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Echo signs of focal scar formation after. Ultrasound diagnosis of an incompetent scar on the uterus in the long-term postoperative period

The problem of neoplasms in the mammary gland can affect any woman at any age, regardless of her social status. In order to detect breast disease in time, it is very important to start diagnosis in a timely manner. A hypoechoic neoplasm means that its structure does not differ from the structure of the tissue. Typically, such an ultrasound conclusion indicates that additional research is needed to clarify the diagnosis.

Features of hypoechoic formation

In most cases, types of breast cancer are: The echostructure of the tumor varies and depends on many factors: the presence of areas of necrosis, fibrosis, calcifications, etc.

You need to know that this is not a final diagnosis, but only a description of the structure of the tumor.

It is only detected. During this procedure, the ultrasonic sensor produces high-frequency sound vibrations. The device also picks up reflected signals.

Evaluation of the ultrasound waves emanating from the transducer is very subjective. It depends on many factors:

wave frequencies;
some anatomical features of a person;
doctor's qualification level;
completeness of information about the signs of a particular disease in the patient.

The hypoechogenicity of an object in the mammary gland depends on the acoustic density of its tissue. In the photo it will appear as an area with a dark color. In this area, high-frequency sound moves much slower than in any other space. These characteristics most often have an object filled with liquid.

What does it mean if a deviation is detected in the mammary gland?

The presence of a hypoechoic formation on the image indicates such diseases.

Breast carcinoma. It has unclear contours, as well as an acoustic shadow. In addition, it is uneven in its structure.
Adenosis. This pathology has similar signs - unclear boundaries and hypoallergenicity.
Typical cyst. She has reduced echogenicity. A typical cyst has regular and clear contours.
An atypical cyst has very thick walls. There is noticeable growth inside it.
the presence of clear and even contours. It looks like a malignant object with slow growth.

Diagnostics of the mammary glands also helps to detect. Using ultrasound, the presence of painful phenomena in the mammary gland, hypoechoic rims, etc. is determined.

What pathologies does this formation indicate?

The presence of a hypoechoic object in the mammary gland causes. Tumors that give a stellate appearance of the pattern have a scirrhous type of structure. One or more areas of fibrous tissue are visualized in the center of the tumor. Along the periphery of such tissue there are areas of tumor cells formed from epithelial tissue. Ultrasound examination of the breast may reveal infiltrative ductal cancer.

Hypoechoic content is also characteristic of medullary and colloid cancer tumors. Medullary cancer has a round or lobular shape. The lobules are very clearly demarcated from each other and do not have a capsule inside. With the growth of such a tumor, dead areas with a lack of echogenicity are found.

Sometimes anechoic areas may indicate the presence of an area of active growth of a malignant tumor in the mammary gland. These types of cancer are rarely seen after menopause.

Colloid cancer grows very slowly. Its cells produce large amounts of mucous secretion. Colloid formation in the mammary gland is characterized by reduced echogenicity.

Intracavitary cancer is also quite rare. Cavity hypoechoic formation with thickened walls and growths often occurs in elderly patients. The difficulty of diagnosis is that they are not easy to differentiate from benign formations.

Hypoechoic structures in the mammary gland also indicate the development of an edematous-infiltrative form of malignant neoplasm. Clinically, this cancer is characterized by redness as well as thickening of the skin. In some cases, it becomes like a lemon peel. The image shows a thickening of the skin, an increase in the echogenic ability of fatty tissue, as well as the presence of hypoechoic tubular structures.

With metastases to the mammary gland, a hypoechoic formation with a heterogeneous structure is visualized. Its shape is round and has definable contours. Metastases can also be located in the area under the skin.

Echogenicity of benign tumors

Among all benign tumors, the most common. It is usually formed as a result of improper development of the gland. The size of fibroadenoma can vary. Occasionally - no more than 20 percent of cases, they are multiple.

Echographically, this is a formation with clear and smooth edges. Compressing a fibroadenoma with a sensor leads to a sliding effect, that is, the tumor moves in the surrounding tissues. If the size of the tumor is less than one centimeter in diameter, such a formation has the correct structure and shape. The larger the size of the fibroadenoma, the more often its hypoechoic rim is detected. In one out of four cases, microcalcifications are visualized.

A fibroadenoma more than 6 cm in diameter is gigantic. It is characterized by the severity of the acoustic shadow. Hypoechoic fibroadenoma is usually poorly defined if the mammary gland has a lot of fatty tissue.

Phylloid tumor is very rare. In one out of ten cases, it can degenerate into sarcoma. The benignity or malignancy of such a tumor can only be determined histologically.

The ultrasound picture of the lipoma is also hypoechoic and homogeneous. If there are hyperechoic inclusions in it, a rim sometimes stands out. Sometimes it can be quite difficult to determine on ultrasound due to the high content of adipose tissue in the mammary gland.

Further diagnostics of the breast

As already mentioned, the presence of a hypoechoic formation in the mammary gland is an indication for further diagnostics in order to clarify the diagnosis. So, detects newly formed tumor structures.

And also power Doppler sonography is a highly informative type of research. Thanks to them, it is possible to detect a much larger number of tumor formations.

In addition, the following methods are used to diagnose the mammary gland:

breast tissue biopsy;
computed tomography;
magnetic resonance imaging;
Mammoscintigraphy.

Mammography breast cancer

Women should remember that after reaching the age of forty, all women should undergo regular mammograms. Computed tomography and magnetic resonance imaging provide the most accurate diagnostic results.

