Galactocele

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

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Causes galactocele

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

The main causes of galactocele are varied and depend on the conditions and correctness of feeding. If the lactation period is normal, the baby sucks out all the milk, or the woman correctly expresses the rest of the milk, then no problems should arise. Galactocele most often occurs in women who have had problems with lactation of another kind - milk stagnation, mastitis.

Galactocele can form as a result of injuries that leave scars on the milk ducts and disrupt the outflow of milk. Also, obstructions to the outflow of milk can occur after previous infectious processes, for example, after mastitis. Then, scar tissue of the duct also forms. Sometimes, if there are no obvious causes of galactocele, then they tend to believe that the disruption of the outflow of milk is caused by the coagulation of the milk itself in the duct. This cannot be associated with a specific factor, so they tend to believe in the peculiarities of the fat composition of milk.

Considering the fact that galactocele does not form in all women, one of the reasons or predisposing factors is certainly improper care of the mammary gland, disruption of the feeding process, cracked nipples, and sudden hormonal changes. Hormones, oddly enough, play an important role in the process of galactocele formation, since their imbalance causes disruption of the regulation of milk synthesis and secretion. That is, with a sharp drop in prolactin and oxytocin hormones, excessive milk synthesis occurs, and at the same time, the contraction of the muscle fibers of the milk ducts is disrupted, which leads to galactostasis, and then to galactocele.

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Pathogenesis

Galactocele does not develop in one day, but is a long-term process that gradually develops and increases in size.

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

This is the main triggering pathogenetic mechanism for the development of galactocele. Due to the disruption of the secretion outflow, the gland expands and milk accumulates in it. The walls of the expanded gland are the epithelium of the milk ducts, which flattens. The distance between the epithelial cells in the expanded duct also decreases and the process of tissue fluid exchange is disrupted. That is, the secretion that accumulates in the duct cannot be absorbed into the intercellular fluid, and the intercellular fluid does not penetrate the expanded duct. This contributes to the fact that the milk in the blocked duct coagulates even more and the outflow is blocked even more. This is how a cyst is formed.

Over time, the duct epithelium changes under the influence of milk components. This contributes to possible complications.

Dysplasia processes may occur, and in the future this is a high risk of developing an oncological process. The size of the galactocele can increase under the influence of hormones, when the amount of milk increases and the cyst expands.

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Symptoms 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 even cause discomfort. In general, the woman will feel completely healthy. Some pathology can be detected during feeding, when changes in the lactation process are noticeable. Sometimes galactocele is noticed only when it is already quite large and visible to the naked eye or palpated. Then the woman can feel a homogeneous seal under her fingers, which moves well, almost painlessly. There is a clear connection with the lactation period, its disorders. Sometimes, when pressing on this formation, milk can be released from the nipple, but only milk without blood and other elements. Such a finding, as a rule, makes the woman worry and she goes to the doctor, which is very good. Unfortunately, galactocele is not always detected in this way. Sometimes women seek help when complications arise - the addition of an infectious process or dysplastic phenomena.

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

There is no disruption to the woman’s general condition, since the process is local in nature.

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

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Complications and consequences

The consequences and complications of galactocele can be very serious if timely and adequate treatment is not provided. 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 the disruption of the lactation process in the mammary gland. When the process of milk outflow is disrupted, 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 get enough to eat and needs additional feeding, and all artificial mixtures will not replace mother's milk.

Complications of galactostasis are also very serious. Disruption of milk outflow contributes to the fact that the child does not get enough and puts additional effort into the process of sucking the breast. In this case, cracks in the nipple may occur, and this is a direct path to infection of the cyst. Then the process from local can quickly spread to neighboring tissues and mastitis develops.

The most terrible complication is considered to be 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 life and they, under the influence of hypoxia and acidosis, can begin to divide uncontrollably.

If left untreated, galactocele can become an obstacle to breastfeeding future children.

Diagnostics galactocele

Galactocele diagnosis should be timely. This helps prevent complications and quickly restore normal lactation function.

Diagnostics should be comprehensive to establish an accurate diagnosis and exclude other possible diseases. If there are doubts about the etiology or structure of the formation, it is better to conduct additional diagnostic methods to exclude a tumor process.

Diagnosis of galactocele begins with anamnesis. The doctor establishes a clear connection between the onset of symptoms and lactation. During examination, a rounded formation with clear boundaries is found. It is most often localized on the periphery of the mammary gland far from the areola. Galactocele is not fused with surrounding tissues, is slightly painful or completely painless. During palpation, regional lymph nodes are not enlarged. They can react only if an infection occurs.

Additional research methods are required to verify the diagnosis.

Laboratory parameters are determined in order to detect any disturbances in the general condition of the woman. In case of galactocele, the tests are not changed.

