RU2185198C2 - Method for treating mammary gland cyst - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves injecting sclerosing agent into cyst cavity. The catheter is introduced into the papilla through lactiferous sinus and then into the lobar duct and cyst cavity. EFFECT: enhanced effectiveness in sclerosing lobar duct and cystic cavity communicating with it.

Description

 The invention relates to medicine, namely to mammology.

 A surgical method for treating breast cysts is known and widely applicable, in which the volume of surgical intervention is usually a sectoral resection of the breast.

 This method involves the removal of a sector of the mammary gland containing a cyst or several cysts (1), the main disadvantages of which are great trauma, the need for anesthesia, the relatively long hospital stay of the patient, which is 4-5 days. With this method, complications are possible in the postoperative period - suppuration of the wound, seam divergence, lymphorrhea, infiltrate, and in the long term - a violation of the architectonics of the mammary gland leads to lactation pathology, cosmetic defect: the formation of keloid scars, deformation of the mammary gland. This surgical intervention is considered by some authors as a starting point in the development of more severe fibrotic changes in the mammary gland.

 Closest to the proposed method is a method of treating breast cysts, which includes the puncture of the formation under the control of an ultrasound probe, aspiration of the contents of the cyst, the introduction of the surgical glue "Sulfacrylate" into the cyst cavity, after which the cyst is sclerosed and the glue is resorbed by 30-45 days after introduction (2).

 The main disadvantages of the method are the difficulties of percutaneous puncture, especially with small and multiple cysts, as a result of which the sclerosant can get outside the cyst cavity, painful interference. In addition, it is impossible to sclerosize the milky duct of one or several lobes, which leads to the re-formation of cysts along the ducts.

The basis of the invention the following tasks:
reduction in morbidity;
reduced indications for anesthesia;
preservation of the architectonics and functional capabilities of the mammary gland;
reduction in patient stay in hospital;
the possibility of simultaneous sclerotherapy of not only the cavity of the cyst, but also of the entire lobar duct, which does not allow recurrence of cysts along the duct.

 The essence of the invention lies in the fact that in a method of treating a breast cyst, comprising administering a medicament that causes sclerosis of a cyst cavity, a sclerosant is administered via a catheter inserted into the mammary nipple through the mammary sinus and then into the lobar duct and cyst cavity. As a medicine, for example, ethoxysclerol.

 The positive effect of this method is achieved by the fact that the active drug substance - sclerosant, penetrating along the lobar duct to the end sections, simultaneously sclerotizes all cystic cavities communicating with this duct and the direct milk duct, which leads to aseptic inflammation with the subsequent development of sclerosis in this anatomical system .

 The method is as follows: the intervention is carried out under the control of radiography. A 0.6 mm diameter catheter is inserted through the mammary gland, which is inserted into the cyst cavity through the milky sinus and lobar duct. Then, a radiopaque preparation is introduced through the catheter, contrasting the ducts and the cavity of the cyst (cyst), after which the duct and cyst are emptied from contrast and secretion. Then a sclerosant is introduced into the catheter and the catheter is removed.

 EXAMPLE 1

 Patient Ignatenko S.N., 41, was admitted to MSC-1 AMO ZIL for planned surgical intervention with complaints of the presence of a tumor-like formation in the left mammary gland.

 Ultrasound examination and mammography diagnosed a cyst of the left mammary gland 24x20x25 mm at the border of the upper quadrants with clear, even contours.

 A cytological examination of punctate was performed: structureless substance, breast epithelium.

 Under the control of the X-ray television installation of the company ABRIS (Russia), catheterization and contrasting through the nipple of the mammary gland into the milky sinus and then into the cyst cavity along the duct are carried out, the cyst walls are smooth, intracystic formations are not detected, after which 0.5 ml is introduced into the cyst 1% ethoxysclerol.

 Ultrasonic control on days 7, 14, 21, 28 - a gradual thickening of the capsule of the cyst, a change in its shape from oval to slit-like and complete sclerosis of the cyst by day 28 was observed in dynamics.

 EXAMPLE 2

 Patient Shchaveleva G.M., 45 years old, was admitted to MSC-1 AMO ZIL for planned surgical intervention with complaints of the presence of a tumor-like formation in the left mammary gland, light discharge from the nipple of the left mammary gland. Mammography performed - multiple cysts.

 An ultrasound scan diagnosed multiple cysts of the left mammary gland with clear even contours, the maximum of which were localized in the paralosal region 24x20x25 mm, at the border of the upper quadrants 15x16x20 mm.

 A cytological examination of the individual and punctate was carried out: structureless substance, breast epithelium.

 Under the control of the X-ray television installation of the ABRIS company (Russia), catheterization and contrasting through the nipple of the mammary gland into the mammary sinuses and then in the cavity of the cysts along the ducts, the walls of the cysts and ducts are smooth, intracystic and intraductal ducts are not determined, and then into the ducts with cysts introduced 2.0 ml of 1% ethoxysclerol.

 Ultrasonic control on days 7, 14, 21, 28, 35 - a gradual thickening of the capsules of the cysts, a gradual flattening of their shape to a slit-like shape and complete sclerosis of the cysts by day 28 were observed in dynamics.

Sources of information
1. Lee L.A., Martynyuk V.V. Does sectoral breast resection cure nodal mastopathy? - Bulletin of Surgery named after I.I. Grekov. - 1998. - T. 157.- 6. - P.77-79.

 2. Kharchenko V.N., Rozhlova N.I., Prokopenko S.P. New technologies in the diagnosis and conservative treatment of breast cysts. Mammalogy. - 1998. - 4. - S.19-27.

Claims (1)

 A method of treating a breast cyst, comprising administering a medicament that causes sclerosis of a cyst cavity, characterized in that the sclerosant is administered via a catheter inserted into the breast nipple through the mammary sinus and then into the lobar duct and cyst cavity.