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Benign Breast Disease in Elderly Women and Men

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Principles and Practice of Geriatric Surgery
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Abstract

Familiarity with breast microanatomy and physiology aids in understanding benign breast physiology. The female breast is composed of ductal and lobular units. The main breast ducts arise from lactiferous sinuses in the nipple and divide several times to form small ducts and then the smallest ductal elements, or “ductules,” which in fact form the lobular unit of the breast. The ductules also divide and terminate blindly with club-shaped endings. The ductules are sensitive to hormone stimulation; during pregnancy, they proliferate and form the alveolar components of the breast [1].

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References

  1. Parks AG (1959) The microanatomy of the breast. Ann R Coll Surg 25:235–251

    CAS  Google Scholar 

  2. Anbazhagan R, Bartek J, Monaghan P, Gusteron BA (1991) Growth and development of the human infant breast. Am J Anat 192:407–417

    Article  PubMed  CAS  Google Scholar 

  3. Reyniak JV (1979) Endocrine physiology of the breast. J Reprod Med 22(6):303–309

    PubMed  CAS  Google Scholar 

  4. Bando H et al (1991) Impaired secretion of growth hormone-releaseing hormone, growth hormone and IGF-1 in elderly men. Acta Endocrinol 124:31–33

    PubMed  CAS  Google Scholar 

  5. Rudman D et al (1981) Impaired secretion of growth hormone secretion in the adult population: relation to age and adiposity. J Clin Invest 67:1361–1369

    Article  PubMed  CAS  Google Scholar 

  6. Waldhauser F, Kovacs J, Reiter E (1998) Age-related changes in melatonin levels in humans and its potential consequences for sleep disorders. Exp Gerontol 33:759–772

    Article  PubMed  CAS  Google Scholar 

  7. Weiner R, Utiger RD, Lew R, Emerson CH (1991) Age, sex and serum thyrotropin concentrations in primary hypothyroidism. Acta Endocrinol 124:364–369

    Google Scholar 

  8. Spaulding SW (1987) Age and the thyroid. Endocrinol Metab Clin North Am 16:1013–1025

    PubMed  CAS  Google Scholar 

  9. Pedrazzoni M et al (1988) Calcitonin levels in normal women of various ages evaluated with a new sensitive radioimmunoassay. Horm Metab Res 20:118–119

    Article  PubMed  CAS  Google Scholar 

  10. Nafziger AN, Bowlin SJ, Jenkins PL, Pearson TA (1998) Longitudinal changes in dehydroepiandrosterone concentrations in men and women. J Lab Clin Med 131:316–323

    Article  PubMed  CAS  Google Scholar 

  11. Hegstad R et al (1983) Aging and aldosterone. Am J Med 74:442–448

    Article  PubMed  CAS  Google Scholar 

  12. Khosla S et al (1998) Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: a key role for bioavailable estrogen. J Clin Endocrinol Metab 83:2266–2274

    Article  PubMed  CAS  Google Scholar 

  13. Sherman BM, West JH, Korenman SG (1976) The menopausal transition: analysis of LH, FSH, estradiol, and progesterone concentrations during menstrual cycles of older women. J Clin Endocrinol Metab 42:629–636

    Article  PubMed  CAS  Google Scholar 

  14. Deslypere JP, Vermeulen A (1984) Leydig cell function in normal men: effect of age, life-style, residence, diet and activity. J Clin Endocrinol Metab 59:955–962

    Article  PubMed  CAS  Google Scholar 

  15. McKinlay SM, Bifano NL, McKinlay JB (1985) Smoking and age at menopause in women. Ann Int Med 103:350

    PubMed  CAS  Google Scholar 

  16. Vorherr H (1974) Menopausal mammary involution. In: Vorherr H (ed) The breast. Morphology, physiology, and lactation. Academic, San Diego, CA, pp 215–217

    Google Scholar 

  17. Tavossoli FA (1992) Postmenopausal involution (atrophy). In: Tavossoli FA (ed) Pathology of the breast. Elsevier, New York, NY, p 20

