The main signs of fibrocystic mastopathy in women. Fibrocystic mastopathy: symptoms, treatment Fibrocystic mastopathy cysts

Is it necessary to treat mastopathy?
(fibrocystic disease)?

The mammary gland is a distinctive feature of an entire zoological class - the class of mammals.

From the birth of a child to the later years of life, the mammary gland changes its appearance many times - starting with a small bud, it goes through its exciting heyday and ends its life in fading calm.

The mammary glands begin to form in the 6th week of intrauterine life. From the moment of birth until puberty, the ducts in the mammary glands lengthen and the nipples enlarge. During puberty, rapid lengthening and branching of the ducts, formation of glandular lobules, and changes in the morphological structure of the mammary gland occur. Connective tissue forms 2 zones: intercellular and interlobar (supporting lobes), subject to hormonal influences. After full puberty, the mammary gland stops developing until the second trimester of the first pregnancy. Thus, from puberty until the end of the first pregnancy, the epithelium of the mammary glands is immature, it is not able to respond to its own circulating progesterone, and this becomes a risk factor in the development of breast cancer.

The mammary gland is extremely dependent on the cyclical physiological processes of the body. In practice, the mammary gland is never at rest, regardless of the woman’s age. Constant variability in the structure of the mammary gland, sensitivity to sex hormones, thyroid hormones, dependence on sexual comfort and the state of the emotional status of a woman, lead to the frequent occurrence of dysplastic processes in this gland, which are most often combined with the term mastopathy or fibrocystic disease.

Mastopathy or fibrocystic disease -

this is a general name for benign changes in the mammary glands, which differ greatly in anatomical characteristics, clinical manifestations and the danger of malignancy, which forces us to consider mastopathy as a precancerous disease.

There are a huge number of reasons for these changes. The main ones are:

• Stressful situations that are present in the life of every woman (dissatisfaction with their marital status, as well as their position in society, domestic conflicts, conflict situations at work) since any stress is accompanied by various functional disorders of the neuroendocrine system.
• Factors of a sexual nature.
• Reproductive factors (number of pregnancies, births, abortions, age at pregnancy and childbirth, duration of lactation, time of first menstruation and menopause, etc.).
• Gynecological diseases and, first of all, inflammatory processes in the pelvis.
• Endocrine disorders (thyroid dysfunction, metabolic syndrome, polycystic ovary syndrome, diabetes mellitus types 1 and 20, etc.). Pathological processes in the liver and bile ducts. Hereditary (genetic) predisposition.

For mastopathy, the most typical complaints are:

• breast tenderness,
• a feeling of increasing their volume,
• engorgement and swelling of the glands,
• the presence of clear or colostrum-like fluid discharge from the nipples of the mammary glands.

Pain may radiate to the armpits, shoulder and shoulder blade. The most common is a combination of symptoms of mastopathy and premenstrual syndrome. The main complaints in these conditions are: headache (often migraine-type), swelling of the face and limbs, nausea, less often vomiting, impaired bowel function, flatulence. With the neuropsychic form of premenstrual syndrome, complaints such as irritability, depression, weakness, tearfulness and aggressiveness may be associated. Difficulties in determining the cause of pain are due to the fact that pain can occur not only with pathology of the mammary gland, but also with cervicothoracic osteochondrosis, radiculoneuritis, intercostal neuralgia and is eliminated with appropriate therapy.

What forms can fibrocystic disease have?

Most often, mastopathy is diffuse in nature and manifests itself:

• predominance of the glandular component (edema, proliferation of glandular tissue) - the most favorable form;
• the predominance of the fibrous component (swelling, enlargement of interlobular connective tissue septa, their pressure on the surrounding tissue, narrowing of the lumen of the ducts, up to their complete fusion;
• the predominance of the cystic component (the presence of one or more elastic cavities filled with liquid contents, clearly demarcated from the surrounding tissues of the gland);
• mixed form (increased number of glandular lobules, proliferation of connective tissue interlobar septa).

A less favorable form of mastopathy is nodular. In this form, as a rule, against the background of the changes described above, there is the presence of one or more nodes, most often representing an adenoma or fibroadenoma.

Fibroadenoma

A fairly common benign tumor of the mammary glands. Occurs at any age, but more often in 20-40 years. In some cases, especially in adolescents, fibroadenomas can grow quickly and reach significant sizes (up to 10-15 cm). According to various authors, the degeneration of benign fibroadenoma into a malignant breast tumor occurs in 1.5-2%.

Also, the nodular form can be represented by atypical hyperplasia (proliferation of glandular tissue). The percentage of degeneration of this nodular formation increases to 20%.

It is also worth recalling a very special manifestation of mastopathy - bloody discharge from the nipple of the mammary gland. As a rule, the cause of such discharge is an intraductal formation (papilloma), which can ulcerate and bleed. Such symptoms should be a serious cause for concern for a woman and promptly seek medical help.

Necessary examination methods that a woman should receive when visiting a mammologist:

• examination and manual examination of the mammary glands, examination of the axillary, subclavian, cervical lymph nodes;
• Ultrasound of the mammary glands and lymph nodes;
• x-ray mammography (all women over 40 years of age);
• blood tests (general analysis, biochemical study, hormonal status, tumor markers);
• when cysts are detected, puncture them with cytological examination of the contents;
• when a nodular formation is detected, cells are collected from the formation using a needle and syringe for cytological examination.

