Mastopathy is a benign disease of the mammary gland, characterized by pathological growth of its tissue, pain, and sometimes pathological secretion.
In Greek, mastopathy means breast disease. And the term fibrocystic disease means damage to the mammary glands, which is characterized by the growth pathological tissue which is accompanied by pain.
According to statistics, this disease affects women aged 30 to 55 years, in a ratio of 55-85%.
The main role in the development of mastopathy is played by a deficiency of the hormone progesterone and an increase in the level of such a hormone as estrogen. This is what leads to increased development of the alveolar epithelium, tissue, and ducts. Prolactin also plays an important role, which is responsible for growth and proper development mammary glands.
There are 2 types of mastopathy.
Diffuse- growth connective tissue where small nodules form. Can be divided into subgroups
Nodal- continuation of the development of the diffuse form, in which the nodes become hard and increase in size to 3-6 cm.
This type of disease is characterized by the growth of punctate cysts that contain fluid. This disease is mainly diagnosed in women aged 25-45 years in a ratio of 35-65%. In menopausal women, the incidence varies around 22%.
The main indicator of this disease is the hormone estrogen. When its quantity is low or absent, diffuse fibrocystic mastopathy develops.
There are 2 types of this mastopathy: proliferative, non-proliferative.
The causes are:
One of the forms of mastopathy. As practice shows, every third woman is faced with this type of disease. The causes are:
The disease is characterized by the presence of different structures and numerous nodules in the mammary glands. Thus, when clinical trial cystosis, fibrosis and adenosis can be seen simultaneously. This species is characterized as benign tumor, which is completely removed during surgery. This type of mastopathy is clearly visible on mammography images. The reasons are the following factors:
In this pathology, the glandular component mainly predominates. The disease spreads from both sides. It is a consequence of a complication of mastopathy that has not responded to medications. As practice shows, this disease is often diagnosed in women under the age of 40. Also, this form of mastopathy can often be found during pregnancy (III trimester). One of the main reasons is a large lack of the hormone progesterone, or, conversely, high levels of the hormone estrogen.
The main reason is considered to be hormonal imbalance. There are also other factors that contribute to the development of the disease:
Fibrocystic mastopathy is recognized by palpation during a routine preventive examination. With the development of the disease, mastopathy makes itself felt. Mostly, this form mastopathy manifests itself:
The pain can be either when you touch the mammary gland or be constant. It can come on suddenly and let go just as abruptly. The nature of the pain syndrome is strictly individual and depends on the woman’s body and the functioning of her endocrine system. The pain can be either squeezing or pulling, aching, dull, sharp. Often the pain radiates to the armpits or shoulder joint. Basically, in all women with this disease, the pain intensifies before the onset of menstruation.
As practice shows, 13% of women with this diagnosis may not experience pain.
Colostrum is usually released from the nipples, and the discharge may also be yellowish or greenish in color. Liquid can be released either when pressed or spontaneously. The discharge may contain a specific odor and blood. In terms of volume, the discharge can be either very small or quite abundant.
Do not forget that any discharge from the milk ducts (except during lactation) is a pathology; you must immediately consult a doctor. This is especially true for discharge that contains at least a little blood.
If this disease is not treated, it can result in very unpleasant consequences. Pathological neoplasms in such cases continue to grow, which can lead to the formation of a malignant tumor. Mastopathy cannot be treated at home on your own, without medical help.
To make an accurate diagnosis, the doctor conducts comprehensive examination women. Initially, the doctor collects a detailed medical history. Then he conducts a thorough examination - palpation. In this case, the doctor evaluates:
At the slightest suspicion of a disease, the doctor may prescribe:
The echography method (ultrasound) is one of the safest, most accurate and modern methods for examining the mammary glands.
All signs are strictly individual. Depends on:
An ultrasound scan directly examines the cystic wall in section, which makes it possible to determine the location, size, and presence of a tubercle.
Used for the treatment of mastopathy complex therapy. To do this, use a conservative or surgical approach. At an early stage of the development of the disease, a complex of medicinal substances is usually prescribed, which contain: hormones, antibiotics, homeopathic remedies.
Self-medication of any mastopathy is dangerous to your health.
The treatment plan includes:
The therapy complex also includes massage and diet.
The massage is aimed at restoring the function of the mammary gland, eliminating swelling, and softening the lump. Massage can also prevent the development of mastopathy. The massage is canceled if no positive effect is observed after several sessions. Other benefits of massage:
With the surgical method of treatment, the main task is to remove the affected area. The operation usually consists of two stages:
In extremely rare cases, there may be a question about removing part of the mammary gland.
Currently, 3 types of operations are used:
All folk remedies are just an addition to the main treatment.
Also, do not forget that many herbs are contraindicated and allergic. Before use, you should definitely consult a specialist.
Treatment folk remedies should not exceed a course of more than 2 weeks. The objectives of such treatment are:
Compress recipes
A decoction of bergenia root and oak bark. For preparation: 30 grams of roots (or bark), 200 ml of water. Boil until exactly half of the water has evaporated. Use as compresses on the affected area of skin.
