Galactocele

Galactocele is one of the problems that can occur in a nursing mother or a woman during the post-lactation period. Along with hypogalactia, mastitis and stagnation of milk, galactocele is one of the leading places in the incidence of women in the lactation period. This problem occurs in many women, but it is not so often diagnosed. Sometimes galactocele is detected even when complications occur. That's why you need to know about this problem and prevent it in advance.

[1]

Causes of the galactocele

Galactocele - a benign formation, inside it is lined with the epithelium of milk ducts and containing milk. In its structure, the galactocele is a cyst formed by an enlarged milk duct. It often develops in women who actively breastfeed, but can also form during pregnancy or a few months after stopping feeding. Therefore, it is rather difficult to establish the exact cause of the galactocele, and each case must be analyzed individually.

The main causes of galactocele are varied and depend on the conditions and the correctness of feeding. If the lactemia period is normal, the baby sucks out all the milk, or the milk is properly decanted by the woman, then no problems should arise. More often galactocele occurs in women who have had problems with lactation of another kind - stagnant milk, mastitis.

Galactocele can be formed due to injuries that leave scarring on the milk ducts and disrupt the outflow of milk. Also, obstacles to the outflow of milk can occur after previous infectious processes, for example, after mastitis. Then the scar tissue of the duct is also formed. Sometimes, if there are no obvious causes of galactocele, they tend to believe that the outflow of milk is caused by the curtailing of the milk itself in the duct. This can not be associated with a certain factor, so they tend to the peculiarities of the fat storage of milk.

Considering the fact that galactocele is not formed in all women, one of the reasons, or predisposing factors, is undoubtedly the wrong care of the mammary gland, the disruption of the feeding process, the crack of the nipple, the sharp hormonal changes. Hormones, oddly enough, play an important role in the process of galactocele formation, because their imbalance causes a violation of the regulation of the processes of milk synthesis and its isolation. That is, with a sharp drop in the hormones of prolactin and oxytocin, excessive synthesis of milk occurs, and at the same time, the contraction of the muscle fibers of the milk ducts is impaired, which leads to galactostase, and then to the galactocele.

[2], [3]

Pathogenesis

Galactocele does not develop overnight, but is a long process that gradually develops and grows in size.

The pathogenesis of galactocele is not so simple. Under the influence of the etiological factor - trauma, infection, hormonal imbalance - the process of outflow of milk is disrupted.

This is the main starting pathogenetic mechanism of galactocele development. Due to the violation of the secretion outflow, the iron expands and the milk accumulates in it. The walls of the enlarged gland are the epithelium of the milk duct, which is flattened. The distance between the cells of the epithelium in the dilated duct also decreases and the process of metabolism of tissue fluids is disturbed. That is, the secret that accumulates in the duct, can not be absorbed into the intercellular fluid, and the intercellular fluid does not penetrate the dilated duct. This contributes to the fact that the milk in the blocked duct is further curled and the outflow is further blocked. So the cyst is formed.

Over time, the duct epithelium under the action of milk components is modified. This contributes to possible complications.

Dysplasia may occur, and in the future this is a big risk of cancer development. The size of the galactocele can increase under the influence of hormones, when the amount of milk increases and the cyst expands.

[4], [5], [6]

Symptoms of the galactocele

Often the disease is asymptomatic. This is due to the fact that the size of the cyst can be so insignificant that it will not cause even discomfort. In general, the woman will feel completely healthy. You can find some pathology during feeding, when changes in the lactation process are noticeable. Sometimes galactocele is noticed only when it is already large enough and can be seen with the naked eye or palpated. Then a woman can feel under her fingers a uniform seal, which is well shifted, almost painless. There is a clear connection with the period of lactation, its violations. Sometimes when you press this formation from the nipple, milk may be allocated, but only milk without blood and other elements. Such a finding, as a rule, causes the woman to become worried and she turns to the doctor, which is very good. Unfortunately, galactocele is not always detected in this way. Sometimes women are treated already in case of complications - joining of the infectious process or dysplastic phenomena.

The first signs of galactocele are the presence of a palpable formation. This formation is more often detected in the premenstrual period, when under the action of hormones it increases in size. It is also often accompanied by painfulness, but not severe pulsating pain, but moderate.

Violation of the general condition of a woman does not occur, because the process has a local character.