The treatment regimen for mastopathy should be selected individually for each woman. When prescribing a regimen, the reasons for the development of mastopathy, examination data, and changes in blood tests should be taken into account. If necessary, a woman should consult such specialists as a neurologist, gynecologist, endocrinologist, or therapist. Also, according to the doctor’s decision, if a nodular formation is identified, surgical treatment can be performed in the oncology department with histological examination of the removed area of ​​the mammary gland.

Fibrocystic mastopathy (FCM) is a serious pathology in which numerous cysts of various sizes begin to form in the mammary gland. It occurs mainly in patients of childbearing age, but can also develop in women after menopause. What is the reason for this? What are the causes of mastopathy? And is it possible to cure it? Let's talk about this in more detail.

Provoking factors

Considering mastopathy and the mechanisms of its development, it should be noted that the main factor stimulating the occurrence of FCM is an imbalance between hormones such as progesterone and estradiol. The following diseases and conditions can lead to their imbalance:

1. Premature formation of the menstrual cycle. When girls start their periods too early, there is a sharp change in hormonal levels, to which the body does not have time to adapt. And under the influence of hormones, the tissues of the mammary glands undergo various changes, which causes the formation of numerous cysts in them.
2. Late onset of menopause. In this case, mastopathy begins to develop against the background of prolonged exposure to the hormones estradiol and progesterone on the mammary glands.
3. Infertility.
4. Medical and surgical abortions, spontaneous miscarriages - all this causes “jumps” in hormonal levels.
5. Lack of lactation after childbirth.
6. Prolonged stay in a stressful state.
7. Kidney pathologies and dysfunction of the adrenal glands, which produce hormones.
8. Impaired metabolism, observed with excess body weight, the development of diabetes mellitus and diabetes insipidus, and the formation of endemic goiter.
9. Pathologies of the thyroid gland, which also produces hormones. Moreover, the development of mastopathy can occur both with hypothyroidism and hyperthyroidism.
10. Inflammatory and infectious diseases of the reproductive system.
11. Deviations in liver function.
12. Long-term use of oral contraceptives.

Important! Age also plays a key role in the development of breast mastopathy. As practice shows, in most cases this pathology is diagnosed in women aged 35-45.

It should be noted that initially FCM was not considered as a pathology that could transform into cancer. But after numerous studies, scientists were able to reveal that mastopathy that appears when exposed to negative factors can easily degenerate into a malignant tumor. Therefore, this disease is currently considered a precancerous condition.

Whether cysts will degenerate into cancerous tumors or not depends on several factors - the duration of pathological processes and the stage of development, as well as on the types of the disease. Fibroadenoma and adenosis are the most dangerous forms of FCM, as they increase the risk of cancer significantly.

Types of FCM

There are several types of mastopathy:

• nodal;
• non-proliferative;
• mixed.

Pathological processes can affect only one gland (unilateral) or spread to both at once (bilateral).

Diffuse

This form of the disease is characterized by the proliferation of connective tissue in the gland. This causes a disruption in the structure of the milk ducts and the lobular structure of the organ, as a result of which numerous small cysts begin to form inside it.

Mastopathy can develop not only due to hormonal disorders, but also genetic predisposition, as well as when the body is exposed to various negative factors, for example, chemicals, radiation, etc.

There are several types of diffuse cystic fibrosis disease:

• Adenosis, with the development of which there is an increase in glandular structures and lobules of the mammary gland.
• Fibroadenomatosis, characterized by the predominance of fibrous tissue in the gland.
• Cystosis is a pathology characterized by an increase in cystic tissue in the structures of the mammary glands.

Sometimes, during examination, women are diagnosed with adenosis, fibroadenomatosis and cystosis at the same time. This indicates the development of a mixed form of the disease.

Diffuse fibrocystic pathology has another type - sclerosing adenosis. It is also characterized by abnormal growth of fibrous tissue into the gland structures. However, during its development, the epithelium and lobes of the organ do not undergo a pathological process.

Depending on the scale of mastopathy and the rate of damage to organ structures, it is divided into:

• insignificant;
• moderate;
• expressed.

Nodal

Nodular mastopathy is a consequence of the development of a diffuse type of disease. It is characterized by pathological proliferation of connective tissue areas of the mammary gland with the subsequent formation of cystic nodes.

With the development of this pathology, nodular formations are clearly palpable in the chest, which have a dense structure and clear boundaries. As a rule, a few days before the onset of menstruation, they begin to increase in size and can be painful when pressed. After the end of menstruation, the swelling of the nodes subsides and they return to their previous size.

Important! When a woman is in a horizontal position, there are practically no signs of nodular type mastopathy - the formations are weakly palpable or not detected at all during palpation. At the same time, the woman is also not bothered by painful sensations.

It is worth noting that nodular formations in the chest are not prone to progressive growth. More often they remain the same diameter for a long time, increasing only before menstruation. Painful sensations can be of a different nature - pronounced, insignificant or completely absent. In other words, the symptoms of nodular type FCM are individual in each case.

Non-proliferative

Non-proliferative mastopathy is not accompanied by signs of proliferation. That is, with the development of the disease, there is no process of cell reproduction with subsequent proliferation of the gland and its intensive division. With the development of this pathology, swelling of the breast tissue is noted, which has a precise localization, which is not accompanied by the formation of new structures.