So for compresses they use:
Herbs
Tinctures from cinquefoil and horse chestnut relieve inflammation. They can be purchased ready-made at the pharmacy.
Herbal tea: calendula, yarrow, nettle leaves. Each type of grass 100g. To prepare, take 12 tablespoons of a mixture of herbs and 0.5 liters of boiling water. Leave for 30 minutes. Drink 1-1.5 liters during the day.
This form of mastopathy, as practice shows, is quite often diagnosed during pregnancy. As we said earlier, mastopathy directly depends on the level of hormones in the blood. At the beginning of pregnancy, there is a sharp jump in estrogen, which contributes to an increase in symptoms. As pregnancy progresses, hormonal levels are restored, and this is what can contribute to the self-resorption of small lesions and improvement of the general condition.
The presence of mastopathy does not affect the fetus or the condition of the placenta in any way.
The basis for prevention during pregnancy is proper nutrition. Exclusion from the diet: fatty, fried, spicy, carbonated water. Eat as much as possible: fruits, vegetables, berries.
What complications may arise if you run:
A positive prognosis for the disease occurs as a result of:
If you are planning to become pregnant, it is recommended to undergo an ultrasound of the mammary glands. If you are diagnosed with fibrous or fibrocystic mastopathy, then pregnancy is not contraindicated. But, if the neoplasms are oncological in nature (tumor), then pregnancy is contraindicated until the end of treatment.
A disease such as mastopathy is not a direct contraindication for breastfeeding in the presence of breast milk.
Yes, you need to follow a diet. Since following a diet helps both normalize hormonal levels and prevent complications.
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What it is? Fibrocystic mastopathy (FCM or fibroadenomatosis) is a pathological process that develops in the structural tissues of the female breast in the form of rapid cellular proliferation of glandular tissue, forming cystic neoplasms (fluid-filled cavities) or nodular ones.
Included in the register of benign pathologies. Does not present any difficulties in treatment early diagnosis, but in advanced cases it can be an intermediate stage of the development of a cancerous tumor.
The disease affects almost half of the female population aged 30 and 50 years. Develops against the background of hormonal destabilization, provoked by an imbalance of hormones (the predominance of estrogen over insufficient progesterone synthesis), excessive hormonal activity, or its sharp decline or rise, often changing them cyclic level for one reason or another. In connection with this feature, the pathology is also called dishormonal hyperplasia.
Clinic of damage to the mammary glands due to fibrosis cystic mastopathy can manifest itself in various forms: diffuse, having several subtypes, nodular and non-proliferative.
Features of diffuse manifestation
Diffuse damage in FCM is caused by the development of a pathological process that covers the entire breast, manifested by a rather strong proliferation of connective (supporting) tissue structures, forming destructive foci of various shapes.
As a result of such dysfunction, processes develop that disrupt the structure of the ducts in the mammary glands and destruction in the alveolar-lobular tissues, contributing to the formation of small cystic-cavitary formations.
Genesis diffuse mastopathy fibrocystic nature is associated with a genetic predisposition, and the development of the process is triggered by many negative factors - external character, the influence of neurohumoral disorders and imbalance of hormone synthesis. Based on the nature of the structural lesion, several types of this form are distinguished:
The severity of such clinical disorders defined as minor, moderate or severe. It manifests itself in unilateral localization and bilateral - both mammary glands are simultaneously affected.
The disease itself is benign, but in the advanced stage, which turns into nodular pathology, there is a high risk of atypical cellular formations and oncological degeneration.
Signs of nodular FCM
As a rule, the development of nodular FCM is preceded by an advanced and complicated diffuse process, manifested by single or multiple dense nodular formations. Sometimes, nodular FCM is called focal.
On palpation, dense elastic formations with clear contours are detected, they are slightly painful and are not fused to adjacent tissues. Pain and swelling occur during menstruation.
A characteristic feature is that in the supine position, the lumps can be felt very rarely or not at all.
Nodes along the periphery of the chest usually do not tend to enlarge. The pain may be slight or not noticeable at all. Pathology is detected, usually during a random examination. And its manifestation can be purely individual.
Form of non-proliferative FCM
This term denotes a pathology of the mammary glands that does not have characteristic signs of excessive growth of glandular tissue in the breast with the formation of neoplasms and signs of intense cellular mitosis.
At the same time, no neoplasms are noted; significant or localized swelling of the breast is possible. Non-proliferative diffuse cystic mastopathy can be successfully treated with proper therapy.
The main symptoms of fibrocystic mastopathy of the mammary gland are manifested by painful seals and clear discharge from the ducts of the gland. Palpation and palpation of the chest reveals compacted areas with small and large formations.
Pain syndrome– differs in individuality, in each specific case. Pain occurs spontaneously or appears in response to touch. Unusual discomfort may be replaced by sharp pain even with a slight touch to the chest. Pain symptom fibrocystic mastopathy manifests itself in varying intensity - it can be dull, shooting and twitching, accompanied by heaviness, puffiness and a feeling of pressure in the chest.
