
- liquid soapy substance.
Depending on this fatty cyst can be:
- oil;
- is damp;
- is a soap body.
There is no statistical data on the dynamics of detection of galactocele cases in the medical literature, it is only noted that they are rather rare.
Causes of
The permeability of the milk ducts can be impaired by fault:
- of congenital anomalies in their anatomical structure ( the ducts may be too narrow or twisted);
- of the transferred injuries of mammary glands;
- infectious inflammatory processes ( the canal can be blocked by its own inflamed walls, sometimes it "clings" under the pressure of inflamed surrounding tissues);
- milk congestion ( lactostasis), which developed due to improper organization of breastfeeding, too much lactation or because of a sharp excommunication of the baby from the breast;
- changes in the biochemical composition of milk ( which occurred under the influence of hormonal disorders and the above factors), which provoked the process of its folding and plugging of milk ducts with particles of a curdled substance.
Symptoms of
- Fatty cyst can be either single or multiple( multicameral).Small new growths, located in the thickest of the breast, can be detected only with ultrasound. A large cyst( sometimes reaching ten centimeters in diameter) can be detected by the patient herself during self-examination of the mammary glands.
- The location of the fat cyst can be any quadrant of the breast, but most often they are formed in the paranasal zone or directly under the nipple.
- Testing the mammary gland, a woman can detect a rounded elastic seal with clear boundaries, not spliced with the skin and easily displaced under the pressure of the fingers. In the initial stage of the pathological process, painful sensations do not occur( the pain of pulling and pulling character is added when you press on an already large cyst or on the chest swollen before the next monthly), and a milk-like liquid can emerge from the nipple.
- Palpating the tumor, the doctor notes the presence of swelling.
- In the case of galactocele, the cystic cavity always contains modified breast milk, the form of which allows you to divide the cysts into the soap, oil, and damp.
- The development of galactocele is characterized by gradualness, painlessness, absence of fever and redness of the skin.
- A ruptured cyst located just under the skin can lead to the formation of a fistula.
- Large-size neoplasm, reaching a late stage, causes the patient pain when wearing too tight clothes.
- Asymptomatic flow is the reason that galactocele can remain undetected for a long time. The walls of a non-growing cyst, which has a small size, are often calcified, soaked with calcium salts, and its contents become dense as a stone.
Diagnosis
For the diagnosis of galactocele, a whole range of laboratory and instrumental studies is needed:
- At the initial examination, the mammologist specialist will necessarily question the patient and palpate the mammary glands.
- Breast ultrasound may detect the presence of a clearly limited oval or round cavity, however, when examining the breast of a nursing woman, the cyst may be hidden by enlarged lobules filled with breast milk. In this case, the mammography procedure will be more revealing.
- Radiographic examination of mammary glands( mammography) helps to reveal the structure and exact dimensions of the cyst, the approximate ratio of protein and fat fractions of its contents, the presence or absence of calcification.
- If the results of the mammography did not give an objective picture, the mammologist can refer the patient to the procedure of doktografiya - contrast radiographic examination of the ducts of the mammary glands. This study allows you to accurately identify the problem area, localization and the number of cystic cavities. Absolute contraindication to this study is breastfeeding and the presence of acute inflammation of the mammary glands.
- The material required for examining the secret contained in the cystic cavity is extracted by a needle-needle puncture followed by vacuum aspiration( suction).The extracted secret, which has a thick creamy consistency, brownish-yellow or greenish( pus-like) color, is immediately sent for cytology and bacterial culture. If the infection does not penetrate the cystic cavity, its contents are sterile.
- If the expert discovers the patient signs of a hormonal failure, she is sent to give a blood test for hormones.
- Galactocele requires compulsory differential diagnosis, excluding the association of the pathological process with malignant and benign( symptomatic picture galactocele very similar manifestations of fibroadenoma) oncology.
Treatment of the breast cyst
The fatty cyst of the breast does not pose a particular danger to the life of the patient.
However, when pathogenic microorganisms get into the cystic cavity a serious inflammatory process is inevitable, fraught with suppuration and an increase in the cyst, which entails the inevitability of surgical intervention.
Tactics of treatment are selected by a specialist on a case-by-case basis.
- Cysts of small size, not delivering discomfort and pain, are subjected to dynamic observation. Sometimes neoplasms of this type dissolve independently.
- Very good effect in the treatment of multiple small cysts gives the use of drugs of female sex hormones. The disappearance of neoplasms occurs as a result of the normalization of the hormonal background.
- The procedure for performing fine needle puncture is very popular with subsequent aspiration( aspiration) of the contents of the cystic cavity under the mandatory control of ultrasound equipment. Use of ultrasound apparatus guarantees the accuracy of surgical treatment. A small puncture made in one place ensures that there is no visual cosmetic defect. The main drawback of this method is the high probability of subsequent relapses, since lobular cells that produce milk remain in a pristine state. If you can not restore the outflow of milk, galactocele, most likely, will arise again.
- Suppuration of the cyst, often accompanied by a vast perifocal process and the formation of a thick-walled capsule, requires an open operation, during which the cystic cavity is uncovered, the pus is drained and the wound drained, following the rules of purulent surgery. In the future, the capsule runs out and secondary seams are applied. Despite a favorable prognosis, such surgery entails the inevitable deformation of the mammary gland( a cosmetic defect can also be associated with scar changes of the operated tissues).In this case, in a remote( no earlier than six months) period, a number of relevant operations are carried out.
- The most effective method of treating a large fatty cyst, excluding the possibility of relapse, is the operation to excise it( together with the membrane) within the healthy tissues, and then suturing the postoperative wound. The duration of the operation, conducted under intravenous anesthesia, is no more than half an hour, the scar it leaves afterwards is almost invisible. In the postoperative period, the patient is prescribed a course of restorative drugs and antibacterial therapy. The length of the rehabilitation period ranges from one to two weeks.
Prevention measures
Prevent the formation of galactocele will help:
- Regular self-examination of the mammary glands.
- Prophylaxis of breast milk stagnation, consisting in the competent organization of breastfeeding. The complex of preventive measures includes the observance of diet and drinking regimen, complete emptying of all lobules of the mammary glands when applying the baby to the maternal breast, wearing a free bra that does not squeeze the breast.
- Thorough hygiene of the mammary glands, which reduces to washing them without using soap, drying the skin, changing the brassiere daily, taking in the air baths for the chest.
- The aspiration of a nursing mother to protect herself from the effects of all kinds of infections to prevent the weakening of the immune system. She should avoid hypothermia and visiting crowded places, fraught with infection with ARVI.
The video shows ultrasound diagnosis of galactocele in the right mammary gland: