概述
相信不少女性朋友在看到自己的超声结果的时候心头都要咯噔一下:撒子是乳腺囊肿?会变成肿瘤吗?为撒子医生说这个就是个水泡泡喃?我到底要不要管它哦?咋个网上还说这个包包还可能癌变喃!
先不要慌!莫要个人吓个人,今天我们就跟大家摆一摆这个在女性中比较常见的疾病——乳腺囊肿。
乳腺囊肿是乳腺门诊上患者最常见的疾病之一。简单来说就是出现在乳腺某个导管内的液体充盈而形成的圆形或卵圆形的包包。有相关的研究表示乳腺囊肿发病的高峰年龄为35-50。常常是乳房两边长多个囊肿,有时囊肿也只长在一边。这个病没有传染性,也不会遗传给娃娃,但是有一定的可能会复发。
我为撒子会遭乳腺囊肿?
到现在科学家也没完全搞chēn tǒu乳腺囊肿发生的机制,但是目前只能推测它和激素的变化有密切关系。
乳腺受到某些激素和激素波动的影响就容易发生囊肿。而处于绝经前后一段时期的女性身体内的激素水平会发生较大的变化,更有可能发生乳腺囊肿。
我咋个晓得自己遭没遭乳腺囊肿喃?有撒子症状嘞?
遭了乳腺囊肿的患者一般不会感觉乳房疼痛。
有些时候患者也可以摸到自己的乳房里头有包包,摸起可能还感觉是èn邦邦的。这个包包摸起来可能是比较小的,也可能是比较大的。如果有感染,患者可能就会感觉到疼痛。
这个病起病慢,一般都是自检或者体检滴时候发现,感觉自己咪咪摸起有包包就应该马上到医院进行相关检查哈!最好不要自己盲目地去查网上的资料来判断,还是相信要专nie医护人员嘞判断和建议!
自检到底咋个弄嘛?
自检就是自己摸摸乳房(关于乳房自查,大家阔以观看公众号之前发送嘞视频来进行xio习!),确定包包位置、触感和大小。一旦发现有包包咯,就应该马上到医院进行相关检查哈!一定不要自己跑切不正规的小店按摩推拿!(你想把嘞个水泡儿按破咩???包包都是按不脱嘞哈!)也不能自己乱吃药哦!
qie医院会检查xi撒子?
医生阔能给你开嘞检查单单儿包括乳腺彩超、钼靶,有xi情况下还要喊你qie做穿刺活检。彩超是最常用的,阔以区分肿块是液性、实性还是混合性。对于里面是水的囊肿,彩超可以很清楚地发现。有的时候医生为了排除一下你的囊肿是否伴随有其他疾病,也会开个钼靶检看一下有没有钙化、对称性以及结构是否扭曲。而细针穿刺活检(FNA)可以直接ju到包包头,把水抽了,同时还可以用显微镜来看一下水里面有没得癌细胞。医生就是根据这些检查嘞结果来分析你咪咪hou头嘞包包有没得撒子问题哦。
那我嘞个囊肿应该咋个治哇?
乳腺囊肿的治疗方式是需要根据患者的临床表现和超声结果共同来决定的哦!一般来说囊肿的恶变几率很低(<1%),所以患者通常只需要进行密切随访,每6个月进行1次超声影像学复查、每1年进行1次钼靶检查来把包包监控到起!如果发生咯啥子变化,比如suo体积增大和一些其他的病变,医生一般会建议患者进行穿刺活检来qio定其性质。
在一些情况下医生会考虑对囊肿进行针刺抽吸,比如
当患者的囊肿出现了剧烈疼痛,痛嘞遭不住的时候,多半是遭感染咯,阔以把脓抽出来缓解不适。
短时间快速长大的囊肿也要抽,怕有癌变。抽吸本身也是一种治疗,有的包包抽了就好啦,但是有的还会再长。
抽出的液体要病检脱落细胞喔。
如果临床检查和超声结果都显示抽吸后囊肿完全塌陷嘞话,就不需要进一步治疗了哈,但是患者应该在2-4个月时进行临床乳腺检查和/或超声检查来监测到有没得新滴变化。之后就阔以恢复每6-12个月1次的常规筛查(具体检查内容在前文关于囊肿嘞随访提到过哈!)啦。如果抽吸之后出现了复发,就需要做进一步的检查来评估病变的部位,甚至再次抽吸。
那我得了这个病以后得不得遭乳腺癌啊?