It is not uncommon for pain to spread to nearby lymph nodes, causing them to become enlarged and tense. They can be local and radiate to the axillary and humeroscapular areas.
Typically, the pain syndrome increases during the “lunar cycle”, which is caused by hormonal surges. This symptomatology of mammary gland mastopathy is not typical for all patients. For some, pain does not appear at all, for others it is observed only during menstruation.
If there are characteristic common features FCM, this phenomenon is explained by the difference in compression of nerve endings or due to individual pain sensitivity. As the disease progresses, signs of fibrocystic mastopathy of the mammary gland appear as more pronounced compactions and noticeable pain, regardless of the critical days.
Discharge from milk ducts– is an individual symptom and is not observed in all patients. In some cases, they may not appear at all, in others they can be very abundant (which sometimes makes it possible to independently identify the disease), or stand out from the nipples with slight squeezing.
Threatening symptom– brown and bloody issues. This sign is observed when oncological process, destroying circulation in the small vessels of the chest and damaging vascular walls milk ducts.
If there are any signs of uncharacteristic discharge from the breast glands, and especially with a bloody admixture, it is necessary to quickly undergo an examination and begin immediate treatment for fibrocystic mastopathy of the mammary glands.
The basis of treatment for fibrocystic mastopathy of the mammary gland is the restoration of hormonal imbalance. Therapeutic methods are compiled on the basis of diagnostic examination results that reveal hormonal imbalance. In accordance with which, drugs are prescribed to correct hormonal levels.
The treatment process includes puncture aspiration biopsy of the cyst followed by sclerotherapy. This technique is applicable to cystic formations without signs of malignant degeneration and without symptoms of tumor development inside the ducts.
In case of multiple cysts, excessive tissue growth and signs of malignancy, the sectoral resection technique is used with mandatory histological examination of the excised samples.
Surgical methods for treating FCM are carried out on the basis of reasoned indicators:
Operative techniques
Surgical techniques consist of:
The operation is performed using local or general anesthesia. Duration surgical intervention is just over half an hour.
Conservative treatment of FCM
For tumors and nodes of small size, quite often, drug treatment with periodic monitoring by a specialist is sufficient. In the treatment of fibrocystic mastopathy, the action of the drugs is aimed at stopping the causative factor of the disease, stabilizing the immune system and eliminating the background diseases that caused an imbalance of hormones (diseases of the thyroid gland and appendages).
Drug therapy includes:
Women over 40 years of age are prescribed steroids - Methyltestosterone, Methylandrostenediol and hormone injections (testosterone or progesterone). Efficiency of all transferred funds is caused only by complex influence.
Forecast options
Favorable prognosis is ensured by correct diagnosis and timeliness.
Only adequate therapy initially benign neoplasm, can prevent the proliferation and transition of a pathological diffuse state to the nodal stage and a malignant tumor.
Of all breast diseases, fibrocystic disease, or fibrocystic mastopathy, is the most common. It occurs in almost 30% of all women, and in women under 30 years of age - in every fourth case of visiting an antenatal clinic. Among women suffering from chronic gynecological diseases, mastopathy was found in 30-70%.
The term “mastopathy” combines about 30 synonymous terms - mammary dysplasia, dyshormonal mammary hyperplasia, Schimmelbusch disease, chronic cystic mastitis, masoplasia, cystic mastopathy, mastodynia, etc.
All these and many other terms are used to designate those numerous changes of a morphological nature (proliferative, cystic, fibrous), which are often, but not necessarily, present simultaneously and are united by one common name.
In practical medicine, the term “mastopathy” is used in relation to many benign diseases mammary glands, differing in diversity clinical manifestations and, most importantly, the histomorphological structure, and are united by the main reason for their occurrence - hormonal imbalances in the body.
Thus, mastopathy is a group of benign diseases, morphologically characterized by a wide range of both regressive and proliferative processes, in which a pathological relationship between the connective tissue and epithelial components of the mammary glands occurs with the occurrence of cystic, fibrous and proliferative changes.
Why is mastopathy dangerous? Despite the fact that this disease is benign and is not considered directly a precancer, at the same time, breast cancer develops on average 4 times more often against the background of diffuse diseases of the latter and 40 times more often against the background of cystic forms with signs of growth (proliferation) of epithelial cells. The risk of malignancy in non-proliferative forms of mastopathy is no more than 1%, with moderate proliferation of the epithelium - about 2.5%, and in the case of significant proliferation, the risk of breast cancer increases to 31.5%.
From this point of view, the prevention and treatment of mastopathy are at the same time the real prevention of malignant neoplasms. Unfortunately, 90% of pathological formations are detected by women on their own and only in other cases are they detected medical workers accidentally as a result of a routine examination.
The combination of dishormonal hyperplasias with malignant neoplasms, identified in most studies, is explained by the common causes and risk factors, the identity of certain types of mastopathy and malignant tumors, similar hormonal and metabolic disorders in organism.
