With the sixth week of embryonic development, almost simultaneously with the organs, like the heart and lungs begin to form mammary glands in children. First of all, in the embryonic tissue (мезенхиме) appear dense germination of the epidermis that extend from the armpit up to the groin area. Later, these structures develop into acini and remain only in the area of the chest. And the nipples are formed in the perinatal period (after the 22nd week of gestation) – the spread of the underlying areola мезенхимы. In infants of both sexes, the nipples are located in small niches and shortly after birth, thanks to the proliferation of their environment, and of the connective tissue, they take a normal appearance. All of this – physiology.
However, many pathological processes, which may not corresponding to age, the increase of the breast to the child and also the redness or the seal of the mammary glands in children.
The mammary glands in children in the first year of life
Most term infants in the first days of life – due to the cessation of the influx of cards of sex hormones in the blood – develops the so-called sexual hypertensive. 3-4 days after the birth occurs, the engorgement, or swelling of the mammary glands in children, which can increase in the course of the next 5-7 days. Can be redness in the breast of the child, and from the nipples may appear to have a smaller volume of highlight as fluid milk. This phenomenon also medical doctors call physiological mastopathy infants.
As pointed out by pediatricians, can occur in the seal of the mammary glands in children – just beneath the nipple. The statement is always a block, of size up to 2-3 cm can disappear for a couple of weeks, and can not pass in the space of a few months, until the child is suckled at the breast: some of the children improved sensitivity to the hormone пролактину, that contains the breast milk.
Parents need to know that it is not a disease, but a specific reaction of the body of a child. It is necessary to consult the doctor, but nothing to treat it is not necessary, you have to observe with attention the hygiene. Because his lack of respect full of mastitis (inflammation of breast) a baby that is able to go into an abscess.
And in this case, the causes of diseases of the mammary glands of the child during childhood – the infection, often, stafilo, or streptococcus mutans, and the development of an inflammatory process, which is necessary to treat (see below).
The mammary glands in children of more mature age
The increase of the mammary glands of the child before the onset of puberty, in particular, girls up to 8 years, it is a refusal. By definition, the doctors, is premature telarche, that is, the beginning of the development of the mammary glands before the entrance of the girls during the puberty (which begins after 10 years). Premature telarche considered benign autonomous of the state, so to speak, a process that consists in the development of the mammary glands without the appearance of other secondary sexual characters.
Its causes can be problems with ovaries (cysts), the adrenal glands or the thyroid gland (hypothyroidism), and the use of exogenous hormones or drugs. So, a couple of years ago, turkey (Gazi University, Ankara, turkey) have discovered that the prolonged use of fennel, which is used to adjust the operation of the intestine in children, and facilitate state, when the stomach bloating, causes an increase of the mammary glands in children and can lead to early breast development in girls up to two years. The fact is that the biologically active substances of this plant stimulate the synthesis of estrogen.
It should also be considered that the asymmetrical development of the mammary glands in girls under the age of 12 years corresponds to the characteristics of this process: one of iron (usually to the left) the development of eco, but, in the final analysis, the breast becomes symmetric.
According to some, about 4% of girls with premature telarche occurs central precocious puberty. What does that mean? This is when the increase of the mammary glands in girls starts earlier, 8 years of age and is accompanied by the emergence of hair removal, pubic and axillary areas. Today, there are good reasons to believe one of the main reasons of this disease, mutations in genes of the leptin (Lep) and leptin receptor (Lepr) – пептидного hormone adipose tissue, responsible for the regulation энергообмена in the body. According to a research conducted by endocrinologists, an increase of the mammary glands of a child that almost 80% of the cases occurs when you exceed the weight of his body above average for age index of 9-10 kg.
The causes of the diseases of the mammary glands of the child
Experts call the following causes of diseases of the breast, the child and also their pathological development:
- the damage to the brain (due to infection, intracranial lesions, novo education, or radiation), it slows down the hypothalamic-pituitary-gonadal axis that leads to the premature release of gonadotropic hormones-luteinizing (LH) and follicle-stimulating hormone (FSH);
- mature hypogonadism (reduced testosterone levels in males due to a functional failure of the eggs);
- an ovarian cysts;
- cancer of the ovary;
- innate adrenal hyperplasia;
- embryonic tumor of the hypothalamus;
- the tumor in the pineal body (pinealom);
- the syndrome McKune-Albright (congenital increase production of somatotropic growth hormone, STG).
The mammary glands in children of both sexes, obese, often are raised; in this case, it may form a tumor consisting of fat cells, surrounded by connective tissue – lipoma of the breast.
The guys have age of puberty (over the age of 12 years), it was observed an increase of the mammary glands, which is called juvenile gynecomastia. The reason lies in the increase the production of pituitary follicle-stimulating hormone (FSH). Accordingly, there is a temporary imbalance of sex hormones, which with the time passes.
The pain in the mammary glands, the child, even the hardening of the tissues in the area of the nipple can be the result even the most minor injury.
In teen girls on the background of this age of hormonal instability can be revealed fibrocystic and hyperlastic changes in the chest:
- cyst in the breast the baby (benign rounded education in the form of the internal cavity of the content);
- hyperplasia of the breast to the child – see mammary Hyperplasia
- fibroadenoma (mobile benign tumor)
The prognosis for most benign variety of fibro-cystic mastopathy of good omen. However, with a remarkable proliferation of the epithelial tissues of the breast there is a threat of malignant transformation of the tumour.
Breast cancer the child
In the practice of pediatric breast cancer the child is diagnosed rarely. Most of the problems with the breasts, and in childhood are benign mastopathy and many resolve without specific treatment.