In other words, with this form of the disease, individual structures of the gland begin to increase in size, as a result of which compactions appear in it, which can be easily confused with cysts. The reasons for this may be various inflammatory and infectious processes.

Important! Despite the fact that non-proliferative mastopathy is not characterized by the appearance of pathological formations in the mammary gland, it also requires a serious approach to treatment. Since any unnatural processes in the gland can subsequently provoke the appearance of cysts, which will require surgery.

Mixed

The mixed form of FCM is characterized by signs of all types of pathology at once. Formations with cystic, fibrous and glandular components appear in the breast. In this case, connective tissue grows and breast volume increases. Upon palpation, numerous painful lumps with clear boundaries of different sizes are noted.

With the development of this pathology, the simultaneous formation of fibroadenoma is possible, which is characterized by the appearance of a mobile round formation in the gland (most often it is benign).

Important! Mixed FCM is an advanced form of the disease, which is accompanied by various complications. It is difficult to treat and requires long-term therapeutic measures.

Double-sided

The development of bilateral mastopathy is characterized by the occurrence of pathological processes in both mammary glands at once. In this case, the connective tissue, glandular or fibrous components of the mammary glands may be affected, which leads to their trophic change and the formation of cysts.

Important! Bilateral FCM can cause the development of a malignant tumor in one of the mammary glands.

As a rule, this form of the disease is a consequence of long-term hormonal imbalance in the body, and therefore treatment in this case is aimed at restoring the level of hormones and treating the pathologies that led to its disruption.

Symptoms

With mastopathy, symptoms and treatment are always individual. They depend, first of all, on the type of pathology and the degree of its development. Clinically, FCM is accompanied by painful sensations when pressing on the breast and the appearance of discharge from the nipple. They have a liquid, mucous consistency that can be yellowish or green.

On palpation, small dense rounded formations are felt. They can be grainy or smooth.

Breast pain is permanent or short-term. It can radiate to the armpit or shoulder joint, and can also be accompanied by a feeling of heaviness in the chest and squeezing.

Important! FCM at the initial stages of development is always pronounced. Symptoms intensify a few days before the onset of menstruation, and also if the woman does not receive appropriate treatment. At an advanced stage of the disease, the clinical picture becomes acute and neoplasms in the breast can be visible to the naked eye. Moreover, their increase no longer depends on the menstrual cycle.

In case of degeneration of neoplasms in the mammary glands into cancer, the following symptoms are observed:

• The seals are soldered to the structures of the organ, as a result of which they become immobile.
• Ulcers and crusts appear on the skin of the chest.
• The gland swells, greatly increasing in size.
• Bloody, brown or black discharge begins to ooze from the nipple.
• The skin of the chest takes on a red tint.
• The breasts become lumpy and their natural contours are disrupted.
• There is asymmetry of the mammary glands.
• The pain syndrome intensifies.

Important! The occurrence of at least one of the above symptoms requires immediate consultation with a doctor.

Is it possible to plan a pregnancy?

Fibrous a cyst is not a contraindication to pregnancy. On the contrary, conceiving a child can help restore hormonal levels, which will have a beneficial effect on the treatment of fibrous mastopathy.

At the same time, lactation is also not contraindicated in this disease. It also contributes to the treatment of FCM. In addition, during lactation, some formations can even dissolve on their own, leaving no traces behind. Therefore, it is believed that pregnancy and breastfeeding are an excellent prevention of FCM and the only safe way to treat it.

During lactation, the growth of epithelium in the mammary glands is activated, which produces its own antibodies that can destroy cells of nodes and cysts. That is why pathological formations stop growing and begin to gradually dissolve. However, long-term breastfeeding must be carried out under close medical supervision. This will allow you to take the necessary measures in a timely manner in the event of lactostasis and prevent the progression of FCM.

Possible complications

If left untreated, this may result in:

• Progressive growth of cystic formations in, which leads to visible changes in its shape.
• Inflammation of the cysts and further infection of the gland, followed by suppuration.
• The occurrence of cancer.
• Education gap.

Given such serious consequences, every woman should know what FCM is and how it manifests itself. Only timely detection and treatment can prevent their occurrence.

Diagnostics

You can identify mastopathy yourself by palpating the mammary gland. When palpating it, compactions and nodular formations with clear and even boundaries are noted.

However, to confirm the diagnosis, you will also need to undergo a breast ultrasound and x-ray. The photo of the X-ray examination shows the number of formations, sizes and contours. Ultrasound allows you to determine the thickness of the walls of cysts, their contents and the likelihood of degeneration into cancer.

An ultrasound examination of the pelvic organs is also mandatory, which allows us to exclude the development of pathologies of the organs of the reproductive system, as well as biochemical and hormonal blood tests.

If the doctor suspects the occurrence of oncology, then before performing FCM therapy, he prescribes an MRI, CT scan and testing for the CA-125 tumor marker.

Treatment

If mastopathy is detected, therapy must be carried out without fail. And the sooner it starts, the lower the risk of serious complications. How to treat is determined only by the doctor, taking into account the results of the examination of the patient and her age category.

Conservative therapy for FCM is carried out only with a diffuse form of development of the pathology. Both hormonal and non-hormonal therapy can be used here. The latter implies the reception:

• Multivitamin complexes.
• Iodine-containing drugs (prescribed if a woman has thyroid pathologies).
• Sedatives, since any stress can lead to progression of the disease.
• Non-steroidal anti-inflammatory drugs.
• Herbal medicines and diuretics.