Due to the wide variety of morphological forms of the disease, there are various classifications. IN practical activities, depending on the predominance of certain changes identified during palpation (palpation) and/or mammography, as well as taking into account the results of histological examination, three main forms of the disease are distinguished, which some authors consider to be different stages of development of the same pathological process:
In turn, diffuse and nodular forms are classified into types. The diffuse form is divided into:
In the nodal form, the following types are distinguished:
Despite the fact that malignant tumors of the mammary glands are not necessarily the consequences of fibrocystic changes. However, their presence greatly increases the risk of developing cancer, which largely depends on the severity of epithelial proliferation inside the ducts and glandular lobules. In accordance with histological studies of material obtained during operations, in 46% malignant tumors are combined with diffuse tumors. This fact further supports the assumption that the prevention of mastopathy is also the prevention of breast cancer.
The etiology and mechanisms of development of mastopathy have not been fully elucidated, but a direct connection has been established primarily between the development of this pathology and the state of hormone balance in the body. Therefore, the hormonal theory of the formation of diffuse fibrocystic disease was the basis for the name of the disease dishormonal mammary hyperplasia.
The latter are an organ that is highly sensitive to any changes in the level of hormones, especially sex hormones, and at any time in a woman’s life. The mammary glands are never in states characterized by functional rest. Their development and condition, physiological changes during menstrual cycles after puberty, activation of function during pregnancy and lactation are carried out and regulated through a whole hormonal complex.
These hormones include GnRH (gonadotropin-releasing hormone) of the hypothalamic region of the brain, prolactin, luteinizing and follicle-stimulating hormones of the pituitary gland, thyroid-stimulating and chorionic hormones, glucocorticosteroids and insulin, and, most importantly, sex hormones (androgens, estrogens, progesterone).
Therefore, any hormonal imbalance, especially between progesterone and estrogens, among which estradiol has the maximum effect on the mammary gland, is accompanied by changes in the structure of its tissues and, as a consequence, the development of mastopathy. The differentiation (specialization) of cells, their division, development and proliferation of epithelial cells of the organ ducts depend on estradiol. This hormone also induces the development of the structural and functional unit of the gland (lobules), the development of the vascular network and the filling of connective tissue with fluid.
Progesterone prevents the division and proliferation of the epithelium of the milk ducts, reduces the permeability of small vessels caused by the action of estrogens. By reducing swelling of connective tissue, progesterone ensures lobular-alveolar separation and promotes the development of glandular tissues, lobules and alveoli.
The greatest importance is relative (in relation to estrogens) or absolute deficiency of progesterone. Its deficiency causes not only edema, but also an increase in the mass and volume of connective tissues inside the lobules, as well as growth of the epithelium of the ducts, leading to a decrease in their diameter, blockage and the formation of cysts. The hormone is able to reduce the degree of activity of estrogen receptors, reduce the local concentration of active estrogens, which helps limit the stimulation of proliferation of glandular tissue.
An increased concentration of the hormone prolactin in the blood also plays a certain role in the development of mastopathy, which leads to an increase in the number of receptors in the tissues of the glands that perceive estradiol. This helps to increase the sensitivity of gland cells to the latter and accelerate the growth of epithelium in it. In addition, an increase in the level of prolactin is one of the reasons for the imbalance in the ratio of estrogen and progesterone, which is accompanied by corresponding symptoms in the second phase of the menstrual cycle - swelling, engorgement and tenderness of the mammary glands.
There are quite a lot causal factors risks, but the main ones are:
Mastopathy and pregnancy are to a certain extent related. If late or interrupted pregnancy, as well as infertility, are risk factors for the development of mastopathy, as mentioned above, then, accordingly, its presence, and especially repeated pregnancies and childbirth, can be considered prevention of the disease. In addition, some authors believe that during pregnancy there may be a delay in the development of mastopathy and a decrease in the degree of its manifestations. This is explained by the high content of progesterone in a woman’s body during pregnancy and breastfeeding.
Diagnosis of any pathology is based on finding out the history of the disease during a conversation with the patient, his subjective feelings and external visual and palpation examinations. All this allows the clinician to choose further methods of instrumental and laboratory diagnostics in order to establish a diagnosis, provoking factors and concomitant diseases that influence the development of a specific pathology.
The main and most characteristic initial signs of mastopathy:
The pain is local, aching or dull, but sometimes intensifies with movement and radiates (gives) to the scapular and axillary regions, shoulder girdle, and arm. They occur in the second half of the menstrual cycle - usually a week, and sometimes more, before the onset of menstruation. After the start of menstruation or after a few days, the pain disappears or its intensity decreases significantly. Severe pain leads to cancerophobia (a feeling of fear about a malignant tumor), anxiety or depression, and emotional imbalance.
