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乳腺生长

维基百科，自由的百科全书
  提示：此条目页的主题不是乳腺发育。
乳腺生长
Mammoplasia
在妊娠阶段乳房会自然增大
分类和外部资源
ICD-10N62
ICD-9-CM611.1
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乳腺生长（mammoplasia）又称乳腺增生、乳腺增殖症，是乳房正常或自发的增大[1]。乳腺生长一般会出生在女性的青春期及妊娠阶段，在月经周期中特定阶段也会有乳房增大的情形[2][3][4]。若是男性乳腺生长，会视为是疾病，称为男性乳房发育症[4]。若是女性乳腺异常生长的情形，会称为巨乳症（或是乳房肥大症），也会视为是疾病[5][6][7]。

乳腺生长可能是因为和乳房制造及储存母乳而产生的暂时性乳房膨胀（英语：breast engorgement）有关，这多半是和哺乳及/或乳溢症（过度或是不正常的母乳制造）相关[8]。乳腺生长也常伴随着乳房疼痛[9][10]。

在月经周期中的黄体期，因为高浓度的雌激素及/或孕酮造成的乳房血流量增加及/或月经前水潴留（英语：Premenstrual water retention），乳房的体积会暂时性的增大，女性会有乳房沉重、肿胀和刺痛的感觉[11][12]。

乳腺生长也可能是许多药物的效果或是副作用，例如雌激素[2][13]、像螺内酯[14]、醋酸环丙孕酮[15]、 比卡鲁胺（英语：bicalutamide）[16][17]及非那斯特莱[18][19]等抗雄激素，生长激素[20][21]以及会提高体内催乳素的药物，例如D2受体拮抗剂，像是维思通等抗精神病药、甲氧氯普胺及多潘立酮[22][23]，以及像选择性5-羟色胺再摄取抑制剂（SSRI）及三环类抗抑郁药（TCA）之类的抗抑郁药[23][24][25]。若是使用文拉法辛之类的5-羟色胺和去甲肾上腺素再摄取抑制剂（SNRI），这类的风险会比较小[26]。非典型的抗抑郁药米氮平及安非他酮不会提高体内催乳素浓度（安非他酮反而会降低催乳素浓度），因此使用这类药物就没有会使乳腺生长的风险[22]。其他和乳腺生长有关的药物包括D-青霉胺（英语：D-penicillamine）、布西拉明（英语：bucillamine）、neothetazone（英语：neothetazone）、环孢素、英地那韦（英语：indinavir）、大麻及西咪替丁[6][27]。

1997的一个研究发现，在其研究的59名女性中，有23名（39%）发现有出现使用SSRI及和乳腺生长的相关性[26]。研究也发现SSRI和乳溢症之间有相关性[24][28][29][30]。这些副作用可能因为药物造成的高催乳素血症（英语：hyperprolactinemia），这个效果可能因为抑制催乳素分泌的结节漏斗（英语：tuberoinfundibular）多巴胺致能（英语：Dopaminergic）神经元，因为血清素调节而被抑制的结果[26][28][29]。值得注意的是这些药物造成的乳腺生长也和体重增加（英语：Weight gain）高度相关（在1997年的研究中，体重增加中的人中有83%也有乳腺生长，而体重没有增加的人之中，只有30%有乳腺生长）[26]。这些伴随着SSRI用药出现的乳腺生长，在停药后是可以复原的[30]。 SSRI和乳癌风险的增加有关[31]，这个现象符合高催乳素和高乳癌风险有关的事实[32][33]。

若是针对女性青春期诱导（英语：puberty induction）而进行的激素替代疗法（HRT）、跨性别女性进行的性别肯定激素治疗（GAHT），或者是荷尔蒙丰胸（英语：Hormonal breast enhancement），都会希望出现乳腺生长的结果[34][35]。