However, there is juvenile secretory cancer – a rare form of disease is more frequent in teenage girls. Secretory breast cancer is a particular variant of invasive carcinoma, characteristic for the smaller patients. It develops slowly in the form of small, ill-defined in ULTRASOUND, single or multiple узелковых neoplasm (of size 0.5-3.5 cm) in the ducts of the mammary glands. Characteristic of this type of tumors is periodic secretory secretions of the tumor cells; in novo-formations can be a microcalcification.
Breast cancer the child to the age of puberty in the form of phylloid cystosarcoma also refers to a rare diagnosis. But it is a tumor, very aggressive, addictive, and parenchyma of the breast, and her skin.
There are other types of cancer that can be spread in the form of metastases in the breast tissue – for example, lymphoma, which affects lymph nodes in the chest area and the armpit; leukemia, soft tissue sarcoma, neuroblastoma, etc.
The causes of the diseases of the mammary glands of the child in case of oncology is often associated with hormonal irregular transition age, and with a predisposition to inherited breast, in particular, mutations of the genes BRCA1 and BRCA2. According to the us National cancer institute (NCI), BRCA1 mutations increase the risk of developing breast cancer (and ovarian) at 55-65%, and BRCA2 mutation – 45%.
The symptoms of diseases of the mammary glands of the child
Briefly list the typical symptoms of the diseases of the mammary glands of the child.
When mastitis in the newborn babies are shown: the increase in the breast with the seal area of the subcutaneous tissue; redness; pain; high body temperature (up to +38°C); can be a worsening of appetite, GASTROINTESTINAL disorders (vomiting, diarrhea). With the development of an abscess temperature rises to +39°C, in the area of redness is formed suppurative infiltration, the child disappeared, and refuses the breast.
For juvenile gynecomastia boys are characterized by: similar with edema, swelling of the mammary glands in children, which occurs under the nipple – with an increased sensitivity of the nipple. And when the gynecomastia, associated with hypogonadism, mammary glands boy form, painful to the touch, the seals, and there are also symptoms such as underdevelopment of secondary sexual organs, the excess of adipose tissue in the upper part of the trunk, pallor of skin, apathy, sleep disorders, etc.
The symptoms of cystic fibrosis disease, and hyperplasia of the breast in adolescent girls may take the form of: increase of the mammary glands after the completion of the menstrual cycle, feelings of fullness in the chest, swelling and pain (pain of varying intensity), the presence in the tissue of the breast elastic, or more solid, rounded nodules or elongated (scarry) neoplasia. When fibrotic pathologies of the education form in the upper quadrant breast. More great education can lead to a change of shape of the glands or their asymmetry. In the affected area can change the color of the skin and the nipple and possible body fluids. In the presence of the cyst, which teenage girls are located under the nipple, often in the skin in the area of the areola, has cyanotic shadow.
You should keep in mind that in many cases the data is a pathology slide without obvious symptoms, and intraepithelial neoplasia is detected random.
Breast cancer, the child can express almost the same symptoms. In addition, often the discomfort and pain can be felt in the armpit, the nipple a little bit retracts inside the areola, and the skin of the breast may appear like an orange peel.
The diagnosis of diseases of the mammary glands in children
Clinical diagnosis of diseases of the mammary glands in children is conducted on the basis of a survey that begins with the examination of a child, and the collection of medical history (including family).
To determine the levels of hormone in the serum of the blood (such as estradiol, prolactin, testosterone, LH, FSH, 17-OPG and DHEA-S, гонадолиберин, somatropin), you need to do a biochemical analysis of the blood. Even the blood is investigated on the AFP – marker germicogenic tumors, alpha-fetoprotein, and markers of tumor growth.
Appointment takes place not only in the breast ULTRASOUND the baby, but ultrasound and ultrasound of the thyroid, adrenal glands and pelvic organs. Mammography children does not take place.
The differential diagnosis of diseases of the mammary glands in children is held with the help of a computer, or magnetic resonance imaging of the adrenal glands and brain structures: pituitary gland, the hypothalamus.
When the cystic fibrosis and hyperplastic changes in the mammary glands – for the elimination of oncology, takes place in thin-needle aspiration biopsy training with histological research received biopsy.
The treatment of the diseases of the mammary glands of the child
The same for all and the treatment of diseases of the mammary glands of a child is impossible, and the therapeutic techniques are in a given diagnosis.
Thus, swelling of the mammary glands in children from the first months of life the treatment has no need, but when mastitis can not do without antibiotics, and sometimes drainage of the abscess (which holds the surgeon in a hospital). And the best prevention of mastitis in children – ideal for cleaning and the right care for the child.
The early treatment of development of the breast does not require any treatment. However, you must keep track of all the changes in the breast size of the girls.
Read more about how to cure premature puberty, read – Precocious puberty – Treatment
The increase of the mammary glands, the guy also requires monitoring, and if the youth of gynecomastia does not pass spontaneously after a couple of years after the initial diagnosis, the doctor endocrinologist – on the basis of the results of the analysis on the level of hormones in the blood – prescribe a hormonal treatment, and recommend wearing the band on the chest.
When a large amount of adipose tissue may also be used in its pumping (liposuction).
Mastitis in girls in the period maturity must be treated by the children's gynecologist. But they can come to the aid of other specialists, because the etiology of the cystic formation is linked to the thyroid, and hyperplasia in the breast the baby can occur because of neuroendocrine diseases and disorders of the hypothalamic-pituitary-gonadal system.
When oncology treatment of diseases of the mammary glands of the child is the ones I the same mode and in the adult (surgery, chemotherapy).