If a histological examination is necessary to establish a diagnosis, then a cyst biopsy is performed under ultrasound control and the material is sent for morphological examination. But this is an invasive method that stops the lactation process for some time and should be done for nursing mothers, as a last resort.

Instrumental diagnostics of galactocele allows to clarify the diagnosis. An ultrasound of the mammary gland is performed, which reveals an echogenic shadow of a round shape with clear contours and a horizontal level of stagnant milk. The walls will be compacted with a perifocal reaction in case of inflammation of the galactocele.

Mammography is a more harmful diagnostic method, but also more accurate. It reveals rounded enlightenments with a clear border. In the center, you can often see calcifications of the "egg shell" type.

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Differential diagnosis

Diseases that are accompanied by the appearance of a lump in the mammary gland often cause concern for both the patient and the doctor. This is due to the fact that the formation may be malignant.

Differential diagnostics of galactocele is carried out with benign and malignant tumors of the mammary gland - atheroma, fibroma, fibroadenoma, fibrocystic mastopathy and breast cancer. Given the seriousness of possible diagnoses, it is necessary to clearly differentiate these conditions.

Fibroma and fibroadenoma have a higher density compared to galactocele. Benign tumors are more common in women over forty years of age, and galactocele is more common in young women during lactation.

As for breast cancer, it often has a positive hereditary history - women in one family, often on the mother's side, had breast cancer. When palpated, the malignant formation has unclear edges, is painful, and is fused with surrounding tissues. Lymph nodes in breast cancer are enlarged and palpated.

According to ultrasound and mammography data, it can be established that galactocele has a horizontal fluid level, and benign tumors are homogeneous in structure. Breast cancer has unclear, blurred contours.

Treatment galactocele

Treatment of galactocele should be comprehensive and timely, so as not to disrupt the process of normal lactation. Treatment can be medicinal, surgical, and folk remedies. The effectiveness of one or another method can be discussed in each case individually.

The regimen for this disease is general, since the woman's condition has not changed. It is necessary to follow the rules for caring for the mammary glands, preventing cracks as a possible route of infection.

The diet is without any special features, given the fact that the woman is a nursing mother - hypoallergenic, selective nutrition.

Breastfeeding does not stop.

If the galactocele is small and does not increase in size, it can be monitored with regular examinations. Such a cyst may disappear on its own.

Drug treatment is recommended when endocrine pathology is detected. Then progesterone preparations are used. Such treatment is most often used for numerous small cysts that respond very well to gestagenic preparations. However, if there is no tendency for 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 restore tissue trophism, relax spasmodic muscle fibers of the milk ducts and have a "draining" effect. These drugs include "Mastodynon", "Remens".

Traditional treatment of galactocele

Traditional methods of treatment are often successfully used to treat galactocele. Local remedies are used, as well as herbal treatment.

To reduce swelling and improve milk flow, a cabbage leaf is placed as a compress overnight and it is advisable to do a light massage in the morning.

A compress of heated salt improves blood circulation in the affected area, but you just need to be sure that there is no infectious complication.

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

A compress of vodka diluted equally with water is applied to the chest for two hours and wrapped in cellophane.

Herbal treatment has several methods:

• Chamomile decoction is drunk throughout the day instead of tea, it reduces swelling and improves microcirculation and lymph flow;
• nettle leaves, valerian, ginger root are taken in equal quantities, poured with boiling water, infused and drunk half a glass twice a day;
• A decoction of oak bark, thyme and flour leaves is infused in boiling water and drunk one tablespoon three times a day.

You should not get carried away with folk methods of treatment and if they are ineffective, you need to consider surgical methods of treatment.

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Surgical treatment of galactocele

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

Also, an absolute indication for surgical treatment is suppuration of the cyst - then the abscess is immediately examined in order to prevent mastitis.

There are two types of surgical treatment for galactocele: minimally invasive biopsy and open surgery.

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

Open surgery is performed when the cyst is large or when there is doubt about its benign nature. Then an incision is made over the location of the galactocele and the cyst is resected without violating its integrity. If the cyst is infected, drainage is installed.

Sometimes doctors immediately resort to surgical treatment to prevent complications.

Prevention

Prevention of galactocele, first of all, involves the correctness of the feeding process itself. The child should grasp not only the nipple, but also the areola, this promotes uniform and correct release of milk from the gland ducts. This also prevents the appearance of cracks in the nipple. If the child does not eat all the milk, then its remains should be expressed after each feeding, then stagnation will not form and the outflow of milk will not be disrupted.

It is necessary to follow the rules of care of the mammary gland, do not use soap and do not rub the nipple, and before feeding just wipe it with a drop of milk. All these are elementary questions, but following these rules completely prevents galactostasis and the development of galactocele.

Also, one should not forget about the nursing mother’s regimen, because poor nutrition and stress contribute to hormonal imbalances and the vulnerability of the mother’s body.

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Forecast

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

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