    Google Scholar 

  18. Lee PA (1975) The relationship of concentrations of serum hormones to pubertal gynecomastia. J Pediatr 86:212

    Article  PubMed  CAS  Google Scholar 

  19. Moore MP (1996) Male breast cancer. In: Harris JR, Lippman ME, Morrow M, Hellman CT (eds) Diseases of the breast, 2nd edn. Lippincott-Raven, Philadelphia, PA, p 859

    Google Scholar 

  20. Cordova A, Moschella F (2008) Algorithm for clinical evaluation and surgical treatment of gynaecomastia. J Plast Reconstr Aesthet Surg 61(1):41–49

    Article  PubMed  Google Scholar 

  21. Harman SM, Metter EJ, Robin JD et al (2001) Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab 86:724–731

    Article  PubMed  CAS  Google Scholar 

  22. Braunstein GD (1993) Gynecomastia. N Engl J Med 328:490

    Article  PubMed  CAS  Google Scholar 

  23. Gordon GG, Olivo J, Fereidoon R et al (1975) Conversion of androgens to estrogen in cirrhosis of the liver. J Clin Endocrinol Metab 40:1018

    Article  PubMed  CAS  Google Scholar 

  24. Evans GF, Anthony T, Turnage RH et al (2001) The diagnostic accuracy of mammography in the evaluation of male breast disease. Am J Surg 181(2):96–100

    Article  PubMed  CAS  Google Scholar 

  25. DiLorenzo G, Perdona S, DePlacido S et al (2005) Gynecomastia and breast pain induced by adjuvant therapy with bicalutamide after radical prostatectomy in patients with prostate cancer: the role of tamoxifen and radiotherapy. J Urol 174(6):2197–2203

    Article  CAS  Google Scholar 

  26. Kuhn J, Roca R, Laudat M et al (1983) Studies on the treatment of idiopathic gynecomastia with percutaneous dihydrotestosterone. Clin Endocrinol 19:513

    Article  CAS  Google Scholar 

  27. Parker LN, Gray DR, Lai MK et al (1986) Treatment of gynecomastia with tamoxifen: a double-blind crossover study. Metabolism 35:705

    Article  PubMed  CAS  Google Scholar 

  28. Dicker AP (2003) The safety and tolerability of low dose irradiation for the management of gynecomastia caused by antiandrogen monotherapy. Lancet Oncol 4:30

    Article  PubMed  Google Scholar 

  29. Colombo-Benkmann M, Buse B, Stern J et al (1999) Indications for and results of surgical therapy for male gynecomastia. Am J Surg 178:60

    Article  PubMed  CAS  Google Scholar 

  30. Smith RL, Pruthi S, Fitzpatrick LA (2004) Evaluation and management of breast pain. Mayo Clin Proc 79(3):353–372

    Article  PubMed  Google Scholar 

  31. Fentiman I (2004) Management of breast pain. In: Harris JR, Lippman ME, Morrow M, Osborne CL (eds) Diseases of the breast, 3rd edn. Lippincott Williams and Wilkins, Philadelphia, PA, pp 57–61

    Google Scholar 

  32. Olawaiye A, Nithiam-Leitch M, Danakas G et al (2005) Mastalgia: a review of management. J Reprod Med 50(19):933–939

    PubMed  Google Scholar 

  33. Tumhan L, Hoyt AC, Bassett LW (2005) Negative predictive value of sonography and mammography in patients with focal breast pain. Breast J 11(5):333–337

    Article  Google Scholar 

  34. Kneece J (2003) Noncyclic pain. In: Kneece J (ed) Solving the mystery of breast pain, 2nd edn. Educare Publishing, Columbia, SC, pp 37–39

    Google Scholar 

  35. Khan HN, Rampaul R, Blabey RW (2004) Local anaesthetic and steroid combined injection therapy in the management of noncyclic mastalgia. Breast 13(2):129–132

    Article  PubMed  CAS  Google Scholar 

  36. Fentimen I (2004) Management of breast pain. In: Harris JR, Lippman ME, Morrow M, Osborne CL (eds) Diseases of the breast, 3rd edn. Lippincott Williams and Wilkins, Philadelphia, PA, pp 57–61

    Google Scholar 

  37. Kneece J (2003) Noncyclic pain. In: Kneece J (ed) Solving the mystery of breast pain, 2nd edn. Educare Publishing, Columbia, SC, p 40