Conservative treatment for mastopathy also includes following a special diet that helps restore hormonal levels without the use of drugs. Nutrition for mastopathy completely excludes the following foods:

• bakery products;
• pasta;
• semolina;
• corn;
• White cabbage;
• confectionery;
• sauces (mayonnaise, ketchup, etc.);
• butter and margarine;
• pickles;
• smoked meats;
• semi-finished products;
• canned food;
• carbonated drinks;
• black tea and coffee.

The diet also completely excludes the consumption of fatty and fried foods. The main diet should be:

• legumes;
• fresh vegetables and fruits;
• nuts;
• seafood;
• lean meats and fish;
• dairy and fermented milk products.

And also a diet for mastopathy requires adherence to a regimen - meals should occur at the same time at least 5 times a day. In this case, a portion of food should not exceed 200 g.

If non-hormonal therapy does not produce positive results, then treatment is carried out using hormonal drugs. In this case, the main emphasis is on the use of gestagens, androgens, inhibitors of prolactin production or antiestrogens. Drugs are prescribed on an individual basis after receiving the results of a hormone test.

If no positive dynamics are observed during hormonal therapy, the pathology is treated through surgery. During the operation, sectoral resection of the mammary gland or enucleation of the tumor can be performed.

Mastopathy is not a death sentence. If a woman promptly seeks help from a doctor, then she has a chance to get rid of this pathology without consequences, and without even resorting to surgery.

Video material on the topic

Echo signs of fibrocystic mastopathy are determined using ultrasound (echography), which is a highly informative, safe, non-invasive and modern method of examining the condition of the mammary glands

Echo signs of diffuse mastopathy are indicators of the disease that were revealed during ultrasound diagnosis of the patient’s mammary gland (echographic method). They may vary depending on the timing of the disease, the patient’s age and health status.

The essence of the disease and its causes

Fibrocystic mastopathy (FCM) is considered a pathological condition of the breast and a benign formation. Symptoms accompanying the disease:

• lumps in the chest;
• cysts that differ from each other in size and shape;
• pain in the chest area;
• nipple discharge;
• changes in the contours and size of the breast.

Important: with bilateral mastopathy, changes and damage to both mammary glands occur, but the changes are expressed and can be different.

Breast mastopathy is common in women of reproductive age. It also occurs in menopausal women.

The main reason for the development of the disease is a hormonal imbalance in a woman’s body. Important indicators of hormone concentrations:

• progesterone;
• estrogen.

The need for ultrasound diagnostics

FCM is treatable if the disease is detected in the early stages. Some time ago, mastopathy was not associated with the occurrence of cancer in the breast. But modern research in this area allows us to consider this disease as a condition that precedes cancer. The examination is prescribed by a mammologist.

Important: FCM is an intermediate stage between a pathological condition and oncology.

For a benign tumor to transform into a malignant one, a combination of certain factors must occur. In order to prevent complications of the disease and the onset of an oncological condition, it is necessary to contact a specialist as soon as possible and undergo all the necessary examinations.

For ultrasound of the mammary glands, watch the video.

Echosigns of the disease

Important: what are the echo signs of fibrous mastopathy and what they will mean, in each specific case you need to check with a mammologist.

The patient is able to determine the symptoms of diffuse fibrocystic mastopathy independently by palpating the chest, standing and lying down.

In medical diagnostics they use:

• analysis of blood composition for hormonal substances and other indicators;
• mammography;
• ultrasonography.

All methods are used in a comprehensive manner, ensuring the accuracy of the diagnosis.

Important: the diagnosis of fibrocystic mastopathy can only occur after the patient has completed all studies.

Mastopathy is diagnosed by carefully studying the tissue of the gland using an echographic method, following from the peripheral parts of the gland to the nipple area. The research method is always bilateral; both mammary glands are examined. Even if the patient complains about only one breast.

In the diffuse form of the disease, the study may show the predominance of one tissue or another, and in this way a diagnosis will be made.

Fibrocystic mastopathy will be determined by ultrasound based on the following echo signs:

• thickness of the layer of glandular breast tissue;
• an indicator of breast tissue density;
• fibrosis of areas of the milk ducts;
• discrepancy between the condition of the breast and the patient’s age;
• damage to the nipple and its area;
• dilation of the gland ducts;
• the presence of cysts.

The study demonstrates that echo signs of fibrocystic mastopathy vary depending on the age of the patient.

The older the woman, the smaller the thickness of the glandular layer and the greater the tissue density. The highest density figures are achieved by the age of 55 for a woman.

Advantages of the method

An ultrasound examination is the safest; it can be performed by young girls and women expecting a baby.

Information content is determined by high resolution. Fibrocystic mastopathy is clearly visible on ultrasound; this method also makes it possible to assess the condition of breast implants and assess the area of ​​inflammation. In addition, the study can show the condition of the lymph nodes located in close proximity to the breast.

Important: preventive ultrasound examinations are necessary to monitor the condition of the mammary gland; a healthy woman should be checked once a year.

This method is indispensable for clarifying the diagnosis of fibrocystic mastopathy. An ultrasound examination is necessary to obtain a complete picture of the manifestations of the disease.

Knowing the thickness of the tissue layer and echo density indicators will make it possible to draw up a competent treatment plan and achieve a state of remission of the disease. Will give you the opportunity to live a full life.

