Milk stasis, bacterial invasion Damage to the nipple allows bacteria to invade along the lymphatic vessels, which is the main route of infection Common bacteria are Staphylococcus aureus and Streptococcus

In the early stage of inflammation, the breasts are swollen and painful, with tender lumps, the surface skin is red and hot, and may also have systemic symptoms such as fever.

Symptoms worsened in the later stages, with pulsating pain, chills, high fever, accelerated pulse rate, swollen and tender axillary lymph nodes on the affected side, and blood WBC ↑

In the abscess stage, the inflammatory mass often softens within a few days to form an abscess. Superficial abscess - fluctuating sensation; deep abscess - often requires puncture to identify. Single or multi-locular abscess, ultimately destroying the breast tissue

outcome

Mammography: Mammography may show localized increases in density, thickening of Cooper's ligament, and even mass formation (due to localized abscesses)

Breast B-ultrasound examination: local echo weakening can be seen, forming a hypoechoic area

Inflammatory period: suspend breastfeeding and promote smooth discharge of milk, apply local hot compress → 25% magnesium sulfate moist heat compress; apply broad-spectrum antibiotics

Abscess stage: timely incision and drainage of pus Deep or retromammary abscess → make an arc incision along the lower edge of the breast and drain it through the retromammary space; subareolar abscess → make an arc incision along the edge of the areola

If the inflammation is obvious but does not fluctuate, puncture/B-ultrasound examination should be performed at the most obvious point of tenderness to detect deep abscesses as early as possible; After incision, fingers should be used to probe into the abscess cavity to separate the intervals between the abscess cavity to facilitate drainage; the drainage tube should be at the lowest position of the abscess cavity

Termination of breastfeeding: when infection is severe or when abscess drainage is complicated by breast fistula

The key is to avoid milk stasis while preventing nipple damage and keeping it clean During pregnancy, nipples should be washed frequently with warm water and soap to correct nipple inversion.

Symptoms: Breast swelling and pain (cyclical) and lumps (tenderness) are related to the menstrual cycle, and the pain is most significant during the premenstrual period; the degree of pain varies, and some lack of cycle

Signs: There are many scattered lumps or nodules in the breast, without obvious boundaries, tough but not hard, on one or both sides of the breast, without adhesions, and can shrink after menstruation; axillary lymph nodes are not swollen. It can be accompanied by nipple discharge, which is yellow-green, brown, bloody, and occasionally colorless serous. The course of the disease is long and the development is slow.

Common tumors in young women and girls, most common in those aged 21-25 years 15% of cases are multiple fibroadenoma Cause: High estrogen levels Clinical manifestations: Except for lumps, patients often have no obvious symptoms. The breast mass is highly mobile, has a smooth surface, is lobulated, has clear boundaries with surrounding tissues, and has no adhesion to the skin; it is painless but may have tenderness. Tumor size does not change after menstruation Treatment: surgical resection + pathological examination

It can be seen in adult women of any age, with the highest incidence occurring in 40-50 years old. 75% occurs in the lactiferous duct below the areola, a single ductal epithelial hyperplastic tumor. The tumor is small, soft, pedunculated and covered with villi. It bleeds easily and is often difficult to touch.

clinical manifestations

Diagnosis and differential diagnosis

Treatment: Early surgery - wedge resection of the breast, intraoperative positioning, intraoperative frozen pathology examination

Certain genetic predispositions (p53 mutations, BRCA1, BRCA2), familial hereditary breast cancer Endocrine causes: role of female hormone E2 Other factors: pregnancy, lactation, benign breast lesions, diet and nutritional status, high-fat diet, obesity, ionizing radiation, breast paralysis

Non-invasive cancer (early stage): intraductal carcinoma, lobular carcinoma in situ

Invasive special cancers: papillary carcinoma, canalicular carcinoma, adenoid cystic carcinoma, medullary carcinoma, mucinous adenocarcinoma

Invasive non-specific cancers (most common): invasive ductal carcinoma, invasive lobular carcinoma, hard carcinoma, simple carcinoma, adenocarcinoma

Direct infiltration (local spread): skin, pectoral fascia, pectoral muscles and other surrounding tissues Lymphatic metastasis: mainly via axillary lymph nodes, intramammary lymphatic vessels Blood supply transfer: transfer to bones, lungs, liver, brain and other parts of the body

symptom

Early days

Late stage

Bone metastasis → bone pain, pathological fracture, inconvenience in walking Lung and pleural metastases are asymptomatic → chest tightness, difficulty breathing, and blood in the sputum. Liver metastasis may be asymptomatic in the early stage. In the later stage, the liver will become enlarged, and the general condition will deteriorate rapidly, with abdominal distension and nodules of different sizes in the liver. Brain metastasis → Symptoms of intracranial hypertension, aphasia, etc.