Mammoscintigraphy is one of the newest types of breast examination. The doctor determines the nature of cancer in the gland using radioactive substances. Women do not need to be afraid of using such substances, as they are harmless.

And of course, every woman should pay special attention to self-examination of the mammary glands. In most cases, women go to the doctor after noticing a suspicious tumor.

Conclusion

Hypoechoic formation of the mammary glands does not yet indicate the malignancy of the process. However, it can be a sign of many diseases. Only a comprehensive diagnosis can accurately determine the disease.
Women should not be afraid of further diagnostic measures after an ultrasound examination. In most cases, they help make the correct diagnosis and prescribe effective treatment.

A histologically altered area of the uterine wall, formed after its damage during surgical and diagnostic interventions or trauma. It is not clinically evident in non-pregnant women. During gestation and childbirth, it may be complicated by a rupture with corresponding symptoms. To assess the condition of scar tissue, hysterography, hysteroscopy, and ultrasound of the pelvic organs are used. In case of threatening rupture, methods of dynamic monitoring of the condition of the fetus are recommended (CTG, Dopplerography of uteroplacental blood flow, ultrasound of the fetus). Pathology cannot be treated, but is one of the key factors influencing the choice of natural or surgical delivery.

General information

According to various sources, in recent years the number of pregnant women with a uterine scar has increased to 4-8% or even more. On the one hand, this is due to more frequent births by cesarean section (in Russia, up to 16% of pregnancies are completed this way, and in Europe and the USA - up to 20%). On the other hand, thanks to the use of modern surgical techniques, the reproductive capabilities of women diagnosed with uterine fibroids or anatomical abnormalities of this organ have improved. In addition, if indicated, gynecologists are increasingly deciding to remove fibroids at 14-18 weeks of pregnancy. The high likelihood of complications during pregnancy and childbirth in the presence of a scar on the uterine wall requires a special approach to their management.

Causes of uterine scar

Scarring of the uterine wall occurs after various traumatic effects. The most common reasons for the replacement of myometrial muscle fibers with scar tissue are:

C-section. Planned or emergency delivery is completed surgically by suturing the incision. This is by far the most common cause of uterine scars.
Gynecological surgeries. Scar tissue in the uterine wall forms after myomectomy, tubectomy for ectopic pregnancy, reconstructive plastic surgery with removal of the rudimentary horn of the bicornuate uterus.
Uterine rupture during childbirth. Often, when the body or cervix ruptures beyond the internal os, a decision is made to preserve the organ. In this case, the wound is sutured, and after its healing, a scar is formed.
Damage due to invasive procedures. Perforation of the uterine wall can result in surgical abortion, diagnostic curettage, and much less often, endoscopic procedures. After such damage, the scar is usually small.
Abdominal injury. In exceptional cases, the integrity of the uterine wall is damaged by penetrating wounds of the abdominal cavity and pelvis during road accidents, industrial accidents, etc.

Pathogenesis

The formation of a scar on the uterus is a natural biological process of its restoration after mechanical damage. Depending on the level of general reactivity and the size of the incision, rupture or puncture, healing of the uterine wall can occur in two ways - through restitution (full regeneration) or substitution (incomplete restoration). In the first case, the damaged area is replaced by smooth muscle fibers of the myometrium, in the second - by coarse bundles of connective tissue with foci of hyalinization. The likelihood of connective tissue scar formation increases in patients with inflammatory processes in the endometrium (postpartum, chronic specific or nonspecific endometritis, etc.). It usually takes at least 2 years for scar tissue to fully mature. The functional viability of the uterus directly depends on the type of healing.

Classification

The clinical classification of uterine scars is based on the type of tissue that replaced the damaged area. Specialists in the field of obstetrics and gynecology distinguish:

Wealthy scars- elastic areas that are formed by myometrial fibers. Able to contract at the moment of contraction, resistant to stretching and significant loads.
Incompetent scars- low-elastic areas formed by connective tissue and underdeveloped muscle fibers. They cannot contract during contractions and are not resistant to rupture.

When determining the examination plan and obstetric tactics, it is important to take into account the localization of scars. The lower segment, body, and neck with the area adjacent to the internal pharynx may be scarred.

Symptoms of a scar on the uterus

Outside of pregnancy and childbirth, cicatricial changes in the uterine wall do not manifest themselves clinically. In the late gestational period and childbirth, an incompetent scar may diverge. Unlike primary rupture, clinical manifestations in these cases are less acute; in some pregnant women, symptoms may be absent at the initial stage. If there is a threat of recurrent rupture in the prenatal period, the woman notices pain of varying intensity in the epigastrium, lower abdomen and lower back. A depression may be felt on the wall of the uterus. As the pathology worsens, the tone of the uterine wall increases, and bloody discharge from the vagina appears. Touching a pregnant woman's belly is extremely painful. A completed rupture in the scar is indicated by a sharp deterioration in health with weakness, pallor, dizziness, and even loss of consciousness.

Rupture of an old scar during childbirth has almost the same clinical signs as during pregnancy, however, some features of the symptoms are due to labor. When damage to the scar tissue begins, contractions and attempts intensify or weaken, become frequent, irregular, and stop after rupture. The pain felt by a woman in labor during contractions does not correspond to their strength. The movement of the fetus along the birth canal is delayed. If the uterus ruptures along an old scar with the last push, there are initially no signs of a violation of the integrity of its wall. After the separation of the placenta and the birth of the placenta, the typical symptoms of internal bleeding increase.

