With the sixth week of embryonic development, almost simultaneously with such organs as the heart and lungs begin to form mammary glands in children. First, in embryonic tissue (mesenchyme) appear dense germination of the epidermis that extend from the armpit to the groin. Later, these structures turn into acini and remain only in the chest area. And the nipples are formed in the perinatal period (after 22 weeks of gestation) – the proliferation of the underlying mesenchyme of the areola. Newborns of both sexes nipples are in small cavities and shortly after birth, thanks to the proliferation of the surrounding connective tissue, take a normal form. This is all physiology.
However, there are many pathological processes that may occur not age appropriate breast enlargement from a child, but also redness or the seal of the mammary glands in children.
Most full-term infants in the first days of life due to the cessation of the influx of maternal hormones into the bloodstream – developing the so-called sexual crisis. On the 3-4th day after birth is the engorgement or breast swelling in children that may increase over the next 5-7 days. May be redness of the breast of the child, and the nipples may appear minor in terms of the allocation of milk-like liquid. This phenomenon doctors call physiological mastopathy newborns.
According to pediatricians, it may be the seal of the mammary glands in children – right under the nipple. Education is always individual, up to 2-3 cm It can disappear for a couple of weeks, and may not take place for several months while the child is on breastfeeding: some babies increased sensitivity to the hormone prolactin, which contains breast milk.
Parents need to know that it is not a disease but is a specific reaction of the child. You should consult the doctor, but nothing to treat is not necessary, should be only carefully observe hygiene. Because of its failure to comply fraught with mastitis (inflammation of Breasts) infants who are able to move into an abscess.
In this case, the causes of diseases of the mammary glands of the child in early childhood infection, most often streptococci or staphylos, and the development of the inflammatory process, which needs to be treated (see below).
Breast enlargement in a child before puberty, particularly in girls before 8 years, is a deviation. By definition doctors, it is premature telarche, that is the beginning of the development of the mammary glands before the girls enter puberty (which starts after 10 years). Premature telarche is considered a benign isolated condition, that is to say, a local process, which is breast development without the appearance of other secondary sexual characteristics.
Its causes can be problems with ovaries (cysts), adrenal or thyroid gland (hypothyroidism), and use of exogenous hormones or drugs. So, a few years ago the Turkish researchers (Gazi University, Ankara) found that long-term use of fennel used to regulate bowel function in infants and help with the bloating, causes breast enlargement in the baby and can cause premature breast development in girls up to two years. The fact that biologically active substances of this plant stimulate synthesis of estrogens.
Also note that the asymmetric breast development in girls before age 12 years corresponds to the features of this process: one of iron (usually left) develops earlier than the second, but eventually, the breast becomes symmetric.
According to some, about 4% of girls with premature telarche occurs Central precocious puberty. What does it mean? This is when breast enlargement in girls begins between 8 years of age and is accompanied by the appearance of pubic hair and axillary regions. To date, there is good reason to believe one of the key reasons of this disease are mutations in genes leptin (Lep) and leptin receptor (Lepr) is a peptide hormone of adipose tissue, responsible for the regulation of energy metabolism in the body. According to research by endocrinologists, breast enlargement from a baby almost 80% of cases observed in excess of the weight of his body above the average age of 9-10 kg.
Experts name the following reasons of breast diseases in the child, as well as their pathological development:
The mammary glands in children of both sexes suffering from obesity, are often enlarged; they can form a tumor that consists of fat cells surrounded by connective tissue – lipoma of the breast.
In boys of pubertal age (over 12 years) observed breast enlargement which is called gynecomastia juvenile. Its reason lies in the age and increases the production of pituitary follicle stimulating hormone (FSH). The result is a temporary imbalance of sex hormones, which eventually passes.
Breast pain in a child, and hardening of tissues in the area of the nipple can result from even the most minor injuries.
Adolescent girls on the background characteristic of the age, hormonal instability can be revealed fibrocystic and hyperlastic changes in your Breasts:
The prognosis for most benign varieties of fibrous-cystic mastopathy favorable. However, significant proliferation of epithelial breast tissue there is a risk of malignant transformation of neoplasia.
In pediatric patients breast cancer a child is diagnosed very rarely. Most of the problems with the Breasts in childhood are benign mastopathy and many are resolved without specific treatment.
However, there are juvenile secretory carcinoma is a rare form of the disease, most often from teenage girls. Secretory carcinoma of the breast is a distinct variant of invasive cancer, which is characteristic for juvenile patients. It develops slowly in the form of small, poorly defined on ultrasound, single or multiple nodular neoplasia (size 0.5-3.5 cm) in the ducts of the mammary glands. The feature of this type of tumors is periodic secretory secretions from the tumor cells; also in new-formations can be a microcalcification.