For more information about the disease, watch the video.

It is important to know! In women who have not given birth under 25-30 years of age, fibrocystic disease (mastopathy) does not cause much concern, but closer to 30, especially during pregnancy and after childbirth, 80 percent of women develop a complication of mastopathy. Along with women who have not given birth, many mothers who devote almost all their time to their baby forget about their health or think that this problem is trivial and will go away on its own. Expectant mothers are in an even more difficult position - during pregnancy and breastfeeding, many pharmaceutical drugs are prohibited. Did you know that mastopathy, if not treated in time by preventing the disease, can cause breast cancer. Read about a completely natural remedy for mastopathy (fibrocystic disease), compatible with breastfeeding and pregnancy here...

Diffuse fibrocystic mastopathy - what is it? This question threatens to become one of the most frequently asked among female audiences. This is due to the fact that this disease remains the most common pathology affecting the milk-secreting glands in women aged 30 to 50 years. Although mastopathy can occur in children of both sexes, in both men and women in the postmenopausal period.

Sometimes patients search for information about diffuse fibrocystic mastopathy of the mammary glands. This definition is redundant. The word “mastopathy” already suggests that the pathological process will affect the glands that secrete milk. The disease itself, by definition, is called either diffuse mastopathy or fibrocystic disease.

General characteristics of the disease

DFCM (diffuse mastopathy) is diagnosed in more than 35% of women of childbearing age. Every year the number of women diagnosed with mastopathy increases. This disease is associated with hormonal imbalance (progesterone deficiency, excess estrogen). With this disease, the level of prolactin also changes upward.

It is characterized by:

• abnormal growth of breast tissue;
• discomfort up to pain;
• in some cases - pathological secretion and swelling.

The pathological process may be accompanied by tissue proliferation. Changed or overgrown tissue, which is considered benign, can develop into cancer (about 2.5-3% of cases).

According to ICD-10, this disease is coded No. 60. According to clinical signs, fibrocystic disease is usually divided into diffuse and nodular. In the first case, the examination reveals a large number of small formations, without a clear predominance of any type. In the second case, the examination clearly identifies the node.

With diffuse mastopathy, one of three types of tissue may predominate, or the changes may be mixed; therefore, several subtypes of the disease are classified:

• glandular form (glandular or adenosis);
• mastopathy with a predominance of the cystic element (DCM or cystosis);
• disease with a predominance of fibrous elements (DFM or fibroadenomatosis);
• a mixed form may occur.

Diffuse cystic mastopathy can be unilateral (affecting only one gland), but bilateral mastopathy is much more common. Based on the principle of formation of pathologically altered tissue, proliferative and non-proliferative forms of the disease are distinguished. In the first case, the tissues involved in the process, namely connective (interstitial) and epithelium, grow through cell division. In the second, cysts form in the tissues. They can be small or quite large. At the initial stage, a so-called grape bunch is formed - a collection of small cysts that can be compared to a branch of grapes in shape and structure.

Over time, if the disease is not treated, the connective tissue becomes denser around the pathological formation, and the process of its growth begins. As a result of the described pathological process, the lobules of the mammary gland are stretched due to cysts forming in them.

Both forms can become malignant, but the proliferative one is more prone to malignization. Malignancy is the ability of cells of normal tissue or benign formation to acquire the characteristics of cancer. In the non-proliferative form of the disease, this ability is minimal and does not reach even 1% of all cases of mastopathy. The disease can be bilateral or affect only one gland.

The danger of mastopathy

Do oncologists consider diffuse FCM dangerous? Despite the fact that the disease is not malignant, experts do not recommend ignoring it and classify it as potentially dangerous. Despite the low risk of magnification, such a danger still exists.

If treatment is inadequate and insufficient, mastopathy can lead to breast cancer.

If the cyst is destroyed, hypothermia, or injury occurs, an inflammatory process may begin in the breast tissue. Cysts can fester, and this is fraught with sepsis.

With pathological tissue growth, the breast may become deformed (its shape and size change). This is not only aesthetically unattractive, but the woman experiences not only moral, but also physical discomfort. Periodic, and over time, constant pain interferes with proper rest, affects the functioning of the nervous system, and reduces performance.

Main types

Mastopathy is classified as a hyperplastic disease that occurs with the proliferation of a particular tissue. Thanks to some morphological characteristics, it was possible to identify individual forms of the disease. If the hyperplasia of glandular tissue is of a highly differentiated nature, the focus of growth is not encysted, then they speak of fibrocystic mastopathy with a predominance of the glandular component or adenosis.

Clinically, adenosis is manifested by the appearance of dense formations in the segments of the gland or diffuse swelling of the entire breast on the affected side. Swelling increases before the onset of menstruation. This form of pathology is more common in young girls.

When multiple cysts are detected, which are formed when the ducts of the gland expand, during the atrophy of its lobules and when the connective tissue changes, they speak of fibrocystic mastopathy with a predominance of the cystic component. With this type of pathological process, the epithelial cells that form the lining of the cyst are prone to proliferation.

With DCM, small cysts of about 0.3 cm and quite large ones up to 6 cm are formed. The contents of cysts in diffuse cystic mastopathy have different colors. This depends on the stage of the process, in the last stage the contents are brown-green and may ooze from the nipple when pressure is applied to it. The chest with this form of the pathological process is painful.

