706 THE REPRODUCTIVE ORGANS OF THE FEMALE. 



Epidemic parotitis is sometimes complicated by mastitis. 



Chronic Inflammation of the interstitial connective tissue of the mam- 

 mary gland may result in the formation of dense connective tissue (Fig. 

 462), with or without cystic dilatation of the milk ducts and atrophy of 



FIG. 463. -CHRONIC INFLAMMATION OF MAMMARY GLAND. 



the glandular elements. Acute exudative inflammation may occur in 

 a gland which is the seat of chronic inflammation, and abscesses may be 

 formed. 



Cystic Hyperplasia. About the time of the menopause, when the mam- 

 mary gland undergoes involution, the fibrous tissue is apt to increase. 

 This fibrous hyperplasia may be excessive, and is then frequently asso- 

 ciated with a cystic dilatation of the smaller ducts. The epithelium may 

 become atrophied or it may proliferate, and frequently forms papillary 

 projections into the dilated ducts. This cystic hyperplasia of the mamma, 

 when the epithelial changes are marked, is scarcely to be differentiated 

 from adenoma, to which indeed it probably frequently leads. ' 



Tuberculous Inflammation of the mammary gland and its excretory 

 ducts is of occasional occurrence. It may manifest itself in the form of 

 miliary tubercles, larger and smaller caseous masses of new-formed tissue, 

 or cold abscesses. 2 



Syphilitic Ulcers may occur in the nipple either as primary chancres 

 or as mucous patches. Gummy tumors have been observed in the 

 mamma. 



TUMORS. 



There may be a general hypertrophy of one or both breasts. This is 

 usually found in young, unmarried women, but sometimes in women in 

 advanced life. There is an increase in both the glandular and the con- 

 nective-tissue elements of the organ. 



1 For a study of this lesion with bibliography see Greenough and Hartwell, Jour 

 of Med. Research, vol. ix., p. 416, 1903. 



2 See a bibliographic summary of tuberculosis of the breast by Scudder, Am. Jour. 

 Med. Sciences, vol. cxvi., p. 75, 1898. 