It should be noted that the increase in regional lymph nodes, their pain and temperature during mastopathy are not signs of the latter. Increase in local and/or general body temperature, increase in supraclavicular and subclavian axillary lymph nodes usually occur in the presence of inflammatory processes in the mammary gland (). In addition, when examining the mammary glands, the doctor always carefully checks the regional lymph nodes, which are the first site of metastasis of a malignant tumor.
Easy accessibility of mammary glands for visual inspection and manual examination, there is great similarity in different periods their functioning physiological changes with many forms of pathology often lead to erroneous interpretation of the examination results and are the cause of both over- and under-diagnosis.
Therefore, clinical examination data should be supplemented by such basic research methods as x-ray mammography and ultrasound diagnostics, allowing to confirm, clarify or reject a preliminary diagnosis.
The X-ray method is the most informative, allowing timely detection of gland pathology in 85 - 95% of cases. The World Health Organization recommends every 2 years for any healthy woman after 40 years, and after 50 years - annually. The study is carried out from the 5th to the 10th day of the menstrual cycle in two projections (direct and lateral). If necessary, targeted (certain limited area) radiography is performed.
For women 35-40 years of age, pregnant and nursing mothers, it is recommended to carry out an echographic examination every six months. Its advantages are safety and high resolution. Ultrasound can accurately distinguish cavitary formations from solid ones, examine glands with high density (in young women, with tissue swelling as a result of injury or acute inflammation), and conduct targeted puncture biopsy. In addition, ultrasound makes it possible to visualize X-ray negative tumor formations located close to chest wall, and regional lymph nodes, to carry out dynamic monitoring of treatment results.
Women with breast pathologies often need hormonal testing. These laboratory tests in some cases make it possible to determine the cause of the disease, risk factors, and adjust treatment in terms of the use of certain hormonal agents.
There are no generally accepted standard principles of therapy, despite the prevalence of the disease and its importance early detection and treatment for cancer prevention.
Treatment of women with nodular forms begins with puncture (using a thin needle) aspiration biopsy. If signs of dysplasia (improper development of connective tissue structures) are detected in the node, it is recommended surgery - sectoral resection or complete removal of the organ (mastectomy) with mandatory emergency histological examination of the removed tissue.
Diet
Preventive and medicinal value has a diet for mastopathy, since nutrition largely affects the metabolic processes of sex hormones, especially estrogens. It is recommended to limit the consumption of carbohydrates and fats, meat products, which helps reduce the content of estrogens in the blood and normalize the ratio of androgens and estrogens. In addition, coarse fibers found in vegetables and fruits, especially some grain products, have also been shown to have anti-cancer properties.
It is important to eat food that contains large quantities vitamins and microelements, especially iodine, zinc, selenium, magnesium, titanium, silicon. To replenish them, it is advisable to take additional special food additives and vitamin-mineral complexes in dragees. One of these drugs is Triovit in peas, enclosed in capsules.
Taking hormonal medications
Because the main reason Mastopathy is a hormonal disorder, the main goal of therapy is their correction. For this purpose, progestin hormonal drugs are most often used, the mechanism of effect of which is based on suppressing the activity of the pituitary-ovarian system, reducing the degree of stimulating effect of estrogens on breast tissue.
For these purposes, Utrogestan, Duphaston and especially Progestogel Gel are used. The latter contains micronized plant progesterone, identical to endogenous and acting at the cellular level. At the same time, it does not increase the hormone content in the blood serum. It is applied to the skin for 3 months from the 16th to 25th day of the menstrual cycle or daily.
Homeopathy
IN last years Homeopathy, based on the use of small doses of active components contained in plants, minerals, substances of animal origin, etc., has taken a certain place in the prevention and treatment of diffuse forms of mastopathy. They do not cause negative side effects. Their action is aimed at stimulating and maintaining the protective abilities of the body itself. Homeopathic remedies include tablets for mastopathy such as:
Active substances help reduce prolactin synthesis by affecting the pituitary gland, thereby improving function corpus luteum ovaries and the ratio of estrogen to progesterone is normalized; this medicine leads to the elimination of signs of premenstrual syndrome, reduction or elimination of discharge from the nipples, normalization of the menstrual cycle, helps reduce the intensity of proliferation processes in the mammary glands and regression pathological processes for mastopathy;
After consultation with the doctor, treatment of mastopathy at home can be carried out using infusions prepared independently from the above or other individual medicinal plants or herbal collections that are offered by the pharmacy chain.
Patients often ask the question, is it possible to do massage for mastopathy? Physiotherapy, ointments, massage, compresses not only in the area of the mammary glands, but also soft tissues in the area thoracic of the spine lead to the expansion of small and medium-sized vessels, increasing the volume of blood flowing to the tissues of the organ. This helps to increase tissue nutrition and accelerate metabolic processes, which stimulates the growth of existing tumor formations. Therefore, mastopathy is a contraindication for the use of such treatments for the named zones and areas.
For engorgement and swelling of the mammary glands, accompanied by pain, Dimexide can be used externally, but not as compresses or ointment, but in the form of 25 or 50% gel, produced in tubes. The drug has anti-inflammatory and moderate analgesic effects when applied to the skin of the mammary glands.
