As anomalies of breast development and function are known:
1.Hypoplasia:
Varying of degrees underdevelopment of the breast are seen and young wemen may seek medical advice on this type of problems.The size of the breast depend on fat as much as on glandular tissue and the development of the nipple is the best guide to the latter.
Causes of hypoplasia:
-deficiencyof ovarian hormons:in this case there is always other evidence of the deficiency such as amenorrhea(absence of a menstrual period) and genital underdevelopment.
-intrinsic defects in the gland itself:the gland may be absent,rudimentary or insensitive to hormone stimuli.This is always the case when ovarian function is normal and when the woman is not wasted.
Treatment:
-By oestrogen.If the case is clearly a deficiency of ovarian hormones,then breast development can be complete by administreting oestrogen and progesteron for several months.If the menstrual and ovarian functions are normal,there is no pont in administreting oestrogen becose the supply is already adequate and it is the breast which are at fault.
-By diet:Encourage the thin patient to increase her weight.
-By physiotherapy:Local massage,exercises for the prctoral muscle and measures designed to improve blood supply are of limited value.
-By plastic surgery.The placing of protheses deep to the breast can give satisfactory results.
2.Breast asymmetry:
The breasts are similar to most paired organs in that they are rarely equally developed.Even if they look the same,their function is unequal when they lactate and the baby prefers one to the other becouse it obtains more milk more easily from it.
Often the breasts are obviously different in size and since both are subject to the same hormone stimulus the fault is always inherent in the target tissue.
Endocrine treatment is valueless but plastic surgery can offer reduction in size of the larger breast and sometimes enlargement of the smaller.
3.Retracted nipples:
Acquired retraction of the nipple developing in later life a sign of cancer.Here we shall consider retraction only as a developmental anomaly caused by fibrous bands fixing the base of the niplle to the underlying fascia.
Plastic operations for this condition are unsatisfactory and more hope lies in regular manipulation or suction.
Pregnancy itself often brings about considerable improvement in the anatomy.
4.Accesory breast and nipples:
Is known as the axillary tail of Spencer and is well developed in some wemen and may result in axillary pain and swalling premenstrually or during lactation.Sometimes there are accesory breast but more commonly there are accesory nipples only.
These are usually found on the nipple line which extends from the anterior fold on the axilla to the pubic spine.small papillomas or pigmentated moles on this line are nearly always accesory nipples,are extremely common and not always recognize for what they are.
No treatment is necessary as a rule.
5.Hyperprophy of the breast:
True hyperprophy of the breast is not common.It affects the glandular tissue and not the nipples.The cause is unknown.
It is nearly always bilateral and often first appears at puberty.the breast enlarge progressively and weight as much as 6-13 kg each.
As treatment the plastic surgery after the age 20 years is necessary.
6.Pendulous breast:
After childbearing and lactation,and with advancing age and obesity ,the breast loses it is firmness and shape.The treatment immediatly after lactation is to support the breast and to do pectoral exercises.A plastic surgery gives good result.
7.Neonatal mastitis:
The breast of male and female babies sometimes become enlarged and hard 3 or 4 days after birth.
The condition is associated with congestion and activity of the primitive ducts and it is related to the withdrawal of the influence of maternal oestrogen.The baby is attempting to lactate at he same time at it is the mother.
No treatment than reassurance of the mother is required.
8.Adolescent mastitis:
A nodular painful enlargement of the breast sometimes occurs at puberty in both boys and girls.
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