很多研究都显示乳腺囊肿病史不会增加患者后续发生乳腺癌滴总体风险!囊内癌很少见,仅占所有乳腺恶性肿瘤的0.1%至1%。前文也提到过,囊肿嘞癌变几率很低,甚至比正常乳腺组织嘞癌变几率还低哈!但是患者还是需要密切随访以监控病情嘞变化,如果包块突然出现改变,比如suo短期内包包迅速变大,或者有其他异常情况发生,嘞个时候就应该引起重视了哈!
得了乳腺囊肿以后,我平常该注意xi啥子喃?
1. 患者应重视定期对乳房进行体检和随访,病情发生变化时应到正规医院进行诊治,不要在非正规医疗场所进行按摩、服药等。(这句话划重点!)同时,日常生活中保持健康均衡饮食、正常运动、心情愉快,培养一个健康嘞生活方式!
2. 囊肿对怀孕没得啥子影响,如果患者有要小宝宝滴打算,是阔以正常怀孕嘞哈!
3. 慎重使用性激素:文章前头提到过,激素阔能与乳腺囊肿的产生有关,因此患者应该减少摄入性激素,对于绝经后女性更是如此。卵巢功能紊乱滴女性,应及时到医院就诊,调节体内激素水平。
参考文献
1. Courtillot C, Plu-Bureau G, Binart N, et al. Benign breast diseases. J Mammary Gland Biol Neoplasia 2005; 10:325.
2. Berg WA, Sechtin AG, Marques H, Zhang Z. Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am 2010; 48:931.
3. Morrow M. The evaluation of common breast problems. Am Fam Physician 2000; 61:2371.
4. Barton MB, Harris R, Fletcher SW. The rational clinical examination. Does this patient have breast cancer? The screening clinical breast examination: should it be done? How? JAMA 1999; 282:1270.
5. Morrow M. Physical examination of the breast. In: Diseases of the Breast, 5th edition, Harris JR, Lippman ME, Morrow M, Osbourne CK (Eds), Lippincott Williams & Wilkins, Philadelphia 2014. p.25.
6. Stachs A, Stubert J, Reimer T, Hartmann S. Benign Breast Disease in Women.Dtsch Arztebl Int. 2019; 116(33-34):565-574.
7. Hughes LE, Mansel RE, Webster DJ. Aberrations of normal development and involution (ANDI): a new perspective on pathogenesis and nomenclature of benign breast disorders. Lancet 1987; 2:1316.
8. Berg WA, Campassi CI, Ioffe OB. Cystic lesions of the breast: sonographic-pathologic correlation. Radiology 2003; 227:183.
9. Kowalski A, Okoye E. Breast Cyst. In: StatPearls. Treasure Island (FL): StatPearls Publishing; September 10, 2020.
10. Mannello F, Tonti GA, Papa S. Human gross cyst breast disease and cystic fluid: bio-molecular, morphological, and clinical studies. Breast Cancer Res Treat 2006; 97:115.
11. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Head and neck cancer. Version 1.2021. Available at: https://www.nccn.org/professionals/physician_gls/ https://www.nccn.org/professionals/physician_gls/ (Accessed on January 29, 2020).
12. Diagnostic Imaging: Breast, Berg WA, Birdwell RL, Kennedy A (Eds), Elsevier, Philadelphia 2007.
13. Sickles EA. Periodic mammographic follow-up of probably benign lesions: results in 3,184 consecutive cases. Radiology 1991; 179:463.