Complications

Cicatricial changes in the uterine wall cause abnormalities in the location and attachment of the placenta - its low location, presentation, tight attachment, accretion, ingrowth and sprouting. In such pregnant women, signs of fetoplacental insufficiency and fetal hypoxia are more often observed. With a significant size of the scar and its localization in the isthmic-corporal department, the threat of placental abruption, spontaneous abortion and premature birth increases. The most serious threat for pregnant women with scar changes in the uterine wall is uterine rupture during childbirth. This pathological condition is often accompanied by massive internal hemorrhage, disseminated intravascular coagulation syndrome, hypovolemic shock and, in the vast majority of cases, antenatal fetal death.

Diagnostics

The key task of the diagnostic stage in patients with a suspected uterine scar is to assess its consistency. The most informative examination methods in this case are:

Hysterography. The failure of scar tissue is evidenced by the altered position of the uterus in the pelvic cavity (usually with its significant displacement forward), filling defects, thinning and jagged contours of the inner surface in the area of possible scar.
Hysteroscopy. In the area of scarring, retraction may be observed, indicating thinning of the myometrium, thickening and whitish coloration in the presence of a large mass of connective tissue.
Gynecological ultrasound. The connective tissue scar has an uneven or discontinuous contour, and the myometrium is usually thinned. There are many hyperechoic inclusions in the uterine wall.

The data obtained during the research is taken into account when planning the next pregnancy and developing a plan for its management. From the end of the 2nd trimester, such pregnant women undergo an ultrasound scan of the uterine scar every 7-10 days. Fetal ultrasound and Dopplerography of placental blood flow are recommended. If a threatening rupture along the birth scar is suspected, the shape of the uterus and its contractile activity are assessed using an external obstetric examination. During ultrasound, the condition of the scar tissue is determined, areas of thinning of the myometrium or its defects are identified. Ultrasound with Doppler and cardiotocography are used to monitor the fetus. Differential diagnosis is carried out with threatened abortion, premature birth, renal colic, acute appendicitis. In doubtful cases, examination by a urologist and surgeon is recommended.

Treatment of uterine scar

Currently, there are no specific methods for treating scar changes on the uterus. Obstetric tactics and the preferred method of delivery are determined by the condition of the scar zone, the characteristics of the gestational period and childbirth. If an ultrasound scan has determined that the fertilized egg has attached to the wall of the uterus in the area of the postoperative scar, the woman is recommended to terminate the pregnancy using a vacuum aspirator. If the patient refuses an abortion, regular monitoring of the condition of the uterus and developing fetus is ensured.

Prognosis and prevention

Choosing the right obstetric tactics and dynamic monitoring of the pregnant woman minimizes the likelihood of complications during pregnancy and during childbirth. For a woman who has undergone a cesarean section or gynecological surgery, it is important to plan a pregnancy no earlier than 2 years after surgery, and if pregnancy occurs, regularly visit an obstetrician-gynecologist and follow his recommendations. To prevent re-rupture, it is necessary to ensure a competent examination of the patient and constant monitoring of the scar, to choose the optimal method of delivery, taking into account possible indications and contraindications.

Scars and constrictions of scar tissue: Surgeries on the liver, kidneys and other organs leave scars. The easiest to detect is scar tissue that forms after ablation operations for tumors of large parenchymal organs, such as the liver. Constrictions of scar tissue that exist for several or decades can cause local anatomical changes.

An example of such changes is a displacement of organs upper floor of the abdominal cavity to the left side, which usually occurs after a partial gastrectomy or other extensive surgery in the upper floor of the abdominal cavity (impossibility of visualizing the displaced gallbladder or pancreas due to adhesions between these organs and the intestinal loops covering them).

Surgical interventions on the chest: chest surgery can also cause anatomical changes in the upper abdominal cavity. An example of such changes may be upward displacement of the liver due to paralysis of the phrenic nerve on the right side and impaired mobility of the lung (for example, due to adhesions to the basal pleura). In these cases, as a rule, the liver and spleen are not visualized by ultrasound.
Recommendations for performing ultrasound:
The liver and gallbladder are identified in the high intercostal plane on the right side.
The pancreas is determined after the stomach is filled with fluid.

Organ transplants:
Typical localization of the renal allograft in the pelvis, denervation and expansion of the pyelocaliceal system. Caution: This condition may be mistaken for urinary tract obstruction.

Pneumobilia: Air is always present in the bile ducts after surgical reconstruction of the bile-intestinal anastomosis and is often found in them after endoscopic papillotomy (complete sphincterotomy). Under the circumstances, this is considered a normal pattern. Cholangiectasia (asymptomatic dilatation limited to the extrahepatic bile ducts): can form as a result of cholecystectomy. however, it is more often associated with age-related changes.

Intestinal anastomoses and intestinal resection: ultrasound assessment is possible only in certain cases, for example, with repeated stenosis of the ileocolic anastomosis in Crohn's disease, with hepato(choledocho)jejunostomy in carcinoma.

Pathological fluid accumulations

When managing postoperative patients, ultrasound is most useful for detecting or excluding pathological fluid collections.

Accumulation of fluid along the periphery of parenchymal organs, accumulations between intestinal loops and in the pouch of Douglas are considered normal for the postoperative period. Larger collections of fluid with clinical manifestations are suspicious in terms of ascites, intra-abdominal bleeding, suppuration or leaks (bilious, from the gastrointestinal tract or pancreas). Caution: A relatively harmless hematoma may be mistaken for a seroma or abscess.