Additional symptoms may appear with complications. Increased temperature, severe soreness in palpation, the reaction of regional lymph nodes - all this occurs when microorganisms enter the cyst and the development of the infectious process.

[7], [8]

Complications and consequences

Consequences and complications of galactocele can be very serious in the absence of timely and adequate treatment. This may be due not so much to late diagnosis, but to the asymptomatic course of the disease.

The main and most important consequence of galactocele is a violation of lactation in the mammary gland. If there is a violation of the process of outflow of milk, stagnation occurs and this contributes to poor synthesis. If some part of the duct is blocked, then over time other ducts begin to function insufficiently and this can cause lactostasis. Then the child does not eat up and needs supplementation, and all artificial mixtures will not replace mother's milk.

Complications of galactostasis are also very serious. Breaking the outflow of milk contributes to the fact that the child does not eat up and applies additional efforts to the process of breast sucking. This can cause nipple cracks, and this is the direct route to infection of the cyst. Then the process from the local can quickly switch to neighboring tissues and develops mastitis.

The most terrible complication is the process of dysplasia and further malignancy. Often the process of breast cancer in women is associated with the preceding galactocele. This is due to the fact that the process of prolonged galactostasis in the cyst disrupts all normal processes of cell vital activity and, under the influence of hypoxia, acidosis can begin to be uncontrolled.

If you do not treat galactocele - it can become an obstacle to feeding future children.

Diagnostics of the galactocele

Diagnosis of galactocele should be timely. This helps prevent complications and quickly restore the function of normal lactation.

Diagnosis should be complex for an accurate diagnosis and exclusion of possible other diseases. If there are doubts in the etiology or structure of education, it is better to conduct additional diagnostic methods to exclude the tumor process.

The diagnosis of galactocele begins with an anamnesis. The doctor establishes a clear link between the onset of symptoms and lactation. When examined, the formation of a rounded shape with clear boundaries is detected. It is more often localized at the periphery of the mammary gland far from the areola. Galactocele is not soldered to surrounding tissues, painless or completely painless. At palpation regional lymph nodes are not enlarged. They can react only if an infection is attached.

To verify the diagnosis, additional research methods are needed.

Laboratory indicators are determined in order to detect any violations of the general condition of a woman. With galactocele, the analyzes are not changed.

If a histological examination is necessary to establish the diagnosis, then a cyst is under the control of ultrasound and the material is sent for a morphological study. But this is an invasive method, which for a while stops the process of lactation and it must be done for nursing mothers, as a last resort.

Instrumental diagnosis of galactocele allows you to clarify the diagnosis. Conduct ultrasound of the breast, which reveals an echogenic shadow of a rounded shape with clear contours and a horizontal level of stagnant milk. The walls will be sealed with a perifocal reaction for inflammation of the galactocele.

Mammography is a more harmful method of diagnosis, but more accurate. Revealed enlightenment of a rounded shape with a clear boundary. In the center you can often see calcifications like "eggshells".

[9], [10]

Differential diagnosis

Diseases that are accompanied by the appearance of compaction in the mammary gland, often cause concern, both patients and doctors. This is due to the fact that education can be of a malignant nature.

Differential diagnosis of galactocele is carried out with benign and malignant breast tumors - atheroma, fibroma, fibroadenoma, fibrocystic mastopathy and breast cancer. Given the severity of possible diagnoses, you need to clearly differentiate these states.

Fibroma and fibroadenoma have a higher density, compared with galactocele. Benign tumors are more common in women after forty years, and galactocele - in young women during lactation.

With regard to breast cancer, he often has a positive hereditary history - in women of the same family, more often on the mother's side, there was breast cancer. With palpation, malignant formation has indistinct edges, tenderness, and is welded to surrounding tissues. Lymph nodes in breast cancer increase and are palpated.

According to ultrasound and mammography, it can be established that the galactocele has a horizontal level of fluid, and benign tumors are uniform in structure. Breast cancer has fuzzy blurred contours.

Treatment of the galactocele

Treatment of galactocele should be comprehensive and timely, so as not to disrupt the process of normal lactation. Treatment can be medicamentous, operative, and also alternative means. The effectiveness of some or other methods can be said in each case individually.

The regime for this disease is common, since the condition of the woman is not changed. Follow the rules for the care of the breasts, not allowing cracks, as a possible way of infection.

