Study of spectrum and clinical profile of benign breast disease in the rural area: is there any change

Background: Recent understanding of pathophysiology and health awareness may have impact on spectrum of benign breast disease (BBD) in rural area. We have analyzed clinical data of 88 cases of BBD for spectrum and clinical profile to compare with present studies.Methods: Clinical records of 88 cases of BBD were reviewed for demographic details, clinical presentation, management and outcome. Recent literature related to BBD in rural area was searched using various search engines. Results of our study were compared with recent studies.Results: Fibroadenoma (FA) was most common condition followed by fibrocystic disease. BBD were common in third decade 46 (52.3%). Lump was present in 87 cases. Lump was painful in 45 (52.3%), and associated with fever in 15 (17.1%) cases. Fine needle aspiration cytology and ultrasound was done in 70 and 32 patients in which diagnostic accuracy with histopathology was seen in 69.7% and 56.2% respectively. Surgical treatment included lumpectomy, lump excision, mastectomy, drainage with debridement and axillary clearance. Three patients of breast tuberculosis were treated with 9 months AKT. When compared with recent studies, over all spectrum was same expect chronic abscess presenting as lump was more in our series.Conclusions: Our study revealed benign neoplasms, inflammatory condition and tumor like lesions in 43.1%, 14.6% and 13.8% cases respectively. FA was the most common lesion. BBD were common in third decade. Except the chronic mastitis, incidence of various types of benign lesions was comparable with those found in other studies. There is not much change in overall spectrum of benign breast disease.

A comparative study with clinico-pathological correlation between ultrasonography, mammography and fine needle aspiration cytology in evaluation of breast lumps in coastal population of Karaikal

Background: Breast cancer is the most common site-specific cancer in women and is the leading cause of death from cancer for women of age 40 to 44 year. It accounts for 33% of all female cancers and is responsible for 20% of the cancer-related deaths in women. However, the vast majority of the lesions that occur in the breast are benign. Aim of the study: To assess the effectiveness of FNAC, Ultrasonography, and Mammography in the evaluation of breast lumps by correlating to histopathology. Materials and Methods: Patients attending Surgery Outpatient Department with breast-related complaints during the period from November 2017 to April 2019 were assessed using Triple assessment. Each patient was subjected to clinical examination, mammography, FNAC, Ultrasonogram and HPE, and the results analyzed. Results: 40 patients were included in the study, with age ranging from 25 years to 60 years. The sensitivity, specificity, positive and negative predictive values of Clinical Examination w a s 87.5%, Balasundaram, A. Nilavazhagan. A comparative study with clinico-pathological correlation between ultrasonography, mammography and fine needle aspiration cytology in evaluation of breast lumps in coastal population of Karaikal. IAIM, 2019; 6(9): 21-27. Page 22 93.75%, 77.77%, 96.77%; FNAC was 87.5%, 100%, 100%, 96.96%; Mammogram was 87.5%, 90.62%, 70%, 96.6%; and SG was 62.5%, 93.75%, 71.42%, 90.90% respectively. Conclusion: In patients with a definite lump, Clinical examination and FNAC alone may be sufficient to rule out malignancy. A mammogram is needed in patients with no clinically palpable lump and to rule out multi-centric and multi-focal disease.

Cytohistological Correlation of Breast Tumors – A case study

Generally patients with breast tumors complain of lump in the breast which may be painful or painless and may be associated with nipple discharge or not. Benign tumors of the breast are common among younger age group <30 years. But the chances of malignancy increases with increasing age. Most of the cases of breast cancer are found in age group >50 years. FNAC forms the initial diagnostic method in patients with breast lump. A total of 250 patients with different breast lesions attended cytology section of our Pathology department for FNAC. Out of which 197 cases came for histopathological correlation in the study period of 2 years from January 2016 to December2017. Among these majority were benign tumors (114 cases) but an alarming number of 51cases were malignant. Next in number were benign breast diseases (24 cases). There was one case each of ductal papilloma, gynaecomastia. The commonest benign breast tumors were fibroadenoma whereas the commonest malignant tumors were infiltrating ductal carcinoma. There was one case each of lobular carcinoma in situ, infiltrating lobular carcinoma, medullary carcinoma, ductal carcinoma in male breast, inflammatory carcinoma, sarcoma breast. Hereby, we have analyzed different types of breast lesions in different age groups based on cytological evaluation followed by its histopathological confirmation.

