Kaltsinata of mammary glands — the sites of calcification of soft tissues of breast which arose against the background of or owing to other diseases. Clinically are shown, probed by nothing in exceptional cases: at the big sizes (more than 1 cm) and a hypodermic arrangement. For diagnostics use mammography which is supplemented if necessary with a biopsy. The choice of medical tactics depends on the main disease because of which there was a kaltsination of fabrics. Taking into account the revealed pathology different approaches are applied: from dynamic observation before purpose of hormonal, anti-inflammatory, chemotherapeutic means, performance of operations and radiation.
Kaltsinata of mammary glands
Usually deposits of calcium in one or both mammary glands come to light incidentally at planned mammography. In itself they do not threaten health and the woman's life, however confirm the postponed or existing pathological processes. In 80% of cases of a kaltsinata have an inflammatory, metabolic, disgormonalny or involute origin, and in 20% — are formed owing to development of malignant neoplaziya. With improvement of quality of medical examination and quantity of the carried-out mammographies detectability of kaltsifikat in chest glands increased. Relevance of high-quality inspection at detection of kaltsinat is directly connected with an oncological component of a problem.
Reasons of kaltsinat of mammary glands
Calcification of tissues of breast happens at a combination of local morphological changes of inflammatory, neoplastic or necrotic character and the calcium raised contents in liquid environments of an organism. According to some experts in the sphere of a mammology, the kaltsifikation of fabrics can not only be result of pathological processes, but also to perform protective function, preventing damage of nearby fabrics. Most often lead the following reasons to formation of kaltsinat:
- Stagnation of milk at a lactation. In 100 g of women's milk about 32 mg of calcium contain; pH makes from 6,8 to 7,4, and acidity level normal does not exceed 3-6 °. At a laktostaza processes of lactic fermentation begin, there is local acidosis promoting loss of salts of calcium.
- Diseases of mammary glands. At patients with mastitis, mastopathies and other pathologies of a breast in soft fabrics metabolism changes, the acidic environment favorable for sedimentation of salts of calcium is often formed. Besides, at cancer of mammary glands there is a symptomatic giperkaltsiyemiya.
- Involution of chest glands. At the pathological fibrous and cystous course of involute processes in fabrics of chest glands there are hollow educations with liquid inside. In certain cases their walls obyzvestvlyatsya or the insoluble deposit drops out of contents.
- Giperkaltsiyemiya. One of complications of the increased content of calcium in blood is sedimentation in fabrics. Its level increases at some endocrine and exchange diseases (a giperparatireoza, a gipertireoza, etc.), uncontrollable reception of A and D vitamins, calcium medicines, a number of malignant tumors.
The mechanism of calcification of fabrics is based on ability of salts of calcium to sedimentation in the conditions of local acidosis. Owing to violation of carbohydrate and lipidic exchange and exhaustion of buffer systems at inflammatory process in the center of damage lactic, pyrogrape acid, ketoacids collect, osmotic pressure increases. As a result in a zone of an inflammation the liquid arriving from cages and the vascular course is late. At the increased concentration of calcium in the inflammatory or necrotic center to acidic environment there is a sedimentation of its salts in the form of kaltsinat of a different form and the sizes.
When determining like kaltsinat of a mammary gland consider their quantity, distribution in fabrics, an origin, the sizes and a form. Most often deposits of calcium happen multiple, is more rare — single. They can be formed in congestions with a diameter no more than 1 cm or dissipate diffuzno in ferruterous fabric. Depending on the volume of defeat of a kaltsinata happen segmentary, striking one segment, and regionarny, taking a lacteal share. Sometimes all gland is involved in pathological process. One of the most important criteria of classification is localization. There are following types of calcic educations:
- Pro-current. Are located in lacteal channels. Most often arise after the postponed laktostaz, at ektaziya of channels and intraduktalny cancer of mammary glands.
- Dolkovye. Are formed in ferruterous segments. Are characteristic of an adenoz, fibrous and cystous option of mastopathy and calcification of cysts at pathological involution.
- Stromalnye. Are formed in connecting fabric. Usually are single and arise at fibroadenoma, cysts, lipomas, atherosclerosis of vessels.
The form and the sizes of kaltsinat depend on a disease against the background of which they arose, and localizations. So, pro-current calcifications can be worm-shaped, linear (needle) and faltering (dot), more characteristic of intra pro-current cancer. Dolkovy educations remind a half moon, a bowl or splinters of an egg shell in a form; stromalny have an appearance of grain, popcorn, an oval or are shapeless. Mikrokaltsinata meet at malignant neoplaziya, macroeducations more often — at good-quality processes.