Diet without any peculiarities, given the fact that a woman feeding her mother is hypoallergenic, selective nutrition.

Breastfeeding does not stop.

If the galactocele is small in size and does not increase in size, then you can observe it with a regular inspection. Such a cyst can disappear by itself.

Medicamental treatment is recommended for the detection of endocrine pathology. Then use progesterone preparations. Such treatment is most often used with numerous small cysts that respond very well to gestagenic drugs. However, if there is no tendency to recovery - it is necessary to consider another method of treatment, mainly surgical.

Homeopathic remedies are also prescribed for galactocele. They improve blood circulation in the mammary gland and resume trophism of tissues, relax the spasmed muscle fibers of the milk duct and exert a "draining" effect. These drugs include "Mastodinon", "Remens".

Alternative treatment of galactocele

Alternative therapies are often successfully used to treat galactocele. They use local remedies, as well as herbal medicine.

To reduce the edema and improve the outflow of milk, a leaf of cabbage is put in the form of a compress for the night and by the morning it is desirable to do a small massage.

Compress of heated salt improves blood circulation in the affected area, but only need to be sure of the absence of an infectious complication.

It is also recommended to grind a tablespoon of honey with the juice of one medium bulb and apply a compress on the formation, twice a day.

A compress of vodka, diluted evenly with water, is applied to the breast for two hours and wrapped in cellophane.

 Herbal treatment has several methods:

•  a broth of chamomile drink during the day instead of tea, it reduces edema and improves microcirculation and lymphatic drainage;
•  leaves of nettle, valerian, ginger root are taken in equal quantities, pour boiling water, insist and drink half a glass twice a day;
•  decoction from the bark of oak, the leaves of the muscular and the thyme are insisted in boiling water and they drink one tablespoon three times a day.

Alternative methods of treatment should not be taken a great interest and if they are ineffective, it is necessary to decide the question of surgical methods of treatment.

[11], [12], [13]

Operative treatment of galactocele

Sometimes surgical treatment of galactocele is used immediately, as the cyst increases in size or initially has impressive dimensions. Therefore, the operative method is not pulled, since the risk of metaplasia increases.

Also an absolute indication for surgical treatment is suppuration of the cyst - then immediately carry out an audit of the abscess with the goal of preventing mastitis.

Operative treatment of galactocele is of two types - minimally invasive biopsy and open surgical.

Biopsy treatment is used under the clear control of ultrasound. A thin needle is inserted into the cyst and aspirated contents of the cyst, then its walls collapse with further scar formation. Another option is possible - when biopsy a sclerosing substance is introduced into the milk duct and the duct "glued together". The sclerosing method is used for small cysts.

Open surgical intervention is performed with a large cyst size or when there is a doubt about the good quality of the character. Then the incision is made over the site of galactocele localization and resection of the cyst is performed without disturbing its integrity. If the cyst is infected, drainage is established.

Sometimes doctors immediately resort to surgical treatment to prevent complications.

Prevention

Prevention of galactocele, first of all, provides the correctness of the process of feeding. The child should not only seize the nipple, but also the areola, this promotes the uniform and proper allocation of milk from the duct of the gland. It also prevents the appearance of nipple cracks. If the child does not eat all the milk, then its remains must be decanted after each feeding, then there will not be stagnation and the outflow of milk will not be disturbed.

It is necessary to adhere to the rules for caring for the mammary gland, do not use soap and do not rub the nipple, and before feeding just rub a drop of milk. All these are basic questions, but compliance with these rules completely prevents galactostasis and the development of galactocele.

Also, do not forget about the feeding mother's regime, because poor nutrition and stress contribute to hormonal failures and vulnerability of the mother's body. 

[14], [15], [16], [17]

Forecast

The prognosis of galactocele in terms of recovery is favorable. But, like any other disease, there is a risk of complications, so early diagnosis and qualified treatment hinders the appearance of these complications. If conservative treatment does not help for a long time, then you should protect yourself and be treated surgically. The prognosis of recovery in this case is high. The prognosis in terms of malignancy is a fairly high probability of metaplasia only with prolonged course and in the absence of adequate treatment.

Galactocele is a problem that bothers many women of the lactation period, but not every woman knows the specifics of this process. This benign education and it can be easily cured, the main thing in time to seek help. But it is even easier to prevent it - because proper breastfeeding will bring pleasure to your baby and keep you healthy.