The value of correction of ultrasound elastography strain rate ratio in BI-RADS grading of breast hyperplasia with fibroadenoma and breast cancer / 重庆医学

Objective To investigate the value of correction of ultrasound elastography strain rate ratio in BI-RADS grading of breast hyperplasia with fibroadenoma and breast cancer.Methods The data of 120 cases of hyperplasia of mammary gland hyperplasia with fibroadenoma and 120 cases of breast cancer confirmed by operation or biopsy in this hospital from January 2012 to October 2016 were analyzed retrospectively.The boundary,shape,echogenicity,aspect ratio,calcification,blood flow distribution,resistance index,BI-RADS grade,ultrasonic elastography strain ratio were analyzed.The value of correction of ultrasound elastography strain rate in breast hyperplasia with fibroadenoma and breast cancer BI-RADS grading ratio were investigated.Results There were significant differences in boundary,rear echo,aspect ratio,calcification,ultrasonic elastography strain ratio between breast hyperplasia with fibroadenoma and breast cancer (P＜0.05);There was no significant difference between the two groups about morphology and internal echo (P＞0.05);Breast hyperplasia with fibroadenoma were mainly 0-Ⅰ in blood flow distribution,RI＜ 0.7,breast cancer showed Ⅱ-Ⅲ,RI≥0.7,the difference was statistically significant (P＜0.05).Ultrasound elastography strain rate ratio improved the diagnose accordance rate of two groups after BI-RADS' classification correction.Conclusion Hyperplasia of mammary glands with fibroadenoma and breast cancer have overlapping ultrasound features.Ultrasound elastography strain rate ratio can improve the diagnose accordance rate of two groups after BI-RADS' classification correction,which has certain clinical value.

Ru-Pi en Medicina Tradicional China: diferenciación y tratamiento / Ru-Pi in Traditional Chinese Medicine: differentiation and treatment

La enfermedad fibroquística constituye la afección más frecuente de la mama durante la etapa de la madurez sexual. Más del 30 % de las mujeres en Cuba la padece. En la Medicina Tradicional China esta se corresponde mayoritariamente con la categoría Ru-Pi. Con el objetivo de identificar las características de esta afección desde la perspectiva de la Medicina Tradicional China, se desarrolló una búsqueda a través de la Biblioteca Virtual de la Salud de Infomed, en varias bases de datos internacionales, y en la Biblioteca del Servicio de Referencia Provincial de Medicina Natural y Tradicional de Matanzas. Fueron revisados 32 artículos y 17 libros sin limitación de año y país, seleccionándose 27 de ellos con calidad, los que se ajustaban a los objetivos de la investigación. Ru-Pi se define ampliamente como un nódulo (o nódulos) de apariencia duradera en las mamas, los que no son supurativos. Se diferencian según el diagnóstico sindrómico tradicional en estancamiento de Qi de hígado, estancamiento de Qi de hígado transformado en fuego, estancamiento de Qi de hígado que concomita con Xu (deficiencia) de Yin y estancamiento de Qi que concomita con desarmonía de los canales Chong y Ren, fundamentalmente. Se expusieron los principios de tratamiento de esta enfermedad y los esquemas terapéuticos definidos según el modelo de la Medicina Tradicional China.

The fibrocystic disease is the most frequent mamma disorder during the stage of sexual maturity. More than 30 % of the women in Cuba suffer from that disease. In Traditional Chinese Medicine, it corresponds mainly with Ru-Pi category. With the aim of identifying the characteristics of this disease from the perspective of the Traditional Chinese Medicine, a search was carried out in the Health Virtual Library Infomed, in several international databases and in the Library of the Provincial Reference Service of Traditional and Natural Medicine of Matanzas. 32 articles and 17 books were reviewed without limitation of edition year and country, choosing 27 of them qualitatively adjusted to the research aims. Ru-Pi is widely defined as a long-lasting appearance nodule (or nodules) in the mamma; these nodules are not suppurative. They are differenced according to the traditional syndrome diagnosis mainly as liver Qi stagnation, liver Qi stagnation transformed in fire, liver Qi stagnation concomitant with Xu (deficiency) of Yin, and Qi stagnation concomitant with Chon and Ren canals disharmony. There it were exposed the treatment principles of this disease and the therapeutic schemes defined according to the models of the Traditional Chinese Medicine.