Conducted studies of women of reproductive age and suffering from various gynecological pathology, revealed a diffuse form of mastopathy in an average of 30%, a mixed (diffuse-nodular) form in the same number of patients; nodular forms of mastopathy were usually combined with uterine myomatosis, endometrial hyperplasia and genital endometriosis. Thus, the choice of treatment methods depends on the form of the pathology, the presence of hormonal imbalance and concomitant diseases.
Breast diseases most often occur against the background of hormonal disorders. Having discovered a lump in her mammary gland, a woman should definitely visit a mammologist, because the earlier the diagnosis is made, the easier and more successful the treatment will be. If there are several nodules, they are painful, this may be a manifestation of a benign pathology - diffuse fibrocystic mastopathy. At an early stage, conservative therapy is usually sufficient. The operation is performed only in case of a real danger of malignant degeneration of tumors.
Content:
Mastopathy is a very common pathology. With this disease, a change in the structure of individual breast tissues occurs, their pathological growth. Depending on what type of tissue begins to predominate, glandular, fibrous or mixed forms of mastopathy occur. Sometimes connective and glandular tissue is replaced by fat (in the fibrofatty form). Distinguish nodular mastopathy(single compactions) and diffuse (a group of small nodules appears).
The formation is characterized by compactions consisting of connective (fibrous) tissue, divided into small cysts filled with fluid. The predominance of fibrous or cystic elements of the structure is possible. Fibrocystic mastopathy is a benign pathology of the mammary glands, but if hormonal imbalance is not corrected in time, a malignant neoplasm appears against its background, which cannot be distinguished from fibrocystic mastopathy by the first signs.
Depending on the nature of the manifestations, 3 forms of diffuse pathology are distinguished: slightly expressed, moderate and pronounced. Seals in diffuse, pronounced fibrocystic mastopathy are found only in one mammary gland or in both (which is observed more often). Fibrocystic mastopathy of diffuse type is most often found in women childbearing age(up to 40 years old).
In newborns and young girls, the so-called physiological fibrocystic mastopathy occurs, which is associated with sudden changes in hormonal levels. As a rule, it recovers on its own, and the pathology disappears.
Diffuse mastopathy of this type can be recognized by the presence of the following signs:
With moderate and pronounced forms of diffuse fibrocystic pathology, discharge from the nipples appears. They can be transparent, white or yellowish, but sometimes they contain blood impurities, which indicates damage to small blood vessels piercing the mammary gland.
If the inflammatory process begins, redness of the chest and increased body temperature are possible. The deterioration of the condition is indicated by the appearance of headache, dizziness, nausea, and fainting.
Warning: Regular self-diagnosis plays an important role, allowing one to detect the first signs of pathology by examining and palpating the mammary glands. You cannot self-medicate without knowing the exact diagnosis. This is extremely dangerous, as it leads to accelerated growth neoplasms, the nature of which can be not only benign.
The main cause of diffuse fibrocystic pathology is a hormonal imbalance in the body, in which estrogens predominate in the ratio of female sex hormones. Factors contributing to the appearance of hormonal abnormalities are:
Women who have a hereditary predisposition to pathologies in the mammary glands are at risk for this type of diffuse mastopathy.
Availability similar disease is not an obstacle to the birth of a healthy child. Sometimes pathology is detected after pregnancy. When visiting a mammologist, a woman must inform the doctor about her special condition, since pregnant women cannot undergo mammography, as well as examination of the milk ducts using contrast fluid.
During this period it is impossible to consume many medicines, including herbal ones, since they have a bad effect on the fetus and can cause miscarriage. Mostly only painkillers and sedatives are prescribed, and rarely - drugs for correcting hormonal levels.
If lumps and other signs of breast disease are detected, instrumental and laboratory diagnostics are prescribed.
Mammography allows you to clarify the form of mastopathy, determine the location and type of tumor nodes. The picture is taken in two projections.
Ultrasound carried out to detect cysts and diagnose the proliferation of organ tissue.
Blood analysis. It is carried out to detect hormonal disorders and allows us to understand the cause of the disease. An endocrinologist is invited for consultation.
Smear. If there is discharge from the nipple, a study of its composition is carried out.
Biopsy. From the lumps found in the mammary glands, tissue samples are taken using a syringe for histological examination to confirm the nature of the pathology.
Pneumocystography(fine needle biopsy). Fluid is sucked out of the cyst to study the structure and shape of the cells. The cavity is then filled with air. Done X-ray mammary gland in 2 projections to determine the shape and size of the cyst, detect the formation of growths on it inner surface. In some cases, cysts can be eliminated by gluing their walls together with a special substance (sclerotherapy is performed).
Ductography. In this study, a contrast solution is injected into the milk ducts, followed by a mammogram. This allows you to find out what condition they are in, whether there are any changes in the structure of the glandular tissue.