The pain syndrome intensifies at the beginning of menstruation. In a quarter of patients with diffuse cystic mastopathy, the cysts become calcified. This is considered one of the first signs of malignancy of a tumor formation, as is the admixture of blood in the contents of cysts.

Diffuse fibrous mastopathy of the mammary glands is characterized by changes in the tissue that makes up the stroma of the mammary gland lobules (connective tissue). With this pathology, the cells lining the gland ducts are prone to proliferation, which is why the lumen of the ducts narrows or closes completely (this is called obliteration). When palpating the chest, cords and lumps form in the affected area. This form of the disease, like the other two, is accompanied by pain.

Diffuse mastopathy with a predominance of the fibrous component is typical for women in the premenopausal period.

In the form of a clearly differentiated form, any of the above-described forms of diffuse cystic fibrous changes in the mammary glands are rarely encountered in clinical practice. Usually the morphological characteristics of each form are diagnosed.

Causes

Considering that this disease has only been studied for about a hundred years, it was not possible to unambiguously establish the cause of the development of the described changes in the breast tissue.

Hormonal imbalance plays the “first fiddle” in the set of factors that provoke the development of the pathological process.

The development of the mammary glands is stimulated by the hypothalamic-pituitary system, ovaries and adrenal glands. Violation of their content leads to changes in the glandular tissue of the breast. Diseases of the thyroid gland also stimulate the development of pathology.

Additional factors that may affect diffuse nodular changes are:

• a large number of abortions;
• spontaneous termination of pregnancy or premature birth;
• the onset of the premenopausal period;
• refusal to breastfeed after childbirth;
• hormone therapy;
• chest injuries, abscesses, etc.

It is believed that diseases of the internal organs can trigger the development of this disease. Quite often the cause of mastopathy remains a mystery. This disease is considered a borderline pathology because it can be stimulated by a large number of different factors, which are sometimes impossible to influence. Therefore, when choosing a treatment strategy, an integrated approach should be chosen.

Diagnosis and treatment

The diagnosis is made based on a physical examination of the patient and hardware examination of the breast. Depending on the age of the patient, the doctor prescribes an ultrasound or mammography. The gold standard for diagnosing diffuse nodular benign formations in women is considered to be a combination of ultrasound methods and mammography. Mammography is contraindicated for pregnant women, nursing mothers and is not recommended for patients under 35 years of age.

An auxiliary method is blood sampling for hormone levels. To diagnose malignant neoplasms, a biopsy is performed. The resulting material is sent for cytological examination.

Therapy for diffuse fibrous changes in the mammary gland, in contrast to the nodular form, can be carried out by one of 2 methods - conservative or surgical. The nodular form can only be treated surgically. Conservative treatment begins with normalization of hormonal levels. Herbal remedies are very successful. The therapeutic strategy depends on the results of the examination, including hormone levels.

Treatment of mastopathy requires the use of different groups of drugs. For this purpose, hormonal agents are used to maintain the balance of hormones in the body, adaptogens and vitamin complexes to increase the body’s immune forces, anti-inflammatory and analgesic drugs to combat pain, diuretics help relieve swelling, and if necessary, sedatives and antidepressants can be prescribed. The drugs used can be prescribed in the form of drops or tablets and in the form of local agents (gels or ointments).

Diet therapy plays an important role in the treatment of this disease. The diet helps maintain the patient’s normal weight and thus reduce estrogen levels. If the cystic form of the disease predominates, the patient may be recommended a puncture-aspiration method of treatment. It involves suctioning fluid from the cysts. This treatment is applicable only for cysts that have not begun to become malignant.

If cancerous degeneration of the gland tissue is suspected, or in the case of the formation of a large number of cysts or excessive growth of interstitial tissue, resection of the affected organ may be used. With a benign course of the process, treatment of this disease requires a systematic approach, the therapeutic course must be repeated. Treatment is carried out under the supervision of a mammologist and oncologist.

The highest incidence of mastopathy is observed in single, smoking women who abuse alcohol. It follows from this that the best prevention of this disease is a warm family relationship, the birth and upbringing of a child.

Video

How to recognize mastopathy and cure it? Find out about it in the next video.

Mastopathy is the general name for a large group of benign pathological changes in the tissues of the mammary glands (MG).

A number of diseases with a wide range of hyperplastic, proliferative and regressive changes in the breast are united under the concept of fibrocystic mastopathy of the mammary glands.

Treatment of diffuse forms of FCM does not lose its relevance and remains a source of debate.

Fibrocystic mastopathy (FCM)
Benign diseases of the mammary glands
Benign mammary dysplasia
Dishormonal hyperplasia of the mammary glands
Fibrocystic disease
Fibroadenomatosis

Causes of fibrocystic mastopathy

All processes of development and growth of mammary gland tissue are hormonally determined.

How do hormones affect the mammary glands?

Estrogens - stimulates the proliferative growth of parenchyma (epithelium of glands and ducts) and, to a lesser extent, the stroma of the breast.

Progesterone - counteracts proliferation processes, suppresses mitotic activity of cells. This hormone ensures the structural differentiation of glandular tissue: alveoli, lobules.

Prolactin – stimulates the secretory activity of lactocytes (milk production in breast lobules). Prolactin increases the number of estrogen receptors in breast tissue and indirectly enhances the proliferative effect of estrogens on breast tissue.

STH (somatotropic hormone) – regulates the development and growth of breast tissue.