Clinico-pathologic profile of women with palpable breast lumps in Chitwan Medical College, Nepal.

Background: Spectrum of female breast diseases is manifold and includes various non-neoplastic and neoplastic conditions. This study focused on the clinico-pathological profile of several breast diseases, including fibrocystic change, fibroadenoma and breast carcinoma. Methods: This cross sectional analytic observational study included Fine Needle Aspiration Cytology cases of female breast diseases diagnosed over three years from 2011 to 2014 in Chitwan Medical College Teaching hospital in Central Nepal. Univariate analysis was carried out to find out age group-wise proportion of the diseases in relation to five cytologic categories and various cytomorphologic diagnoses. Independent samples t-test was used to find out the significance of difference between mean age of benign and malignant breast diseases. Results: The proportion of benign, suspicious for malignancy and malignant breast diseases was 90.4 %, 0.8% and 8.8 % respectively. The mean age of patients at diagnosis for benign diseases and malignant disease was 31.7± 10.4 years and 49.2 ± 12.0 years respectively. t-test showed difference in mean age between benign and malignant diseases to be statistically significant (t=8.79, p= <0.001). Fibrocystic change and fibroadenoma were the most common breast disease overall and the most common neoplasm respectively. 58.1 %, 25.9 % and 6.5 % of all carcinoma cases in this study were found below 50, below 40 and below 30 years of age respectively. Conclusions: Fibrocystic change and fibroadenoma are most common disease of breast and most common neoplasm of breast respectively. Breast cancer occurs in younger women in Nepal in comparison to women in developed countries. Therefore, breast cancer prevention programs in Nepal should target young women also.

Comportamiento de la enfermedad fibroquística de la mama según la Medicina Tradicional China. Matanzas, 2012 / Behavior of mamma fibrocystic disease according to Traditional Chinese Medicine. Matanzas, 2012

Se realizó una investigación observacional de tipo transversal, en el período comprendido de agosto de 2011 hasta agosto de 2012, en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez, de Matanzas, con el fin de establecer el comportamiento de la enfermedad fibroquística de la mama según la Medicina Tradicional China. El universo estuvo comprendido por la totalidad de las pacientes diagnosticadas con esta enfermedad, remitidas de la consulta provincial del Hospital Ginecobstétrico Provincial Docente Julio R. Alfonso Medina, de la ciudad de Matanzas. Se incluyeron las pacientes mayores de 18 años, dispuestas a participar en la investigación. Se seleccionó una muestra no probabilística constituida por 100 pacientes a las que se les realizó la historia clínica tradicional y el diagnóstico según la Medicina Tradicional China. La descoordinación entre hígado y bazo-estómago fue el síndrome más significativo. La realización de un diagnóstico tradicional chino permite indicar un tratamiento adecuado e individualizado a cada una de estas pacientes.

We carried out a cross-sectional observational research, in the period from August 2011 to August 2012, in the Clinical Surgical Hospital Comandante Faustino Perez, of Matanzas, with the aim of establishing the behavior of mamma fibrocystic disease according to the Traditional Chinese Medicine. The universe covered all the patients diagnosed with this disease, referred from the provincial consultation of the Teaching Provincial Gyneco-obstetric Hospital Dr. Julio R. Alfonso Medina of Matanzas. There it were included the patients aged 18 years who wanted to participate in the research. A non probabilistic sample composed by 100 patients was chosen. The traditional clinical record was filled out and the patients were diagnosed according to Chinese Traditional Medicine. The most significant syndrome was discoordination between liver and spleen-stomach. Achieving a traditional Chinese diagnosis allows indicating an adequate and individualized treatment to each one of these patients.