Radiometry. The method is based on the difference in the intensity of electromagnetic radiation and the temperature of healthy and affected tissues. Used when there is suspicion of a malignant nature of the seals.
The patient is sent to additional examination to a gynecologist to identify diseases of the genital organs that could lead to hormonal imbalance.
Most often used conservative methods: drug therapy, physiotherapy. Changing the nature of nutrition plays an important role. The surgical method is much less commonly used.
First of all, the treatment of diseases that lead to hormonal imbalance. In order to eliminate it and reduce the concentration of estrogen in the blood, hormonal drugs are prescribed:
The effect of estrogen on the body is also suppressed by non-steroidal drugs, reducing the sensitivity of nerve receptors to these hormones (tamoxifen). To regulate the level of progesterone and prolactin, homeopathic remedies Mastodinon and Remens are used. To restore the functions of the thyroid gland and eliminate hypothyroidism, iodine preparations (iodomarin) are prescribed.
Anti-inflammatory treatment is carried out using drugs such as diclofenac, nise. They help eliminate pain in the mammary gland. To eliminate swelling in the chest, diuretics (furosemide) are used.
Vitamin therapy is carried out, which is necessary to strengthen the body's defenses. Particular emphasis is placed on the consumption of vitamins A, C, E and group B. Remove emotional stress and thus sedatives can improve hormonal levels.
In the treatment of diffuse mastopathy, various gels and creams are used, for example, progestogel (with progesterone), balm ointment healer (anti-inflammatory action), Traumeel C (to reduce pain and inflammation).
Physiotherapy methods are used (acupuncture, electrophoresis, laser therapy, radon baths and others) to slow down the development of nodes and strengthen the body. Great importance is attached to dieting and the fight against excess weight.
Acceptable use of funds traditional medicine that have a calming effect (infusions of motherwort, valerian, mint and other plants). At home, to relieve inflammation and pain, you can use ointments with camphor, propolis, and celandine. To resolve seals, take tinctures and decoctions of boron uterus, burdock, and red brush.
It is performed only in the case of a rapid increase in the size and number of compactions, when relapses of the disease occur, or if cancer is suspected. In this case, resection of the affected area of the mammary gland is performed, if necessary, along with surrounding tissues.
In order to reduce the likelihood of diffuse cystic mastopathy, it is necessary to eliminate the impact on the body harmful factors(stress, chest trauma, obesity), refuse bad habits, as well as from visiting the solarium. You should constantly self-monitor your condition mammary glands and undergo regular gynecological and mammological examinations.
Any hormonal drugs (including contraceptives) can be used only on the recommendation of a doctor.
What is fibrocystic mastopathy today? This is the most common “supplier” of breast cancer. Another name for the pathology is dishormonal mammary hyperplasia. Symptoms of this disease appear in women aged 30 years and older. Oncologists and mammologists believe that FCM is an obligate precancerous condition, which inevitably leads to malignancy without proper and adequate treatment.
This pathological condition of the mammary glands (in men, mammary glands) is characterized by the appearance of all kinds of compactions and focal formations. Most often, diffusely enlarged cystic (focal) mastopathy is observed in patients of childbearing (reproductive age) who are capable of conceiving a child. On initial stages development, breast fibromatosis can be successfully treated, so you need to try to diagnose it in time, without waiting for various dangerous consequences. How does fibrocystic mastopathy manifest and how is it treated?
| Types of mastopathy | Physiology | Clinical manifestations |
|---|---|---|
| Diffuse | Nodules and cords in the breast tissue; seals. | Pain, enlargement and hardening of the breasts during the menstrual period. |
| Nodal | Development of neoplasms to tactile sizes - from a pea to a walnut. | Tactile swelling; the breasts are very painful and enlarged regardless of the day of the cycle; enlarged lymph nodes in the armpits. |
| Fibrocystic | Mixed form of mastopathy; tissue proliferation manifests itself both in the form of small neoplasms and in the form of nodes; Together, these growths form conglomerates in the form of cystic cavities filled with fluid. | Acute pain even with slight movement of the hand, pain radiates to neighboring parts of the body - shoulder blade, arm, etc. Discharge from the breast - milky, watery, or even mixed with blood. |
Having heard the diagnosis of fibrocystic mastopathy - what is it? - women ask, and what are the factors influencing its appearance? The causative factors for the development of fibrocystic breast disease are diverse.
The most important cause of diffuse cystic mastopathy is a hormonal imbalance in a woman’s body.
Great importance is attached not only to sex hormones (estrogen and progesterone), but also to hormonal substances produced. Signs of diffuse fibrotic changes in the mammary gland occur in hypothyroidism, diffuse nodular Diabetes, diseases of the adrenal glands affect the risk of developing dishormonal problems.
Symptoms of fibrocystic mastopathy of the mammary gland are not uncommon when using hormonal drugs for contraception.
The use of steroid hormonal drugs can also affect the condition of patients and cause diffuse fibrocystic mastopathy.