参考资料

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  1. ^ Nathanson, Ira T. Present Concepts of Benign Breast Disease. New England Journal of Medicine. 1946, 235 (15): 548–553. ISSN 0028-4793. doi:10.1056/NEJM194610102351505. 
  2. ^ 2.0 2.1 Ismail Jatoi; Manfred Kaufmann. Management of Breast Diseases. Springer Science & Business Media. 11 February 2010: 21–. ISBN 978-3-540-69743-5. 
  3. ^ Nagrath Arun; Malhotra Narendra; Seth Shikha. Progress in Obstetrics and Gynecology--3. Jaypee Brothers Medical Publishers Pvt. Ltd. 15 December 2012: 393–394. ISBN 978-93-5090-575-3. 
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  6. ^ 6.0 6.1 David J. Dabbs. Breast Pathology. Elsevier Health Sciences. 2012: 19–. ISBN 1-4377-0604-5. 
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  9. ^ Christoph Zink. Dictionary of Obstetrics and Gynecology. Walter de Gruyter. 1 January 1988: 152–. ISBN 978-3-11-085727-6. 
  10. ^ Michael Heinrich Seegenschmiedt; Hans-Bruno Makoski; Klaus-Rüdiger Trott; Luther W. Brady (编). Radiotherapy for Non-Malignant Disorders. Springer Science & Business Media. 15 April 2009: 719–. ISBN 978-3-540-68943-0. 
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  16. ^ Patrick C. Walsh; Janet Farrar Worthington. Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, Second Edition. Grand Central Publishing. 31 August 2010: 258–. ISBN 978-1-4555-0016-1. 
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  19. ^ Jacqueline Burchum; Laura Rosenthal. Lehne's Pharmacology for Nursing Care. Elsevier Health Sciences. 2 December 2014: 802–. ISBN 978-0-323-34026-7. 
  20. ^ Sat Dharam Kaur. The Complete Natural Medicine Guide to Breast Cancer: A Practical Manual for Understanding, Prevention & Care. R. Rose. 2003: 79. ISBN 978-0-7788-0083-5. 
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  27. ^ Dancey, Anne; Khan, M.; Dawson, J.; Peart, F. Gigantomastia – a classification and review of the literature. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2008, 61 (5): 493–502. ISSN 1748-6815. PMID 18054304. doi:10.1016/j.bjps.2007.10.041. 
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  29. ^ 29.0 29.1 Mondal, S.; Saha, I.; Das, S.; Ganguly, A.; Das, D.; Tripathi, S. K. A new logical insight and putative mechanism behind fluoxetine-induced amenorrhea, hyperprolactinemia and galactorrhea in a case series. Therapeutic Advances in Psychopharmacology. 2013, 3 (6): 322–334. ISSN 2045-1253. doi:10.1177/2045125313490305. 
  30. ^ 30.0 30.1 Benjamin Sadock. Kaplan & Sadock's Pocket Handbook of Psychiatric Drug Treatment. Lippincott Williams & Wilkins. 26 November 2013: 312– [2017-04-15]. ISBN 978-1-4698-5538-7. （原始内容存档于2019-12-17）.  （页面存档备份，存于互联网档案馆）
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  32. ^ Hankinson, S. E.; Willett, W. C.; Michaud, D. S.; Manson, J. E.; Colditz, G. A.; Longcope, C.; Rosner, B.; Speizer, F. E. Plasma Prolactin Levels and Subsequent Risk of Breast Cancer in Postmenopausal Women. JNCI Journal of the National Cancer Institute. 1999, 91 (7): 629–634. ISSN 0027-8874. doi:10.1093/jnci/91.7.629. 
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  35. ^ Hartmann BW, Laml T, Kirchengast S, Albrecht AE, Huber JC. Hormonal breast augmentation: prognostic relevance of insulin-like growth factor-I. Gynecol. Endocrinol. 1998, 12 (2): 123–7. PMID 9610425. doi:10.3109/09513599809024960. 

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