Breast cancer is the child of puberty age in the form of phylloid cystosarcoma also refers to a rare diagnosis. But it is a very aggressive tumor, addictive and parenchyma of the breast and its skin.
There are other types of cancer, which can spread in the form of metastases in breast tissue – for example, lymphoma, affecting the lymph nodes in the chest and armpits; leukemia, soft tissue sarcoma, neuroblastoma etc.
Causes of diseases of the breast in case of cancer are often associated with irregular hormonal puberty and predisposition inherited through the maternal line, 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) by 55-65%, and BRCA2 mutations is 45%.
Briefly list the typical symptoms of breast diseases in children.
Mastitis in newborns are observed: increase of breast area of the seal the subcutaneous tissue; redness; soreness; high body temperature (up to +38°C); can be poor appetite, gastrointestinal disorders (vomiting, diarrhea). With the development of the abscess the temperature reaches +39°C, in a zone of redness is formed purulent infiltration, the child is lethargic and refuses the breast.
For juvenile gynecomastia in boys is characterized by: similar to the swelling breast swelling in children that occurs below the nipple with increased sensitivity of the nipples. And in gynecomastia, associated with hypogonadism, in the Breasts of the boy formed painful to the touch of the seal or there are symptoms such as underdevelopment of secondary sexual organs, the excess of adipose tissue in the upper body, pale skin, lethargy, sleep disturbances etc.
The symptoms of fibrocystic diseases of hyperplasia of mammary glands in adolescent girls can manifest in the form of enlarged Breasts after menstruation, distension in the chest, edema and mastalgia (pain of varying intensity), the presence in the tissue of the Breasts more elastic or solid rounded or elongated nodules (scar) neoplasia. In fibrotic pathologies of the education form in the upper quadrant of the gland. Larger units can lead to the change of shape of the glands or their asymmetry. In the affected area can change the color of the skin, nipple and of possible liquid discharge. In the presence of cysts that adolescent girls are localized beneath the nipple, often the skin in the area of the areola has a bluish tint.
It should be borne in mind that in many cases, these pathologies occur without obvious symptoms, and neoplasia detected accidentally.
Breast cancer in a child can manifest itself in virtually the same symptoms. In addition, often the discomfort and soreness can be felt in the armpit, the nipple is retracted slightly inside the areola, and the skin on the breast may look like orange peel.
Clinical diagnostics of pathologies of mammary glands in children is based on a survey which begins with the examination of the child and medical history (including family).
To determine the level of hormones in the serum (such as estradiol, prolactin, testosterone, LH, FSH, 17-OPG and DHEA-S, leaks, somatropin), it is necessary to pass the biochemical analysis of blood. Also the blood is examined for AFP – marker germicogenic tumors alpha-fetoprotein and markers of tumor growth.
The purpose is not only breast ultrasound the child, but the ultrasound sonography of the thyroid gland, adrenal glands and pelvic organs. Mammography children is not carried out.
Differential diagnostics of pathologies of mammary glands in children is conducted using computed or magnetic resonance tomography of the adrenal glands and brain structures: pituitary, hypothalamus.
In fibro-cystic and hyperplastic changes in the mammary glands – to prevent Oncology – performed fine-needle aspiration biopsy of education with a histological study of the obtained biopsy.
Same for all the treatment of diseases of the breast in a child is impossible, and therapeutic methods are subject to a specific diagnosis.
So, breast swelling in children during the first months of life in treatment is not needed, but mastitis can not do without antibiotics and sometimes drainage of the abscess (which is held by the surgeon in the hospital). And the best prevention of mastitis in infants – the cleanliness and proper care of the child.
Treatment of early breast development does not require treatment. However, you need to monitor any changes in size of mammary glands girls.
Read more about how to treat precocious puberty, read – precocious puberty – Treatment
Breast enlargement the boy also requires observation, and if not juvenile gynecomastia resolves spontaneously a few years after the diagnosis, the endocrinologist – on the basis of the results of the analysis on the level of hormones in the blood, will appoint treatment and will advise to wear a bandage on his chest.
When a large amount of adipose tissue can also be used its evacuation (liposuction).
Mastitis in girls, during puberty need to be treated at the children's gynecologist. But you can come to the aid of other specialists, since the etiology of cystic masses associated with the thyroid gland, and hyperplasia of the mammary gland in a child may arise from neuroendocrine abnormalities and disorders of the hypothalamic-pituitary-gonadal system.
In Oncology treatment of diseases of the breast in a child is those mi same methods as in adults (surgical, chemotherapy).