• Thyroid hormones.
• Hormones of the adrenal cortex.
• Insulin.

Any imbalance of these hormones can lead to mastopathy.

A decisive role in the development of FCM is played by:

The excessive influence of estrogens on breast tissue disrupts the functioning of the receptor apparatus and causes proliferative growth of the epithelium of lobular alveoli and ducts. This leads to the formation of cysts, intraductal papillomas, and cystadenopapillomas of the breast.

Accompanied by edema and hypertrophy of intralobular tissue - hyperplasia of the breast lobules.

Lack of progesterone indirectly increases the sensitivity of estrogen receptors and increases the local level of estrogen in breast tissue.

The complex mechanism for regulating hormonal balance in the body is not fully understood. The central nervous system plays an important role in this process.

What contributes to the development of FCM:

• Genetic predisposition.
• Neuroendocrine disorders.

• Diseases of the hypothalamic-pituitary system.
• Thyroid diseases.
• Diabetes.
• Obesity, hyperlipidemia.
• Diseases of the liver and biliary tract.
• Age over 35-40 years.
• Abortion.
• Prolonged mental tension, stress.
• Pregnancy and childbirth.
• Late first pregnancy.
• Short period or absence of breastfeeding.
• Early sexual development (menarche at age) menopause.
• Gynecological diseases.
• Inflammatory diseases of the mammary glands.

Fibrocystic mastopathy ICD-10 code

ICD-10 – International Classification of Diseases, Tenth Revision, approved by WHO.

• N60 Benign breast dysplasia

• N60.1 Diffuse cystic mastopathy without epithelial proliferation.
• N60.2 Fibroadenosis of the mammary gland.
• N60.3 Fibrosclerosis of the mammary gland.
• N60.3 Cystic mastopathy with epithelial proliferation.
• N60.8 Other benign breast hyperplasia.
• N60.9 Unspecified mammary dysplasia.
• N64.4 Mastodynia.

• N60.0 Breast cyst.
• D24 Benign breast formation. (Breast fibroadenoma, etc.)

Symptoms of fibrocystic mastopathy

Mastodynia – premenstrual swelling of the breast: a feeling of enlargement, tension, engorgement of the breast.

• Pain in the mammary gland.
• The pain may radiate to the shoulder, shoulder blade, or armpit.
• Sometimes: enlarged axillary lymph nodes.
• Sometimes: discharge from the nipple (yellowish, greenish, brownish-green).

Diagnosis of FCM

During the examination they evaluate:
— breast size (increased, decreased);
— shape of the nipple (bulging, retracted);
— condition of the breast skin (redness, swelling, “lemon peel”);
— nodular seals in the breast, their size, mobility, consistency;
- the nature of the discharge (if any) from the nipples.

A highly informative diagnostic study of breast cancer for young (under 35 years of age) women.
It is carried out in the first phase of the menstrual cycle.
In benign fibrocystic mastopathy, breast ultrasound reveals areas of varying brightness. Conglomerates of white spots are characteristic of malignant processes in the breast.

A simple and quite informative method for the differential diagnosis of FCM. Based on recording breast temperature with a special device.
The temperature of the skin area over the benign formation is slightly increased compared to the temperature of the skin over the healthy area of ​​the breast (“cold” node).
A marked increase in temperature (“hot” node) indicates the possibility of a malignant process in the breast.

X-ray examination of the breast is especially important for women over 35 years of age.
Mammography is done in the first phase of the menstrual cycle (preferably immediately after the end of menstruation) in two projections.

The study is carried out in a hospital setting.
Indications for ductography:
— Discharge from the mammary ducts.
— Intraductal papillomas.
- Breast cysts.
— Topical diagnosis of the pathological process in the breast.

The method is based on the property of radioactive phosphorus 32 P to accumulate in pathologically altered areas of the breast. The greatest accumulation and the least excretion of 32 R is observed in cancer tissues.

with fine-needle aspiration (for differential diagnosis of various forms of FCM) followed by cytological examination of the aspirate.

Is it possible to cure fibrocystic mastopathy?

It is possible if the treatment tactics for FCM are general and not isolated (symptomatic) in nature.

Individual treatment of mastopathy should be carried out after a thorough laboratory and instrumental examination of the patient and include competent correction of her hormonal, mental and psychological status.

For a successful result of treatment of FCM, the cooperation of specialists is necessary: ​​mammologist-oncologist, gynecologist, endocrinologist, neurologist, psychotherapist, surgeon.

There is no single algorithm for the treatment of diffuse fibrocystic mastopathy.

Large, growing (proliferating) nodular (fibroadenomas, cysts, papillomas) forms of FCM are treated surgically with mandatory histological examination of the removed tissue. Diffuse mastopathy is treated conservatively.

Non-hormonal therapy of diffuse fibrocystic mastopathy

activate the function of the thyroid gland and indirectly reduce the proliferative activity of tissues, promote the resorption of cystic elements in the breast.

1.1 Potassium iodide 0.25% solution: 1 tbsp. spoon 3 times a day after meals (with milk), excluding menstruation days. Course of treatment: up to 6-12 months.

1.2 “Klamin” is a plant adaptogen, made from brown algae (iodine content in 1 tablet: 50 mcg). Recommended intake: 1 tablet. 3 times a day with an individual course.

- prescribed by a neurologist to achieve psycho-emotional comfort for the patient.

