Amastia: che cos’è e quali sono i rimedi
Che cos’è l’amastia?
Si definisce amastia l’assenza di sviluppo della ghiandola mammaria sia mono che bilaterale. Essa può essere congenita, per alterazioni embrionali o fetali della gemma epiteliale da cui la ghiandola dovrà svilupparsi, o acquisita per distruzione post-natale della matrice ghiandolare.
Amastia congenita
L’amastia congenita si associa frequentemente ad assenza del capezzolo (atelia) e talora rientra nel quadro di sindromi malformative complesse della parete toracica, essendo associata ad aplasia del m. pettorale o ad agenesia costale o a malformazioni costo-sternali (pectus excavatum) .
Amastia acquisita
Le amastie acquisite possono essere di origine infettiva, traumatica o più frequentemente iatrogena a seguito di interventi chirurgici o di terapie radianti effettuate in età infantile in sede mammaria. Si manifestano in età puberale con un deficiente sviluppo della eminenza mammaria di solito monolaterale.
Amastia secondaria
Vanno ricordate le amastie secondarie in cui il mancato sviluppo ghiandolare è conseguente ad alterazioni del normale stimolo ormonale come ad esempio nella Sindrome di Turner o nella sindrome adreno-geniale.
Trattamento
Il trattamento della malattia è esclusivamente palliativo, in quanto non è possibile ricostruire una ghiandola funzionalmente valida, ma solo un cono esteticamente e palpatoriamente simile alla mammella normale per mezzo dell’introduzione di protesi in materiale alloplastico in sede sottocutanea o preferibilmente al di sotto del m. grande pettorale. Viene utilizzato anche il lipofilling (trapianto di grasso) in casi selezionati.
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(Bibl. Manuale di chirurgia plastica, ricostruttiva ed estetica, Nicolò Scuderi, Piccin Nuova Libraria S. P. A., Padova, 2015)
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