14. Varas X, Leborgne F, Leborgne JH. Nonpalpable, probably benign lesions: role of follow-up mammography. Radiology 1992; 184:409.
15. Guray M, Sahin AA. Benign breast diseases: classification, diagnosis, and management. Oncologist 2006; 11:435.
16. O'Malley FP, Bane AL. The spectrum of apocrine lesions of the breast. Adv Anat Pathol 2004; 11:1.
17. Reynolds HE, Dershaw DD. Fine-needle aspiration and cyst aspiration. In: Imaging-Guided Interventional Breast Techniques, Dershaw DD (Ed), Springer, New York 2003. p.145.
18. NCCN Guidelines Version 1/2011 Breast Cancer Screening and Diagnosis nccn.org/professionals/physician_gls/pdf/breast-screening/pdf (Accessed on July 02, 2012).
19. Chang YW, Kwon KH, Goo DE, et al. Sonographic differentiation of benign and malignant cystic lesions of the breast. J Ultrasound Med 2007; 26:47.
20. Bleicher RJ. Management of the palpable breast mass. In: Diseases of the Breast, 4th, Harris JR, Lippman ME, Morrow M, Osborne CK (Eds), Lippincott Williams & Wilkins, Philadelphia 2010.
21. Daly CP, Bailey JE, Klein KA, Helvie MA. Complicated breast cysts on sonography: is aspiration necessary to exclude malignancy? Acad Radiol 2008; 15:610.
22. Vargas HI, Vargas MP, Gonzalez KD, et al. Outcomes of sonography-based management of breast cysts. Am J Surg 2004; 188:443.
23. Hsu HH, Yu JC, Lee HS, et al. Complex cystic lesions of the breast on ultrasonography: feature analysis and BI-RADS assessment. Eur J Radiol 2011; 79:73.
24. Chuo CB, Corder AP. Core biopsy vs fine needle aspiration cytology in a symptomatic breast clinic. Eur J Surg Oncol 2003; 29:374.
25. Philpotts LE, Hooley RJ, Lee CH. Comparison of automated versus vacuum-assisted biopsy methods for sonographically guided core biopsy of the breast. AJR Am J Roentgenol 2003; 180:347.
26. Youk JH, Kim EK, Kim MJ, Oh KK. Sonographically guided 14-gauge core needle biopsy of breast masses: a review of 2,420 cases with long-term follow-up. AJR Am J Roentgenol 2008; 190:202.
27. Doshi DJ, March DE, Crisi GM, Coughlin BF. Complex cystic breast masses: diagnostic approach and imaging-pathologic correlation. Radiographics 2007; 27 Suppl 1:S53.
28. Bhate RD, Chakravorty A, Ebbs SR. Management of breast cysts revisited. Int J Clin Pract 2007; 61:195.
29. Shin S, Schneider HB, Cole FJ Jr, Laronga C. Follow-up recommendations for benign breast biopsies. Breast J 2006; 12:413.
30. Ashbeck EL, Rosenberg RD, Stauber PM, Key CR. Benign breast biopsy diagnosis and subsequent risk of breast cancer. Cancer Epidemiol Biomarkers Prev 2007; 16:467.
31. Chun J, Joseph KA, El-Tamer M, et al. Cohort study of women at risk for breast cancer and gross cystic disease. Am J Surg 2005; 190:583.
32. Meares AL, Frank RD, Degnim AC, et al. Mucocele-like lesions of the breast: a clinical outcome and histologic analysis of 102 cases. Hum Pathol 2016; 49:33.
33. Mullen R, Pollock AM, Ashton M, Anderson E. Rapidly recurring cysts of the breast: caution needed. Br J Hosp Med (Lond) 2016; 77:599.
34. Ramos V, Fraga J, Simões T, Figueiredo Dias M. Intracystic Primary Squamous Cell Carcinoma of the Breast: A Challenging Diagnosis. Case Rep Obstet Gynecol 2016; 2016:6081634.