Limit: animal fats, meat products, chocolate, tea, coffee, cocoa, cola, alcohol, table salt, refined sugars.
Increase: fiber content in the diet, fresh vegetables, fruits.

• Vitamin A

It has an antiestrogenic effect, reduces the proliferation of the epithelium and stroma of the breast.
Recommended intake: 50,000 IU per day, individual course.

• Vitamin E

• Vitamin B 6

Improves the functioning of the nervous system. Indirectly reduces the level of prolactin in the blood.
Recommended intake: 10-40 mg per day, in an individual course.

• Vitamins C and P

Improve microcirculation. Strengthen the walls of blood vessels, reduce swelling.
Combined drug "Ascorutin" 1 tablet 2-3 times a day in an individual course.

“Wobenzym”, “Serta”, “Alfetin”, etc. (the frequency of the drug and the duration of the course of treatment are prescribed by the doctor).

Pharmacy herbal preparations “For the treatment of mastopathy”
taken in the second phase of the menstrual cycle for 3-6 or more months.

• Plant antioxidant, immunomodulator "Fitolon".

The drug contains copper derivatives of chlorophyll. For a better absorbable effect, it is prescribed in combination with herbal preparations: orally in the form of drops, tablets or topically in the form of oil applications on the breast (consultation with a doctor is required).

7.1 “Mastodinon” is a combined herbal remedy for the treatment of fibrocystic mastopathy.
Recommended intake: 30 drops 2 times a day; or 1 tablet 2 times a day. The course of treatment is 3 or more months.

7.2 “Mastopol” is a drug for the treatment of mastopathy during the reproductive period.
Recommended dosage: 1 tablet under the tongue 3 times a day, course 8 weeks.

7.3 "Remens" is a drug for complex therapy of FCM. Helps normalize hormonal balance, improves microcirculation and the functioning of the pituitary-hypothalamic-ovarian system,
Recommended intake: 10-15 drops 3 times a day. Individual course.

7.4 “Cyclodinone” is a drug based on twig extract. Normalizes the balance of female sex hormones, reduces the level of prolactin in the blood.
Recommended intake: 40 drops in the morning. For a long time.

"Indinol" is a herbal and mineral remedy for the complex treatment and prevention of FCM.
Recommended intake: 1 capsule per day; course: 2-3 weeks.

Hormonal therapy for diffuse fibrocystic mastopathy

Hormonal treatment of FCM is carried out individually, together with a gynecologist, depending on age, presence and nature of gynecological pathology. The regimen and duration of therapy are prescribed by the doctor (all drugs have contraindications and side effects).

Used in the 2nd phase (from 16 to 25 days, or from 14 to 28 days) of the menstrual cycle.
Primolut, Norkolut, Provera, Duphaston, Utrozhestan, etc.

“Progestogel 1%” gel (natural micronized progesterone) – 1 dose of the drug is applied to the skin of the mammary glands once a day.
Increases the local concentration of progesterone in breast tissue, has virtually no effect on the level of progesterone in the general bloodstream.

“Depo-Provera” (medroxyprogesterone) is a long-acting drug, administered intramuscularly once every 3 months.
“Norethindrone-enanthate” (NET-EN) – administered intramuscularly once every 2 months.

"Norplant" (levonorgestrel) - capsules with the drug are sewn under the skin.

Individual therapy of fibrocystic mastopathy with combined oral contraceptives (estrogens content not more than 0.035 mg) gives a good therapeutic and prophylactic effect.
Rigevidon, Marvelon, Regulon, Mercilon, Femoden, Logest, Silest, Novinet, etc.

Tamoxifen at a dose of 10-20 mc/day, 3-6 months.
The drug stimulates ovulation; barrier contraception is recommended during treatment. Not used for the treatment of cyclic mastopathy.

Treatment with these drugs is indicated mainly for older women (45 years or more):
Danazol (Danone), Methyltestosterone, Testobromo-lecid,
Sustanon-250 and others.

Dostinex (cabergoline), Parlodel (bromocriptine) - drugs inhibit the secretion of prolactin and growth hormone within a few hours after administration. Effective in the treatment of cyclic fibrocystic mastopathy, as well as FCM associated with organic/functional hyperprolactinemia.

They are used as injections after 45 years of age when FCM is combined with uterine fibroids, endometriosis, and endometrial hyperplasia.
Zoladex (gazerelin), Lucrin-depot (leuprorelin), Buserelin, Diferelin, Sinarel, etc.

Treatment of mastodynia

Treatment of premenstrual edema of the breast is carried out from the 16th to 25th day of the menstrual cycle along with PMS therapy under the supervision of a physician.

For pain in the breast: NSAIDs (ibuprofen, indomethacin, nimesulide, etc.) – 1 tablet (capsule, sachet) 2-3 times a day.
Diuretics means (to relieve tension and swelling of the breast):
Furosemide: 0.02-0.04 g 1 time per day in the morning.
Hypothiazide: 0.05 g 1-2 times a day.

Fibrocystic mastopathy - consequences

FCM is a benign disease. But against the background of mastopathy, breast cancer develops more often. The danger of malignancy (degeneration into cancer) is represented by atypical and proliferative forms of FCM.

Cases of mastopathy with severe pain (constant, cyclical), with changes in the breast that are obvious upon palpation, and with discharge from the nipple require consultation with a mammologist-oncologist.

Competent treatment of FCM will improve the patient’s quality of life and minimize the risks of developing breast cancer.

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