    Google Scholar 

  38. Rosolowich V, Saettler E, Szuck B et al (2006) Mastalgia. J Obstet Gynaecol Can 28(1):49–74

    PubMed  Google Scholar 

  39. Srivastava A, Mansel RE, Arvind N et al (2007) Evidence-based management of mastalgia: a meta-analysis of randomized trials. Breast 16(5):503–512

    Article  PubMed  CAS  Google Scholar 

  40. Quereshi S, Sultan N (2005) Topical nonsteroidal anti-inflammatory drugs versus oil of evening primrose in the treatment of mastalgia. J R Coll Surg Edinb Ireland 3(11):7–10

    Article  Google Scholar 

  41. Colak T, Ipek T, Kanik A et al (2003) Efficacy of topical nonsteroidal anti-inflammatory drugs in mastalgia treatment. J Am Coll Surg 196(4):525–530

    Article  PubMed  Google Scholar 

  42. Rosen PP (1997) Mammary duct ectasia. In: Rosen PP (ed) Rosen’s breast pathology. Lippincott-Raven, Philadelphia, PA, pp 29–32

    Google Scholar 

  43. Devitt JE (1996) Benign disorders of the breast in older women. Surg Gynecol Obstet 162:340–342

    Google Scholar 

  44. Heywang-Kobrunger SH, Scherer I, Dershaw DD (1997) Benign breast disorders. Thieme, Stuttgart, pp 141–165

    Google Scholar 

  45. Kern WH, Clark RW (1973) Retrogression of fibroadenomas of the breast. Am J Surg 126:56–59

    Article  Google Scholar 

  46. Hunter TB, Roberts CC, Hunt R et al (1996) Occurrence of fibroadenomas in postmenopausal women referred for breast biopsy. J Am Geriatr Soc 44:61–64

    PubMed  CAS  Google Scholar 

  47. Dixon JM (1991) Cystic disease and fibroadenoma of the breast: natural history and relation to breast cancer risk. Br Med Bull 47:258–271

    PubMed  CAS  Google Scholar 

  48. Egan R (1988) Fibroadenoma. In: Egan R (ed) Breast imaging. Diagnosis and morphology of breast diseases. Saunders, Philadelphia, PA, pp 178–182

    Google Scholar 

  49. Kopans DB (1988) Benign and probably benign lesions. In: Kopans DB (ed) Breast imaging. Lippincott-Raven, Philadelphia, PA, pp 351–373

    Google Scholar 

  50. Peck DR, Lowman RM (1978) Estrogen and the postmenopausal breast: mammographic considerations. JAMA 240:1733–1735

    Article  PubMed  CAS  Google Scholar 

  51. Kaewrudee S, Anuwatnavin S, Kanpittaya J et al (2007) Effect of estrogen-progestin and estrogen on mammographic density. J Reprod Med 52(6):513–520

    PubMed  Google Scholar 

  52. Aiello EJ, Buist DS, White E (2006) Do breast cancer risk factors modify the association between hormone therapy and mammographic density? Cancer Causes Control 17(10):1227–1235

    Article  PubMed  Google Scholar 

  53. Laya MB, Larson EB, Taplin SH et al (1996) Effect of estrogen replacement therapy on the specificity and sensitivity of screening mammography. J Natl Cancer Inst 88(10):643–649

    Article  PubMed  CAS  Google Scholar 

  54. Crandall CJ, Karlamangla A, Huang MH et al (2006) Association of new-onset breast discomfort with an increase in mammographic density during hormone therapy. Arch Int Med 166(15):1578–1584

    Article  CAS  Google Scholar 

  55. Carney PA, Kasales CJ, Tosteson AN et al (2004) Likelihood of additional work-up among women undergoing routine screening mammography: the impact of age, breast density, and hormone therapy use. Prev Med 39(1):48–55

    Article  PubMed  Google Scholar 

  56. Rutter CM, Mandelson MT, Laya MB et al (2001) Changes in breast density associated with initiation, discontinuation, and continuing use of hormone replacement therapy. JAMA 285(2):171–176

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Kay O. Lovig .

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Lovig, K.O., Ward, B.A. (2011). Benign Breast Disease in Elderly Women and Men. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6999-6_37

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  • DOI: https://doi.org/10.1007/978-1-4419-6999-6_37

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