Galactorrhoea

Galactorrhoea

Galactorrhea is manifested by secretion of milk by nipple, besides moments breast feeding the child. It can affect both breasts (bilateral galactorrhea) or may occur only in one nipple (unilateral).

Galactorrhea is not a specific disease but a sign of other diseases. Although most often affects women, galactorrhea can occur in men.

In women, galactorrhea may be caused by excessive stimulation of mammary glands, side effects of medications or disorders of the hypothalamus or pituitary gland.

In males, galactorrhea associated with erectile dysfunction and low libido due to deficiency of testosterone (male hypogonadism). Sometimes causes galactorrhea can not be identified, but more often are the increasing levels of prolactin, the hormone that stimulates lactation.

Galactorrhea sometimes occurs in newborns. High levels of estrogen in the blood enters the fetus through the placenta, causing the development of breast tissue, which may lead to the secretion of milk.

Mammary secretions are not always a sign of breast cancer. It can be a normal (physiological) even at a woman after menopause. In about 10% of the mammary secretion indicate breast cancer. Most commonly however, breast discharge containing blood due to an intraductal papilloma (benign tumor).

Galactorrhea mainly affects women aged between 20 and 35 years who had at least one pregnancy.

Galactorrhoea

Causes of Galactorrhea:

Galactorrhea is caused by excess prolactin - the hormone responsible for milk secretion (lactation) after birth. Prolactin is produced by the pituitary, a gland located at the base of the brain that regulates many hormones.

Among the causes of galactorrhea include:
»Some drugs: anxiolytics, antidepressants and antihypertensives
»Plants: fennel, anise, or fenugreek seeds
»Contraceptives
»A benign pituitary tumor (prolactinoma) or other disorder of the pituitary
»Hypothyroidism (thyroid hormone deficiency)
»Chronic kidney disease
"Excessive stimulation of the breasts (as a result of frequent breast self-examination, for example)
"Damage to the nerves in the chest (eg during surgery or burns)
»Spinal cord injury

In men, hyperprolactinemia (too much prolactin in the blood) train:
»Gynecomastia (excessive development of breast tissue and glandular tissue)
»Loss of libido
»Impotence
»Oligospermia (low sperm count seminal fluid), accompanied by infertility and a decrease in testosterone levels in the blood

If pituitary size increase occurs headache accompanied by visual disturbances (especially in the case of a pituitary adenoma).


Signs and symptoms
Galactorrhea Breast leak occurs, usually white or clear, but can also be yellow or green. Galactorrhea not include bloody nipple discharge (containing blood).

Breast Leakage can occur either spontaneously or after pressing breast and may be persistent or intermittent.

Bloody nipple discharge, spontaneous and persistent, arising from a single duct, may be a sign of breast cancer. Instead, secretions involving several mammary ducts and occur after stimulation of the breasts and not spontaneously show affection rather a benign (noncancerous).

Galactorrhoea

Nature fluid leaking from the nipple is not defined precisely. A quarter of women who had at least one pregnancy shows no overt nipple.
In general:
»White mammary secretions have a lipid composition so that it can be said that it is milk
»Green secretions can be caused by fibrocystic changes and needs analyzes
»Mammary secretions translate this blood red, and in this case is suspected breast cancer
Need to distinguish between similar-looking breast milk secretion (lactation) which is called galactorrhea and bloody secretions (containing blood).
Generally, secretions unilateral (single-nipple) are associated with a risk of cancerous tumors. On the other hand, the fact that secretion occurs in isolation, in the absence of other symptoms, especially of a tumor is a good sign.
A leakage of blood through the nipple not systematically translates a tumor of the breast cancer. In fact, in case of two bloody secretions have a benign cause.

Regarding galactoreele (especially bilateral), that carry milk, it can be stated that in case of 3 are the result of disturbances in the level of prolactin. Prolactin is a hormone of protein, secreted by the pituitary, especially the lobe or above.
In other cases, they are associated with benign breast disease and rarely with cancer pathology.
Diagnosis
The doctor will ask questions about medical history and perform an exam of the breast to detect the presence of a node. It can also be collected a sample of mammary secretion and will be analyzed in the laboratory.

Sampling and analysis of milk secretion from the nipple provides certain information. Secretory cells that compose this study put in evidence the presence of cells sometimes galactophorous (channels and holes from galactophorous), which translates frequently benign pathology.

The patient will be asked if:
»Have regular menstrual cycles
"Has difficulty obtaining a pregnancy
»Take medication
"Suffer from headaches or have vision problems

When breast milk secretions are associated with infertility or with amenorrhea (absence of abnormal menstruation), it is necessary to practice a dosage of prolactin in the blood.

If during the clinical examination of the breast is found a lump or other abnormality, will perform imaging tests - mammogram or ultrasound. They can highlight the presence of microcalcifications and changes ducts, and the presence of cysts or adenomas (benign tumors that develop in a gland). Galactografia is to visualize ducts after injection of a contrast agent and provide information on possible location of tiny cysts. In some cases, radiological images performed by a specialist in mammography, leading to suspicion of a malignant tumor.

Also, a biopsy can be performed to check for cancer.

If hormonal results indicate a high level of prolactin in the blood, an investigation MRI (magnetic resonance imaging) may be performed to highlight a possible pituitary tumor or other abnormality.
Treatment
Treatment depends on the cause galactorrhea in:
"If a pituitary adenoma (prolactinoma), we recommend excision (surgical removal) for large adenomas associated with other clinical signs.
"Bromocriptine - drug also used in Parkinson's disease - is prescribed after surgery when there is hyperprolactinemia (significant increase in blood prolactin) persistence.
»Microadenoamele are generally treated with bromocriptine, administered in doses gradually, while it is controlled prolactinemia (level of prolactin in the blood).
"Regarding the treatment of benign mammary secretions, to be clinically supervised (by a doctor) and by additional tests (mammograms), it is possible to use drugs NSAIDs (which do not contain cortisone).
"If drug therapy is considered to be followed because galactorrhoea, it should be discontinued or modified.
"In the case of hypothyroidism (deficiency of thyroid hormone), thyroid hormone replacement therapy will stop breast secretions.
»Removing milk ducts (tubes that carry milk) is practiced if a nipple when breast palpation and mammography not highlight a tumor or lesion.