Any surgical intervention is a great test for the patient’s body. This is due to the fact that all his organs and systems are under increased stress, no matter whether the operation is small or large. It especially affects the skin, blood vessels, and, if the operation is performed under anesthesia, the heart. Sometimes, after everything seems to be over, a person is diagnosed with “seroma of the postoperative suture.” Most patients do not know what it is, so many are frightened by unfamiliar terms. In fact, seroma is not as dangerous as, for example, sepsis, although it also does not bring anything good with it. Let's look at how it happens, why it is dangerous and how it should be treated.

What is it - postoperative suture seroma?

We all know that many surgeons perform “miracles” in the operating room, literally bringing a person back from the other world. But, unfortunately, not all doctors conscientiously perform their actions during the operation. There are cases when they forget cotton swabs in the patient’s body and do not fully ensure sterility. As a result, in the operated person, the suture becomes inflamed, begins to fester or separate.

However, there are situations where problems with the stitch have nothing to do with medical negligence. That is, even if 100% sterility is observed during the operation, a liquid that looks like ichor or pus of a not very thick consistency suddenly accumulates in the patient’s incision area. In such cases, they speak of seroma of the postoperative suture. What it is, in a nutshell, can be said this way: it is the formation of a cavity in the subcutaneous tissue in which serous effusion accumulates. Its consistency can vary from liquid to viscous, the color is usually straw-yellow, sometimes supplemented with blood streaks.

At-risk groups

Theoretically, seroma can occur after any violation of the integrity of lymph vessels, which do not “know how” to thrombose quickly, as blood vessels do. While they are healing, lymph continues to move through them for some time, flowing from the rupture sites into the resulting cavity. According to the ICD 10 classification system, seroma of the postoperative suture does not have a separate code. It is assigned depending on the type of operation performed and the reason that influenced the development of this complication. In practice, it most often occurs after such cardinal surgical interventions:

abdominal plastic surgery;
cesarean section (this postoperative suture seroma has ICD 10 code “O 86.0”, which means suppuration of the postoperative wound and/or infiltration in its area);
mastectomy.

As you can see, it is mainly women who are at risk, and those who have solid subcutaneous fat deposits. Why is this so? Because these deposits, when their integral structure is damaged, tend to peel off from the muscle layer. As a result, subcutaneous cavities are formed, in which fluid begins to collect from the lymph vessels torn during the operation.

The following patients are also at risk:

those suffering from diabetes;
elderly people (especially overweight);
hypertensive patients.

Reasons

To better understand what it is - postoperative suture seroma, you need to know why it forms. The main causes do not depend on the competence of the surgeon, but are a consequence of the body’s reaction to surgical intervention. These reasons are:

Fat deposits. This has already been mentioned, but we will add that in overly obese people whose body fat is 50 mm or more, seroma appears in almost 100% of cases. Therefore, doctors, if the patient has time, recommend liposuction before the main operation.
Large wound surface area. In such cases, too many lymph vessels are damaged, which, accordingly, release a lot of fluid and take longer to heal.

Increased tissue trauma

It was mentioned above that seroma of the postoperative suture depends little on the conscientiousness of the surgeon. But this complication directly depends on the skills of the surgeon and on the quality of his surgical instruments. The reason why seroma can occur is very simple: the work with the tissues was carried out too traumatically.

How to understand this? An experienced surgeon, when performing an operation, works with damaged tissues delicately, does not squeeze them unnecessarily with tweezers or clamps, does not grab them, does not twist them, and performs the incision quickly, in one precise movement. Of course, such jewelry work largely depends on the quality of the instrument. An inexperienced surgeon can create a so-called vinaigrette effect on the wound surface, which unnecessarily injures the tissue. In such cases, the ICD 10 code for seroma of the postoperative suture can be assigned as follows: “T 80”. This means “a complication of surgery not noted elsewhere in the classification system.”

Excessive electrocoagulation

This is another reason that causes suture gray after surgery and to some extent depends on the competence of the doctor. What is coagulation in medical practice? This is a surgical procedure performed not with a classic scalpel, but with a special coagulator that produces a high-frequency electric current. In essence, this is a targeted cauterization of blood vessels and/or cells by current. Coagulation is most often used in cosmetology. She has also proven herself excellent in surgery. But if it is performed by a physician without experience, he may incorrectly calculate the required amount of current or burn excess tissue. In this case, they undergo necrosis, and neighboring tissues become inflamed with the formation of exudate. In these cases, seroma of the postoperative suture is also assigned the code “T 80” in ICD 10, but in practice such complications are recorded very rarely.

Clinical manifestations of seroma of small sutures

If the surgical intervention was on a small area of skin, and the suture turned out to be small (accordingly, the doctor’s traumatic manipulations affected a small volume of tissue), the seroma, as a rule, does not manifest itself in any way. In medical practice, there are cases where patients did not even suspect it, but such a formation was discovered during instrumental studies. Only in isolated cases does a small seroma cause minor pain.

How to treat it and is it necessary to do it? The decision is made by the attending physician. If he deems it necessary, he may prescribe anti-inflammatory and painkillers. Also, for faster recovery, the doctor may prescribe a number of physiotherapeutic procedures.

Clinical manifestations of seroma of large sutures

If the surgical intervention affected a large volume of the patient’s tissue or the suture was too large (the wound surface is extensive), the occurrence of seroma in patients is accompanied by a number of unpleasant sensations:

redness of the skin in the suture area;
nagging pain that gets worse when standing;
during operations in the abdominal region, pain in the lower abdomen;
swelling, bulging of part of the abdomen;
temperature rise.

In addition, suppuration of both large and small seromas of the postoperative suture may occur. Treatment in such cases is very serious, including surgical intervention.