Therapeutic Observation of Electroacupuncture plus Topical Laser Treatment for Hyperplasia of Mammary Glands / 上海针灸杂志

ObjectiveTo observe the clinical efficacy ofelectroacupunctureplustopical laser treatmentin treating hyperplasia of mammary glands.MethodFifty-eight patients with hyperplasia of mammary glands were randomized into a treatment group of 30 cases and a control group of 28 cases. The treatment group was intervened byelectroacupunctureplustopical laser treatment, while the controlgroup was by oral administration of Ru Zeng Ning tablets. The intervention began from 15 d prior to the menstrual period. After 3 successive treatment courses, the clinical efficacies were compared, and the efficacies in treating three different patterns of mammary glands hyperplasia were also compared, i.e. qi-stagnation due to liver depression, accumulation of phlegm and stagnation, and imbalance of the Thoroughfare and Conception Vessels.ResultAccording to the comprehensive efficacy evaluation, the total effective rate was 86.7% in the treatment group versus 57.1% in the control group, and the difference was statistically significant (P0.05).ConclusionElectroacupunctureplustopical laser treatmentis effective in treating hyperplasia of mammary glands, especially for the type of qi-stagnation due to liver depression.

Therapeutic Observation of Acupoint Application plusXiao Pi Jianfor Hyperplasia of Mammary Glands / 上海针灸杂志

ObjectiveTo observe the clinical efficacy of acupoint application plusXiao Pi Jianin treating hyperplasia of mammary glands.MethodTotally 103 patients with hyperplasia of mammary glands were randomized into a treatment group of 52 cases and a control group of 51 cases. The treatment group was intervened by acupoint application plus oral administration ofXiao Pi Jian, while the control group was by oral administrationofXiao Pi Jianalone. The criteria for diagnosis and therapeutic evaluation of hyperplasia of mammary glands were adopted in the study.ResultThe total effective rate was 94.2% in the treatment group, significantly higher than 82.4% in the control group(P<0.05).ConclusionAcupoint application plusXiao Pi Jiancan produce a significant efficacy in treating hyperplasia of mammary glands.

Atención a pacientes con afecciones benignas de la mama durante 11 años / Care for patients with benign breast conditions during 11 years

Se realizó un estudio descriptivo, observacional y retrospectivo de 1 551 pacientes con afecciones benignas de la mama, atendidas en el Hospital Provincial Docente "Mariana Grajales Coello" de Santiago de Cuba durante el período 2001-2011, con vistas a mostrar las características clínicas y el tratamiento de estas afecciones. En la serie predominó la displasia mamaria en sus formas fibrosa (39,3 %), adenosis (27,7) y quística (16,6 %), seguidas del fibroadenoma (12,8 %). El dolor prevaleció en todas las féminas con fibrosis; el nódulo, en todas aquellas con fibroadenomas, quiste y papiloma. La descarga por el pezón, estuvo presente en 100 % de las que presentaron ectasia y papiloma, así como también en 75 % de las que afectadas por adenosis. Se aplicó tratamiento higienicodietético y hormonal a 83,7 y a 53,1 % de las integrantes de la serie, respectivamente. Se concluye que las afecciones benignas de la mama, constituyen una causa importante de morbilidad en las mujeres de cualquier edad.

A descriptive, observational and retrospective study was carried out in 1 551 patients with benign breast conditions, attended in "Mariana Grajales Coello" Provincial Teaching Hospital of Santiago de Cuba during the period 2001-2011 in order to show the clinical characteristics and treatment of these conditions. In the series breast dysplasia prevailed with its fibrous (39.3%), cystic (16.6%) and adenosis (27.7%) forms, followed by the fibroadenoma (12.8%). Pain prevailed in all the females with fibrosis; the pump in all women with fibroadenomas, cyst and papilloma. The nipple discharge was present in 100% of those who had ectasis and papilloma, and in 75% of those affected by adenosis as well. Hygienic-dietetic and hormonal treatment was administered to 83.7 and 53.1% of members of the series respectively. It is concluded that benign breast conditions are an important cause of morbidity in women of all ages.

A study of accuracy of triple assessment as a clinical tool for the diagnosis of a palpable breast lump.

