In faraway Australia, there was a mother who had just given birth to her second child. She should have been enjoying the sweetness of motherhood again, but she was suffering from pain in her perineal wound.
What exactly is causing this mother to suffer so much pain? Is it due to improper care by the mother herself, or is it the foreign doctor's lack of skill?
Welcome to the latest episode of "Getting Closer to Obstetrics and Gynecology": "A Bizarre Case of Perineal Wounds"
She was a 29-year-old mother of two. Four days after her vaginal delivery, she experienced unbearable swelling and pain at the incision site of her perineal tear. Carrying her baby, she limped to the hospital. The mother told the doctor, "Look, it's been four days since I gave birth, and the area where you stitched me up is so painful and swollen, with a white, milky discharge." The doctor examined the swollen and oozing incision and said, "Hmm, it seems to be an incision infection, an abscess."
So the doctor responsibly performed a minor surgery. However, the result surprised everyone!
That white, milky secretion—it was actually milk.
If we were following the typical "Approaching Science" approach, this would probably involve a bizarre scene where a mother injects her own milk into a wound with a syringe. But as a reliable medical professional, today I want to talk about this:
Ectopic breast tissue
Ectopic breast tissue, simply put, means it's not where it should be. It's actually quite common; many mothers find a painful lump in their armpit in the days following childbirth—what's commonly called an accessory breast. This accessory breast is actually ectopic breast tissue. About 5% of women experience this, though it's rare for it to appear on the vulva. Moreover, ectopic breast tissue doesn't discriminate by gender; both men and women can develop it, with a male-to-female ratio of approximately 1:5.
The question is, why don't the neinei grow in the places they should?
To explain the reason, we must first talk about the nipple line. This nipple line is not the same as the mammary gland, but rather the location where the precursors of the nipple exist.
When we (both male and female) are just 6-week-old embryos, there are 6-8 locally raised mammary gland primordia on both sides of our abdomen, also called the milk lines. As we grow, except for the pair on our chest which continues to develop, the ones in other locations gradually atrophy. If these milk primordia do not completely degenerate, ectopic breast tissue will appear. Therefore, since there were once 6-8 pairs of milk primordia, ectopic breast tissue can appear not only in the armpits and the uncommon vulva, but also in other rather unusual locations such as the shoulders and thighs.
These tissues are similar to the mammary gland tissue in normal breasts and are also regulated by the hormone levels in our bodies. For example, when your breasts are swollen before your period, they are silently enduring it; when you start breastfeeding after giving birth, they are also working hard... which is why the mother mentioned earlier experienced white, milky discharge.
Some people may wonder, can ectopic breast tissue have a nipple?
In fact, some ectopic breast tissues do have nipples. There are also combinations where there is only a nipple without a breast tissue, and only a breast tissue without a nipple. Ectopic breast tissue may grow into a "thumbtack" shape or an irregular lump. It may be painful to the touch, and the size of the lump may fluctuate with menstruation.
How long does this thing grow? Will it affect my health ?
Actually, as unregistered members of the breast, appearance isn't the main issue. The key point is that most ectopic breast tissue lacks a milk transport system. In other words, ectopic breast tissue inherently "blocks milk ducts," and the long-term accumulation of milk can potentially cause breast hyperplasia and benign lesions. Ectopic breast tissue also has the potential to become cancerous. Hearing this, many people can't help but feel a tightness in their chest.
What kinds of ectopic breast tissue require treatment?
For example, if there is pain or discharge of unknown fluid from ectopic breast, or if an examination reveals an abnormal lump or suggests a tumor, then of course, if it prevents girls from wearing their tank tops and looking beautiful, then it is also a serious offense.
This article was first published on the Obstetrics and Gynecology Channel of Medical World.
Author: Pili
Editor: Guo Yue
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