Diagnostics

We have already discussed why seroma of a postoperative suture can occur and what it is. Treatment methods for seroma, which we will consider below, largely depend on the stage of its development. In order not to start the process, this complication must be detected in time, which is especially important if it does not announce itself in any way. Diagnostics is carried out using the following methods:

Examination by the attending physician. After surgery, the doctor is required to examine his patient's wound daily. If undesirable skin reactions are detected (redness, swelling, suppuration of the suture), palpation is performed. If there is a seroma, the doctor should feel fluctuation (flow of liquid substrate) under the fingers.

Ultrasound. This analysis perfectly shows whether or not there is accumulation of liquid in the seam area.

In rare cases, a puncture is taken from the seroma to clarify the qualitative composition of the exudate and decide on further actions.

Conservative treatment

This type of therapy is most often practiced. In this case, patients are prescribed:

antibiotics (to prevent possible further suppuration);
anti-inflammatory medications (they relieve inflammation of the skin around the suture and reduce the amount of fluid released into the resulting subcutaneous cavity).

Nonsteroidal drugs such as Naproxen, Ketoprofen, and Meloxicam are more often prescribed.

In some cases, the doctor may prescribe anti-inflammatory steroids, such as Kenalog, Diprospan, which block inflammation as much as possible and accelerate healing.

Surgical treatment

According to indications, including the size of the seroma and the nature of its manifestation, surgical treatment may be prescribed. It includes:

1. Punctures. In this case, the doctor removes the contents of the resulting cavity with a syringe. The positive aspects of such manipulations are as follows:

can be performed on an outpatient basis;
painlessness of the procedure.

The disadvantage is that the puncture will have to be done more than once, and not even twice, but up to 7 times. In some cases, it is necessary to perform up to 15 punctures before the tissue structure is restored.

2. Installation of drainage. This method is used for seromas that are too large in area. When drainage is placed, patients are simultaneously prescribed antibiotics.

Folk remedies

It is important to know that regardless of the reasons for the seroma of the postoperative suture, this complication is not treated with folk remedies.

But at home, you can perform a number of actions that promote healing of the suture and prevent suppuration. These include:

lubricating the seam with antiseptic agents that do not contain alcohol (“Fukorcin”, “Betadine”);
application of ointments (Levosin, Vulnuzan, Kontraktubeks and others);
inclusion of vitamins in the diet.

If suppuration appears in the suture area, you need to treat it with antiseptic and alcohol-containing agents, for example, iodine. In addition, in these cases, antibiotics and anti-inflammatory drugs are prescribed.

In order to speed up the healing of sutures, traditional medicine recommends making compresses with an alcohol tincture of larkspur. Only the roots of this herb are suitable for its preparation. They are washed well from the soil, crushed in a meat grinder, put in a jar and filled with vodka. The tincture is ready for use after 15 days. For a compress, you need to dilute it with water 1:1 so that the skin does not get burned.

There are many folk remedies for wound healing and surgery. Among them are sea buckthorn oil, rosehip oil, mumiyo, beeswax, melted with olive oil. These products should be applied to gauze and applied to the scar or seam.

Postoperative suture seroma after cesarean section

Complications in women whose obstetrics were performed by caesarean section are common. One of the reasons for this phenomenon is the mother’s body, weakened by pregnancy, and unable to ensure rapid regeneration of damaged tissues. In addition to seroma, a ligature fistula or keloid scar may occur, and in the worst case scenario, suppuration of the suture or sepsis. Seroma in women giving birth after cesarean section is characterized by the fact that a small dense ball with exudate (lymph) inside appears on the suture. The reason for this is damaged blood vessels at the site of the incision. As a rule, it does not cause concern. Seroma of postoperative suture after cesarean does not require treatment.

The only thing a woman can do at home is to treat the scar with rosehip or sea buckthorn oil to speed up its healing.

Complications

Postoperative suture seroma does not always go away on its own and not in everyone. In many cases, without a course of therapy, it can fester. This complication can be provoked by chronic diseases (for example, tonsillitis or sinusitis), in which pathogenic microorganisms penetrate through the lymph vessels into the cavity formed after surgery. And the liquid that collects there is an ideal substrate for their reproduction.

Another unpleasant consequence of seroma, which was not paid attention to, is that it does not fuse with muscle tissue, that is, the cavity is constantly present. This leads to abnormal skin mobility and tissue deformation. In such cases, repeated surgery must be used.

Prevention

On the part of the medical staff, preventive measures consist of strict adherence to the surgical rules of the operation. Doctors try to perform electrocoagulation more gently and injure less tissue.

On the part of patients, preventive measures should be as follows:

Do not agree to surgery (unless there is an urgent need) until the thickness of the subcutaneous fat reaches 50 mm or more. This means that you first need to do liposuction, and after 3 months, surgery.
After surgery, wear high-quality compression stockings.
Avoid physical activity for at least 3 weeks after surgery.

When a doctor diagnoses a focal breast formation, most women do not quite understand what it is. Many begin to panic and think that it is cancer, others ignore this phenomenon. Both are wrong, there is no need to panic - most often these are benign formations, but it is not safe to ignore this process.

In essence, it is a single tumor or many smaller tumors. The formation may have clear and even contours, or they may be blurred. A benign formation, when it reaches a large size, can put pressure on the tissues located around it, and their blood circulation will become worse. If left untreated, such formations are prone to degeneration into malignant tumors.

Pathology occurs in women of different ages. The main task of doctors is to diagnose this formation in time, stop its growth and prescribe adequate treatment so that there are no consequences in the future.