Background: Diseases related to breast are the highest in this country as well as in the world. Various types of lesion from inflammation to carcinoma can affect breast. Some lesions are common in young females while others in elderly age group. Early presentation and prompt diagnosis is essential to relieve anxiety of non-neoplastic conditions, and in case of carcinoma, it can save the patient from metastases. In this study many cases related to breast lesions from the region are reported in the surgery clinics of this institute and various breast diseases are being managed in the clinical departments. For disease confirmation, many diagnostic procedures are recommended with aims to help in decision for surgical treatment. To study prevalence of various breast disease condition coming to our hospital and their management. Analysis of pattern and prevalence will be a valuable guideline for clinicians of this location to compare with that of others. This study was to evaluate the accuracy of Triple assessment (physical examination, mammography and fine needle aspiration cytology) as a clinical tool for the diagnosis of a palpable breast lump. Aims & Objective: (1) To study incidence for breast disease; (2) To study etiopathogenesis of it; (3) To study patient presentation and manifestation; (4) To study management of various breast diseases; and (5) To study various modalities of treatment. Material and Methods: This prospective study was carried out in the department of surgery during period from 1st march 2011 to 28th February 2012 in indoor and outdoor patients. Each patient was study in detail with relevant clinical history, examination, mammography and histological findings and management. The study comprised of total 100 patients of breast disease treated with various modalities. Results: In the study of total 100 cases, inflammatory conditions were present in 15%, fibrocystic lesion 35%, fibroadenoma 20%, gynaecomastia 2% and carcinoma 10%. This comparative study reported data by clinical analyses, mammography and histological findings in 100 women with ages from 18 to 60. Malignant carcinoma found in 10% of cases while benign breast disease and other condition found in 90% of cases. Conclusion: Fibrocystic disease was the commonest lesion in this study with 30 years as the average age of presentation. Malignancy was detected above 47 years of age. Ninety patients with breast lumps interpreted by Triple Assessment as benign correlated with the histopathological findings whereas of 10 malignant lumps. This gives Triple Assessment an overall accuracy of 100% in our study.

Estadificación imagenológica de niños y adolescentes con enfermedad fibroquística / Imaging stages of children and adolescents with fibrocystic disease

Se realizó un estudio descriptivo y transversal de los 13 menores de 18 años de edad con enfermedad fibroquística, atendidos en el Hospital Infantil Docente Sur de Santiago de Cuba, desde febrero de 2009 hasta julio de 2010, a fin de obtener los hallazgos imagenológicos de las afectaciones pleuropulmonares y sinusales, así como el estadio clínico en el que se encontraban. Se logró evaluar el pronóstico y gravedad de los pacientes, lo cual permitió indicar un tratamiento oportuno y adecuado.

A descriptive and cross-sectional study of the 13 children under 18 years of age with fibrocystic disease, assisted in the Teaching Southern Children Hospital in Santiago de Cuba was carried out from February, 2009 to July, 2010, in order to obtain the imaging findings of the pleuropulmonary and sinusal disorders, as well as the clinical stage in which they were. It was possible to evaluate the prognosis and the patients' severity, which allowed to indicate an opportune and appropriate treatment.

Expressions of Notch1 and Cyclin D1 in mammary ductal hyperplasia and ductal carcinoma / 中国医师进修杂志

Objective To investigate the relationship between mammary ductal hyperplasia and ductal carcinoma by detecting the expressions of Notch1 and Cyclin D1 in various histotypic mammary ductal diseases.Methods A total cases of 44 normal ductal tissues,44 usual ductal hyperplasias.40 atypical ductal hyperplasias,42 ductal carcinomas in situ and 51 invasive ductal carcinomas were included in this study.Expressions of Notch1 and Cyclin D1 were detected by S-P immunohistochemistry.Results There was significant difference of expression of Notch1 among the five subgroups of this study(P<0.01);there were significant differences between every two subgroups(P<0.05)except for normal ductal tissues versus usual ductal hyperplasias and ductal carcinomas in situ versus invasive ductal carcinomas(P>0.05).There was also significant difference of expression of CychnD1 amongthe five subgroups of this study(P<0.01),and there were significant difference between every two subgroups(P<0.05)except for normal ductal tissues versus usual ductal hyperplasias and normal ductal tissues versus atypical ductal hyperplasia(P>0.05).The correlation between Notch1 and Cyclin D1 was negative (r=-0.428,P<0.01).Conclusions There is a relationship between mammary ductal hyperplasia and ductal carcinoma.Decrease of Nowhl or increase of Cyclin D1 expressions may promote nmnmmry ductal hyperplasia advancing to manunary ductal carcinoma.