Among endocrine diseases considered as the cause of the described pathology, hyperthyroidism, obesity, as well as different kinds impaired glucose tolerance. Hypothalamic syndrome, for example, with mastopathy occurs in Lately Often.
Diffuse cystic mastopathy can be triggered by stressful situations. The described disease can also occur with systematic dissatisfaction with sexual life. Symptoms of breast pathology progress with the presence of this factor in a woman’s life.
Men can also have this disease. In the presence of diffuse cystic mastopathy, the process is usually unilateral rather than bilateral. She is progressing quickly. Pain syndrome is rare. Male mastopathy very quickly develops into cancer.
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Let's consider characteristic symptoms diffuse cystic mastopathy or FCM. They do not always bother you at the same time; some of them are present, while others may be absent.
Pain with mastopathy may not always be present. It appears in the second half of the menstrual cycle, intensifying towards its end. The chest pain is not very severe, but women perceive this manifestation very emotionally and anxiously. With age, the tendency to hypochondria and cancer phobia increases, especially with the spread of knowledge about breast cancer statistics.
The nature of the pain can be aching or twitching, like spasms. Sometimes there is irradiation to the shoulder, shoulder girdle, axillary region, which dictates the need for differential diagnosis with cardiogenic manifestations.
There are 15-30% of patients with absence pain. The equivalent of this syndrome will be discomfort and a feeling of distension of the organ. The reason for this is the different pressure of enlarged cystic structures on pain receptors. In addition, each patient has his own pain threshold. Clinically, cystic mastopathy of the mammary gland resembles the picture of premenstrual syndrome. But with it there are no nodular formations in the glands.
For diffuse fibrous cystic mastopathy, the appearance of nipple discharge is typical. They have a transparent white color and liquid consistency.
The liquid can be released spontaneously (by friction with clothing) or in situations where the doctor or the patient himself presses on the areola area. As a rule, there is no smell. The purulent nature of the discharge occurs when secondary microflora is attached.
Tissue compaction in glandular cystic mastopathy is caused not so much by proliferative processes as by the formation of connective tissue foci. This will confirm the doctor’s opinion functional diagnostics: local fibrosis of the mammary gland. The patient can identify the presence of a lump during self-examination. Most often, these signs are detected by the doctor during palpation. Diffuse fibrous mastopathy of the mammary glands means that the process of replacing parenchyma with connective tissue occurs very intensively. Carefully read the instructions for breast self-examination and do this procedure at least once a month.
Increase. Oncologists and mammologists consider diffuse fibrocystic mastopathy as an obligate precancer*. Why is this pathology dangerous? In the presence of certain factors, mastopathy, even focal, can transform into a cancerous tumor.
These include:
All these factors greatly increase the likelihood of malignant neoplasm against the background of diffuse fibrocystic mastopathy. This is the danger of such a pathology as fibrotic.
Obligate precancer - early stage oncological pathology, which sooner or later transforms into cancer. These changes require radical treatment. Optional precancer does not necessarily turn into a malignant tumor; it requires careful monitoring, but not treatment.
The variant of diffuse fibrocystic mastopathy is not much different from others. When performing an ultrasound examination, the volume of connective tissue increases. Its increase is progressive.
Palpation reveals a group of nodules with clear boundaries, which, before the onset of menstruation, enlarge, swell, and after the end of menstruation again take their shape.
The nodular form of the disease is characterized by formations that resemble nodes or cysts, which are multiple or single in nature; this form of the disease is called nodular mastopathy.
The mixed form of mastopathy combines the signs of the diffuse variety and the focal form. To diagnose the described pathology, as well as determine its type, mammography is required. So, if fibrocystic mastopathy is diagnosed: what is it in terms of treatment?
How is mastopathy of the mammary glands caused by improper functioning of hormones (dishormonal) treated? This task is performed by a mammologist together with a gynecologist and endocrinologist. Treatment is aimed at restoring hormonal levels. The attending physician may prescribe medications containing estrogens in a minimal dose. This medicine improves the prognosis of the disease and also reduces vegetative manifestations. Some clinical situations require that a drug such as Progestogen be prescribed. These hormonal drugs contain gestagen. The purpose of this remedy should be agreed with an endocrinologist and gynecologist.
Mastodinon for fibrocystic mastopathy helps relieve symptoms of pain, bloating and other manifestations of discomfort. This medicine is herbal in composition and origin. It has a very gentle effect on all body systems, having minimal effect on hormonal status. Treatment drugs are prescribed carefully.
Nutrition issues in fibrocystic mastopathy occupy an important place in treatment. Doctors recommend eliminating caffeine, alcohol, strong drinks and spicy foods. The diet should be high in calories, with sufficient fiber and vitamins.
Complex vitamin preparations can be used not only for treatment, but also for preventive purposes. They are used with caution, as allergic reactions may develop to them. If you are intolerant, you can use homeopathic medicines with the permission of your doctor. An important condition for cancer prevention is regular observation by a doctor, monitoring the condition of the mammary glands using ultrasound, mammography, and self-examination.
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