Experts are confident that focal formation in the mammary gland occurs as a result of hormonal changes.

This is influenced by:

Increased production of estrogen. In this case, the balance of hormones is disrupted, and estrogens begin to inhibit the functioning of other hormones.
Indiscriminate and unauthorized use of hormonal contraceptives. These drugs should be prescribed by a doctor in accordance with the woman’s individual condition and tests.
Doctors are confident that contraceptives themselves do not greatly affect the hormonal balance of the female body, but their long-term use can increase the risk of the formation of both benign and cancerous formations in the breast.
Ovarian dysfunction and the inability to conceive, as a consequence.
Hormone replacement therapy, which is prescribed to women undergoing menopause. There are statistics that indicate that while taking such drugs, a certain mechanism is triggered in a woman’s body, provoking the formation of new tissue cells.
Inflammatory processes in the inside of the uterus, for example, endometritis.
Stressful conditions.
Poor nutrition, which affects metabolic processes in the body, is at risk for women who are overweight; the fact is that estrogens are contained precisely in fat cells.
Inflammatory or infectious diseases in the thyroid gland.
Inflammatory processes in the fallopian tube, pathologies of the uterus and its appendages.
Abortion is a strong hormonal stress for the body.
Osteochondrosis developing in the thoracic spine.
Rarely, but it affects dysfunction of the gallbladder and the pathways that excrete bile.
If a woman has formations in other organs, the likelihood of a formation in the breast increases significantly.

Varieties

Benign tumors have different symptoms; doctors classify them as follows:

diffuse mastopathy;
nodular mastopathy;
tumor-like processes and benign tumors;
leaf-shaped tumor and other acute forms.

Diffuse mastopathy most often has dysplasia in both mammary glands. The main symptoms of this formation, as well as focal mastopathy, are pain in the mammary gland, which becomes stronger before and during menstruation. A substance may be released from the nipples that is not associated with lactation. It depends on the type of mastopathy whether all these symptoms will be present or just one.

Most often, focal and nodular mastopathy occurs in women who are in the premenopausal period. The duration of the menstrual cycle can be more than 35 days, which does not affect the very nature of menstruation. The duration of menstruation itself also increases - 10 days or more.

Clinical picture

If the formations are small, then they may not cause any inconvenience to the woman and can only be palpated with a thorough examination of the mammary gland. When the formations begin to actively develop, the woman begins to feel unwell. A nagging pain sensation appears in the chest; when you raise your arms up, the mammary gland becomes lumpy. On palpation, a compaction is felt, which causes pain to the woman, especially if pressure is applied to it.

A woman may be bothered by a feeling of fullness in her chest, there may be a burning sensation and redness. If the disease has spread to the area of the milk ducts, discharge may begin from the nipples with or without blood. A change in the shape of the mammary gland occurs when the tumor reaches a large size.

Often a woman experiences such symptoms only during her period, and the rest of the time her breasts can behave calmly. If an infection occurs, purulent discharge may be released from the nipples, the skin may turn red and even acquire a bluish tint. Body temperature rises, inguinal and axillary lymph nodes protrude greatly.

Diagnostics

When a woman, on her own or at a mammologist’s appointment, discovers that she has a lump in her breast, she is offered various diagnostic procedures.

These include:

Palpation of the breast.
Take a general blood test.
Do a plasma test for hormones.
Do an ultrasound of the breast. Typically, this research method is offered to women under 35 years of age, because for this age this diagnostic procedure is the most accurate.
Get a mammogram. In this case, the mammary gland is examined using X-rays with a very low concentration of rays. It is prescribed to women after 35 years of age. The examination may show large formations in the mammary gland; if necessary, an ultrasound is performed to identify small formations.
In special cases, the doctor may ask for a CT scan. This is a very informative diagnostic study, but to date there is no evidence that this procedure does not negatively affect the human body. Therefore, before agreeing to it, you should clearly know that it is really necessary.
At the slightest suspicion of malignancy, the doctor gives a referral for a biopsy to find out if there are mutations in the cells. If the cellular material taken for biopsy is purple or brown in color, and also if the study revealed that the number of epithelial cells exceeds the norm, then the suspicion of malignancy increases.
If necessary, examination of lymph nodes located nearby is carried out.
To examine the blood vessels and identify disturbances in the blood flow, the woman is referred for Doppler sonography.
There is another research method - chromoductography - diagnostics of the mammary gland using a contrast agent.

Treatment

Unfortunately, there is no conservative treatment for focal formations - only surgery. The patient is given general anesthesia and undergoes resection of the mammary gland, while histological and cytological examination of the tumor is performed.

There is no clear differentiation between a benign and a malignant tumor, therefore, in order not to miss a malignant tumor and to prevent the degeneration of a benign tumor into a malignant one, the doctor suggests that the woman undergo a resection as quickly as possible. During the operation, the patient's breast is removed down to healthy tissue. To completely defeat the disease, a woman after surgery must strictly follow the recommendations and instructions of doctors.

To normalize hormonal levels, vitamin therapy is prescribed. The use of non-steroidal anti-inflammatory drugs, such as Indomethacin or Naproxen, is mandatory. To normalize metabolic processes and the activity of the gastrointestinal tract, hepatoprotectors are indicated.

Since the operation was a strong stress for the woman’s body, it was impossible to do without psychotropic drugs. The doctor will definitely prescribe herbal medicines that have proven themselves very well in mammology: Klamin, Mastodion, Klimadion, etc.

Despite the fact that focal formation in the mammary gland is a serious and quite dangerous disease that requires long-term and thorough treatment, if you consult a doctor in a timely manner, recovery will come faster. Be healthy!