Uso del tamoxifeno en las alteraciones fibroquísticas de la mama / Therapeutic use of tamoxifen in the fibrocystic disease of breast

Se realizó un estudio longitudinal, prospectivo observacional en 30 pacientes que acudieron a la consulta externa del servicio de cirugía general del Hospital Militar Clínico Quirúrgico Docente "Octavio de la Concepción y de la Pedraja", en el primer semestre del año 2000 con el diagnóstico clínico de alteración fibroquística de la mama; a las cuales se les aplicó tratamiento con Tamoxifeno 10 mg / por vía oral diario, durante tres meses. Todas las pacientes que conformaron la muestra cumplían dos premisas fundamentales: a) haber procreado, b) rango de edad entre 25-35 años. La efectividad del tratamiento a los tres meses fue excelente, no se observaron efectos adversos.

A longitudinal, prospective - observational study was carried out in 30 patients who attendet to the external consultation of general surgery at " Octavio de la Concepción y de la Pedraja" Miltary - Clinical- Teaching Hospital during the firts semester of 200 with the clinical diagnosis of fibrocystic disease of breats: to whorn a treatment whit tamoxifen 10 mg/ orally/ day during three months was applied . All patients participating in the sample fulfill two main premises: a) to have procreated, b) age group among 25-35 years. Treatment effectiveness after three months was excellent, adeverse effects were not reported. Literature is received.

Experimental Study on Effects of Qingxiang Concentrated Pill on Mammary Gland Hyperplasia in Rats / 中药新药与临床药理

Objective To observe the therapeutic effect of Qingxiang Concentrated Pill (QCP) on mammary gland hyperplasia (MGH) in rats. Methods Injection of estradiol were given to establish rat models of MGH and QCP was given QCP at the same time. Pathologic changes of mammary gland in rats were observed under light microscope. Changes of breast diameter, mammary gland volume and weight were measured; serum sex hormones levels, SOD activity and MDA content were also estimated. Results QCP could decrease the increased breast diameter, mammary gland volume and weight, reduce the numbers of mammary gland lobules and mammary acini and the diameter of acinar cavities. It could also decrease eatradiol level and MDA content in serum, inhibit the decrease of the coefficient of thymus and increase the serum progesterone level. Conclusion QCP can regulate sex hormone levels, inhibit lipid peroxidation and relieve the pathologic changes of mammary gland in MGH rats.

The Clinic Study of Synthesis Imaging Diagnosis in Fibrocystic Disease or Breast / 实用放射学杂志

Objective To analyse the necessity and feasiblity about the diagnosis and classification of fibrocystic disease of breast, through using synthesize imaging methods.to increase the diseases diagnosis rate. Methods Using imaging checks (molybdenum photography,ultrasonography and infra - red scanner) for 600 breast's cases and contrast to pathogenesis if they were done operations. Results 143 cases were normal. 166 cases got other disease of breast,291 cases were fibrocystic disease of breast(48. 1%), 155 cases of them were performed operations and pathogenesis. the diagnosis similar rate between performed operations check and pathogenesis was 83. 2%. Conclusion The sensitivity of three kinds imaging check method is different each other,but one method can give some help each other. The synthesize imaging check can increase the diagnosis rate and avoid mis - diagnosis and doing needless operations.