Symptoms of kaltsinat of mammary glands
In the presence of calcic deposits in breast tissues any specific symptoms in most cases are absent. Generally kaltsinata become a casual find at mammography. Patients usually do not show any complaints or note the clinical manifestations characteristic of the main disease — pain, discomfortable feelings in one or two mammary glands, allocations from nipples, consolidations of the different sizes and a consistence. In the presence of large (it is more than 1 cm) the inclusions located closer to the surface of skin, they can be probed in the form of dense painless educations. However such concrements in mammary glands meet extremely seldom.
Kaltsinata in chest gland do not pose any threat to health and quality of life of the woman. The risk arises only when the patient with adjournment of calcium in channels plans to give birth to the child and to nurse it. In similar situations the probability of emergence of a laktostaz and postnatal mastitis increases. At women with a disturbing ipokhondricheskim reaction type at detection the kantserofobiya can develop in tissues of a mammary gland of kaltsinat. The main danger to patients is connected with the disease which led to formation of deposits of calcium, especially if it is about malignant neoplaziya.
At identification in breasts of kaltsinat diagnostic search is directed to assessment of their sizes, a form and the presumable place of localization, and also identification of the reasons which led to adjournment of salts of calcium in a mammary gland. Comprehensive laboratory and tool examination is for this purpose appointed. The most valuable data for statement of the correct diagnosis gives such methods as:
- Mammography. A main objective of a research is receiving preliminary conclusions about an origin of kaltsinat. In a x-ray picture of adjournment usually have the identical sizes, structure, accurate contours and the form characteristic of dolkovy and stromalny educations. In respect of malignant process the multiple mikrokaltsinata and educations with indistinct borders reminding cotton wool pieces are considered suspicious.
- Cytologic research of a bioptat. It is appointed at suspicion that the kaltsifikation of fabrics of chest glands became result of malignant process. Send the fragments of fabrics received by method of a punktsionny biopsy under X-ray control to histology. If the double tonkoigolny biopsy was not informative, the trepanobiopsiya allowing not only to define morphological structure is shown but also if necessary to execute an immunohistochemical research.
As additional methods of diagnostics MPT, KT, a stsintigrafiya of mammary glands, determination of levels of an onkomarker of CA 15-3, the general and ionized calcium of blood, estrogen, FSG, LG can be recommended ultrasonography. Usually difficulties with recognition of the revealed kaltsinat do not happen, differential diagnostics with fibrous and cystous mastopathy is in rare instances carried out. For definition of the reasons which caused a kaltsination the oncologist, the endocrinologist can be involved in inspection.
Treatment of kaltsinat of mammary glands
Therapeutic tactics depends on the reasons which provoked formation of kaltsinat. In the absence of clinical manifestations to patients with large stromalny educations treatment is not appointed, and observation at the mammologist is recommended. The combination of kaltsinat to benign tumors of mammary glands or pathological involution usually demands application of complex medicamentous therapy. The scheme of treatment of such women includes:
- Hormonal medicines. The choice of concrete medicines — inhibitors of secretion of sex hormones, estrogen, gestagen or their combinations — depends on results of a research of a hormonal background. At refusal of the woman of hormonal therapy phytoestrogenic and homeopathic medicines are applied.
- Nonsteroid resolvents. At the majority of diseases in tissues of mammary glands the conditions promoting adjournment of calcic salts remain. Therefore at a pain syndrome or other signs of an inflammation hormonal therapy is combined with a preventive course of anti-inflammatory treatment.
Correction of a diet with restriction or an exception of the products containing large amounts of calcium — milk and fermented milk products, some species of sea fishes (for example, sardines), nuts, almonds, sesame, bean is effective. Do not delete with a surgical way of a kaltsinata because of small effectiveness, technical complexity and invasiveness of operations. If led a malignant new growth of a mammary gland to adjournment of calcium, the suitable method of treatment is chosen by the oncologist-mammologist. At the same time taking into account a stage of process and type of a tumor usually carry out one of mastectomy options with the subsequent purpose of hormonal medicines, himio-and radiotheraphy.
Forecast and prevention
The forecast depends on the main pathology at which there were kaltsinata of mammary glands, at the asymptomatic course and lack of malignant process it is favorable. In the preventive purposes it is recommended to follow rules of breastfeeding. At administration of drugs with calcium and vitamin D it is important to exclude long stay to the sun and visit of sunbeds, during the summer period to apply on skin structures with sun-protection filters. For the prevention of a kaltsifikation of tissues of breast timely treatment of gynecologic diseases, disgormonalny states, maintaining a healthy lifestyle with the sufficient level of physical activity, the correct mode of rest and food are effective.