Video

You will learn about formations in the mammary glands and methods of their treatment from our video.

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Focal formation of the mammary gland - what is it and how to treat it

Focal formation of the mammary gland - what is it, how to recognize the disease, and why is it dangerous? According to open WHO data, more than half of girls and women from all over the world have an increased risk of benign mammary dysplasia (this is what focal mastopathy and similar diseases of the connective tissue of the breast are called).

The main danger of benign changes in the breast is that they are difficult to recognize at an early stage. The clinical picture depends on the individual characteristics of the organism. At the beginning of development, the disease practically does not manifest itself.

Classification of focal formations

Since symptoms vary greatly and diagnosis is difficult, doctors for a long time could not accept a single classification for focal formations.

Currently, most experts adhere to the division into four main groups of diseases:

Diffuse mastopathy.
Nodular mastopathy.
Benign tumors and tumor-like neoplasms without the risk of degeneration.
Unspecified forms of mastopathy (for example, leaf-shaped tumor).

The most common form of mastopathy is nodular or focal. It occurs against the background of a diffuse form of the disease in the absence of treatment.

For each of the four categories, different methods of therapy are used. They usually depend on the size of the affected area and the reasons for the development of the tumor.

How does the disease manifest itself?

Focal mastopathy is manifested by a number of symptoms that can easily be confused with ordinary malaise or other breast diseases. Due to the vague symptoms, every woman should know the main manifestations of the disease and consult a doctor in time if mastopathy is suspected.

First, let's look at the typical signs of diffuse mastopathy. It is manifested by changes in the tissues of both mammary glands. Some discomfort may occur before menstruation - breast swelling, aching pain. The disease manifests itself more clearly when it becomes focal or nodular.

Symptoms more characteristic of nodular mastopathy:

Mastalgia is the scientific name for breast pain. The pain intensifies in the first and last days of the cycle.
Lumps, nodules in the chest, which are best palpated at the beginning of the cycle.
Nipple discharge.

Symptoms may be mild and often go unnoticed for a long time. The only reliable diagnostic tool is instrumental examination, ultrasound or mammography.

The severity of symptoms depends on the stage of mastopathy, the type of disease and the general condition of the body. To make a diagnosis, you need to undergo an examination; a conclusion is not made based on complaints and examination. This is due to the fact that serious malignant processes in the early stages can be disguised as mastopathy.

Development of the disease

Nodular or focal mastopathy most often develops in women between 35 and 50 years old. Often changes in the breast begin during the premenopausal period. It is believed that the trigger for mastopathy is hormonal changes. First, a diffuse form occurs, then it develops into nodular fibrocystic mastopathy.

The disease is difficult to identify because there are no clear symptoms. In patients, the menstrual cycle does not change (sometimes it may change slightly upward), and there is no severe pain.

From a physiological point of view, the following changes occur in the body:

Glandular or connective tissue grows.
Areas of fibrosis appear.
Cysts form, singly or in groups.

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It is important to know that mastopathy and other benign changes do not affect the epidermis. If changes appear on the skin (peeling, itching, burning, redness) and are accompanied by symptoms typical of mastopathy, then a malignant tumor can be suspected.

Clinical picture

Focal mastopathy is not an independent disease; it is a continuation of the pathological processes that occur with diffuse mastopathy. Therefore, the clinical picture greatly depends on the stage of the disease, on how the diffuse form proceeded and on the hormonal background.

The main criterion is the presence of seals, usually round or oval, smooth, and not fused to the surrounding tissues. Typical cysts can be felt in the chest. Palpation is painless most of the time; discomfort may appear only at the beginning of the cycle. The cysts have smooth edges and no changes on the skin. With this disease, nodes can be found in one mammary gland or in both. Interestingly, in more than half of the cases, cysts are found in the upper part of the breast.

The number of cysts varies - from one to several dozen. If the cysts have a granular structure, there are most likely several of them. If the cyst is large and smooth, most often there is only one.

Cysts do not grow, they may increase slightly in size and are better palpable before menstruation, but, as a rule, the growth is minimal. The nodes are best palpated in a standing position; lying down, they can lose their shape.

Laboratory tests do not reveal a relationship with hormonal levels - its changes only trigger the initial form of the disease, but do not subsequently affect the course and symptoms.

Diagnostic tools

Diagnostic tools are divided into instrumental examinations and laboratory tests. The first help to determine the shape, size and location of benign focal changes. Laboratory studies clarify the picture of the disease.

The most accurate diagnostic tool is mammography. This is an X-ray examination of breast tissue. The image clearly shows the affected areas; diffuse changes are easily distinguishable from benign tumors and malignant neoplasms. Approximately the same picture is observed on ultrasound. There is no need for expensive diagnostic methods such as MRI, CT or digital mammography.

During diagnosis, a number of measures are required to differentiate benign from malignant lesions. Thus, mammography can be prescribed several times on different days of the cycle to obtain a reliable picture of tumor variability. During the cancer process, the tumor remains the same size and shape, and the focal form of mastopathy of the mammary gland is manifested by variable cysts, which are visible sometimes better or worse.

If oncology is suspected, the patient is sent for a consultation with an oncologist, where more complex examinations are prescribed.

Treatment of focal mastopathy

Treatment is predominantly surgical. However, there are a number of cases when the operation may be postponed for a long time and dynamic observation may be prescribed:

Pregnancy and lactation.
Recent breast surgery.
The presence of a chronic disease in the acute phase.
Some endocrine and gynecological diseases.
Infectious diseases.