Cytologic Classification of Fibrocystic Disease of the Breast: A Proposal for Use of Cytologic Criteria Grading System / 대한세포병리학회지

Fine needle aspiration biopsy has been proved as a safe, accurate and cost-effective diagnostic modality in palpable breast lesions. Cytologically, fibrocystic disease can be classified into 3 categories as nonproliferative breast disease, proliferative breast disease without atypia, and proliferative breast disease with atypia. This terminology for the needle aspirates is compatible with that of diagnostic histopathology. Cytologic differentiation of nonproliferative disease from proliferative breast disease is important, since the risk of cancer development in cases of atypical hyperplasia is 4-5 times higher than that of general population. Twenty five needle aspirates of fibrocystic disease confirmed by subsequent histopathology were re-evaluated and classified into 3 categories depending on their architectural and nuclear features. In addition. these aspirates were scored according to the cytologic grading system, devised by Masood et al. and based on six cytologic criteria. Concordance rates between cytomorpholgic diagnosis and cytologic diagnosis using the cytologic criteria grading system and histologic diagnosis were 88% and 92%, respectively.

Comparative study of ultrasonographical and pathological manifestations of juvenile macromastia / 中华超声影像学杂志

Objective To expatiate the ultrasonographical and pathological manifestations of breasts with juvenile macromastia.Methods Four patients with juvenile macromastia were examined by high frequency ultrasonography.The sonographical and pathological images were observed and reported.Results The sonographical characteristics of the breasts with juvenile macromastia were similar: the anatomical structures of the breasts were obscure,which were characterized by cystic formation,reticular structure,patched hypoechoic or hyperechoic regions and distorted gland structure.One patient had fibroadenoma and dermatic erythema.The results of pathological examination showed marked cystic proliferation of glands accompanied with ductal epithelial hyperplasia,irregular ductal distribution,no lobules formation or proliferation of fat tissue,fibrocyte and fibroblast.Conclusions The abnormalities of juvenile macromastia may not only be the huge volume,but also may include abnormal ultrasonographical and pathological manifestations,awaiting more follow-up studies.

Study on Correlativity of TCM Syndrome Types with Sexual Hormones in Patient of Hyperplasia of Mammary Glands / 中医杂志

Objective:To explore relation of TCM syndrome types in patient with sexual hormones of hyperplasia of mammary glands,so as to establish objective indexes of TCM syndrome types of hyperplasia of mammary glands.Methods:112 cases of hyperplasia of mammary glands were divided into 3 types:stagnation of liver-Qi,intermingled phlegm and blood stasis,disharmany of thoroughfare vessel and conception vessel.Level of estradiol(E_2),progestin(PT),testosterone(TT),prolactin(PRL),follicle- stimulating hormone(FSH)and luteotropic hormone(LH)during ovulatory period in the patients were determined.The relation of hormone level with TCM syndrome types was analyzed.Results:Level of LH and E_2 decreased,PRL and PT increased and level of TT and FSH did not significantly change during ovulatory period in the patient of hyperplasia of mammary glands.LH and E_2 level in the patients with stagnation of liver-Qi or intermingled phlegm and blood stasis was significantly lower than normal values,and the level of PRL and PT was significantly higher than that of normal values.The level of LH and E_2 was also lower than the normal value in the patient with disharmany of thoroughfare vessel and conception vessel,but the level of FSH was significantly higher than normal value.Conclusion:The patient of hyperplasia of mammary glands during ovulatory period manifests endocrine dysfunction,and the patients with different TCM syndrome are different in secretion of sexual hormones; Changes of sexual hormones can be used as objective indexes of TCM syndrome types and basis of clinical medicinal application.

Benign proliferative disorders of the breast

Fibrocystic disease of the breast has been generally regarded as a disorder due to either excess hormonal stimulation or an exaggerated proliferative response by hypersensitive breast epithelium. The unique lobular lesion-adenosis- and its variants have been regarded as non-neoplastic and non-preneoplastic glandular hypertrophy and hyperplasia, and have different organoid patterns and origins. We have examined a total of 242 cases previously diagnosed as 'fibrocystic disease' at the Department of Pathology with the purpose of clarifying the variants of adenosis in detail and refining the infinitely large 'fibrocystic disease' classification as non-proliferative fibrocystic change and proliferative disorders, such as epitheliosis and atypical hyperplasia. In this study, 224 cases (92.5%) were nonproliferative disease, mostly adenosis (40.1%), and 18 cases (7.5%) were proliferative disease, which consisted of moderate to florid hyperplasia and epitheliosis.