Typically, sectoral resection is used for treatment - part of the healthy tissue is removed along with pathological ones. Modern surgical techniques make it possible to preserve the shape of the breast and make the scar almost invisible. After surgery, cysts are necessarily sent for histological examination.

It is customary to prescribe surgery, since some benign neoplasms have a high risk of degeneration. And it is impossible to differentiate a non-dangerous benign tumor from a dangerous tumor (with a risk of degeneration) with a 100% guarantee. The decision to undergo surgery is made together with the patient. If there is a categorical refusal to undergo surgery, observation is prescribed.

In order to reduce the risk of relapse and stop pathological processes, drug therapy is also necessary, which includes:

Complex vitamin therapy. It is important to maintain sufficient amounts of vitamins A, B, C, E.
Non-steroidal anti-inflammatory drugs - allow you to stabilize metabolic processes, relieve swelling and tension in tissues after surgery, and prevent inflammation.
Hepatoprotectors. Stabilize metabolic processes.
Sedatives are often prescribed. The operation and treatment itself is highly stressful. In addition, a relationship has been identified between unstable mood and mastopathy.
Preparations to maintain tone - various herbal supplements and other dietary supplements.

After the recovery period, it is necessary to be observed by a mammologist once every three months for the first year, once every six months for two years, and then at least once a year.

If you are reading these lines, we can conclude that all your attempts to combat chest pain have not been successful... Have you even read anything about medications designed to defeat the infection? And this is not surprising, because mastopathy can be fatal to humans - it can develop very quickly.

Frequent chest pain
Discomfort
Experiences
Discharge
Skin changes

Surely you know these symptoms firsthand. But is it possible to defeat the infection without harming yourself? Read the article about effective, modern ways to effectively combat mastopathy and more... Read the article...

Nodular mastopathy and other forms of benign breast tumors do not pose a threat to health with proper treatment. The main thing is to identify the disease in time and begin the therapy suggested by the doctor. Women over 40 years of age should pay special attention to breast health.

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Home > Mastopathy > Types > Focal formation of the mammary gland: what is it, causes and risks

Breasts are of great importance for women not only in aesthetic terms: they are also important for feeding their offspring.

At the same time, this part of the body is often exposed to all sorts of diseases, one of which is mastopathy.

What is it
Causes and manifestations
Diagnostics
Treatment of the disease

What is it

Focal mastopathy is in first place in the list of diseases of the mammary glands.

Its name comes from the Greek words for “breast” and “disease,” and the disease itself was first studied more than a hundred years ago. Mastopathy is a benign disease in which connective and glandular tissues begin to grow.

This leads to the appearance of dense formations and cysts - they appear in 60-80% of patients. The disease usually affects one breast, for example, the right one, but it happens that both glands are affected.

It is important to know: despite the fact that focal mastopathy is a benign formation, if left untreated it can easily turn into cancer.

There are two types of focal mastopathy:

Nodular: It is also called nodular. With this disease, a node forms in the mammary gland. The latter also comes in two types: in the form of a benign tumor (fibroadenoma) and in the form of a liquid formation (cyst). Both options will require surgery.
Diffuse: characterized by a large number of nodules. They can also be represented by cysts, fibroadenomas, nodes with a glandular component, or be a “mixture”, for example, fibrocystic mastopathy.

Causes and manifestations

The causes of the disease can be:

Hormonal disorders: excess of the norm of female sex hormones (estrogen) and a decrease in the amount of progesterone - this leads to the proliferation of connective tissue.
Stressful situations, nervous tension.
Diseases of the liver and thyroid gland.
Bad heredity: if the mother had mastopathy, the daughter will have a predisposition to this disease.

Please note: the presence of lumps is the most significant sign of the emergence of any problems, and therefore you should not delay going to the doctor.

Symptoms of the disease include:

Pain in the chest in the absence of any source.
Lumps in the mammary gland that are easy to feel when palpated.
Enlargement of the mammary gland or lymph nodes, and sensitivity often increases.
Discharge from the nipples when pressed: can be transparent, whitish, with a brown or greenish tint, or with blood. The latter are the most dangerous.

Diagnostics

Primary diagnosis should be carried out by patients themselves: it is necessary to regularly feel the breasts for the presence of any unknown lumps.

If you have any suspicions, you should definitely visit a doctor. It is also recommended to visit a mammologist once a year to have your breasts checked.

Women at risk should be especially careful:

Having any gynecological diseases.
Subject to constant stress.
If you are pregnant or have recently given birth, have had an abortion, or are taking hormonal medications.
Women with breast injury, early puberty or menopause.

Doctor's advice: if the patient is at risk, she needs to be especially attentive to the appearance of any changes.

When visiting a doctor, you must:

Mammography: using an X-ray, the doctor will be able to accurately determine the presence or absence of tumors in the mammary gland, their size and location.
Ultrasound: allows you to determine the exact location of formations.
Pneumocystography: The mammologist takes a small part of the lump for examination. This allows you to determine if there are cancer cells in the cyst;
Ductography: involves checking the milk ducts.

Treatment of the disease

Depending on the causes of focal mastopathy, treatment methods differ.

The full course is selected strictly individually and can take several years. However, the prognosis is most often positive, and the treatment itself does not affect lifestyle in any way:

Folk remedies: these can be lotions, ointments and decoctions for oral administration. They help reduce pain and slightly reduce swelling, but they are not able to cure mastopathy. Traditional recipes can be used as auxiliaries or for temporary relief of the situation, but in any case you will have to consult a doctor.