Is it necessary to treat mastopathy (fibrocystic disease)? Types, causes and signs of breast mastopathy Mastopathy at the age of 20

Sometimes the epithelium, areas of connective tissue grow in the tissues of the mammary glands, as a result of which nodules and small seals appear. Among benign neoplasms, changes in the structure of the connective tissue of the mammary glands are diagnosed in almost 40% of women. Among gynecological pathologies, mastopathy is registered in about 60% of the fairer sex. The disease is unlikely to be fatal, mastopathy detected in the initial stage of development responds well to competent therapy.

The clinical picture of the disease is characterized by three main features:

  • chest pain
  • seal or knot
  • discharge from the nipples

At an early stage of its development, fibrocystic mastopathy of the mammary gland is manifested by painful sensations in the chest shortly before the onset. The pain can be aching, dull or sharp, in some cases it is so strong that it hurts to touch the mammary glands.

The pain syndrome can be localized or give to the shoulder blade. In the premenstrual period, in addition to pain, swelling is added. Blood stagnation occurs in the veins, which causes swelling of the connective tissue and the chest becomes hard to the touch. .

Symptoms intensify depending on the female pain threshold. About 15% of women did not experience pain, although an external examination by a mammologist revealed nodules characteristic of mastopathy. According to statistics, 10% of patients had enlarged axillaries.

Women write off other signs of mastopathy on PMS: irritability, tearfulness, excessive aggression and anxiety. After menstruation, the symptoms disappear, but soon the pain reappears, becomes constant, only changes in intensity according to the phase of the menstrual cycle.

Discharge from the nipples does not appear in every case of the disease. Their color and quantity also varies.

Most often they are white or transparent, stand out on their own or after pressure on the nipples. The green color of the detachable signals the attachment of the secondary. And brown or red discharge can be a symptom of a malignant tumor.

It is better to establish the correct diagnosis in the mammologist's office, where additional methods of instrumental diagnostics are used.

Predisposing factors for the development of the disease

All metabolic processes in the chest occur under the influence. Accordingly, a violation of the hormonal balance contributes to the appearance of atypical formations in the breast. The disease has been studied for more than 100 years, but the true culprits of the pathology have not been established.

Doctors have proven that all patients suffering from mastopathy have a complete or partial lack of estrogen or hormone deficiency. At the same time, an increased level of prolactin is recorded.

Mastopathy does not develop suddenly, the first signs appear only after two years of hormonal imbalance in the body. Atypical formations in the mammary glands appear under the influence of a combination of factors.

Hormonal balance is affected by:

  • hereditary factor
  • puberty before 12 years (the body does not have time to rebuild)
  • menopause, after 55 years (hormones affect the structures of the breast for too long)
  • and alcoholism
  • frequent
  • short or no breastfeeding
  • gynecological diseases associated with a violation of hormones - endometriosis, fibroids
  • use of hormones without a doctor's prescription
  • chest injuries, uncomfortable underwear
  • , goiter
  • problems in the liver
  • thyroid dysfunction - thyrotoxicosis, hypothyroidism, hyperthyroidism
  • constant stress along with endocrine pathologies
  • tumor of the hypothalamus or pituitary gland
  • Social conditions. Women who are often in stressful situations are at greater risk of the disease. 7% of patients with mastopathy note frequent conflicts at work, 40% of patients at home. A nutritious diet containing a sufficient amount of vitamins and trace elements can reduce the risk of developing mastopathy;
  • Heredity, first of all - the incidence of benign and malignant tumors of the mammary gland, mastopathy in relatives on the maternal side;
  • The risk of developing mastopathy increases in the absence of childbirth, abortion. Early first pregnancy (but not earlier than 18 years), as well as large families and prolonged feeding create a protective effect;
  • The risk of mastopathy increases with chronic inflammation of the uterine appendages, since inflammation disrupts the balance of sex hormones;
  • Pathology of the thyroid gland plays a special role. Violations of the structure and dysfunction of the thyroid gland are found in half of women suffering from mastopathy, that is, in the presence of any pathology of the thyroid gland, the risk of mastopathy increases by 3.5 times;
  • Diseases of the liver and gallbladder are also associated with the development of mastopathy. The liver utilizes excess estrogens, and when its functions are disturbed, this ability decreases, as a result, an excess of sex hormones appears in the blood, which provoke the development of mastopathy;
  • Combination: obesity + diabetes mellitus + arterial hypertension - significantly increases the risk of developing mastopathy;
  • The sexual factor is also important. The absence or irregularity of sexual life contributes to diseases of the mammary gland;
  • Risk factors for the development of mastopathy also include addiction to alcohol and smoking;
  • Injuries, not necessarily serious, to the mammary gland can also subsequently contribute to the onset of mastopathy.

As a result, if:

  • You are over 35;
  • Your mother, grandmother or their sisters had or have mastopathy;
  • You have never given birth or had one child but did not breastfeed him;
  • you had an abortion;
  • Do you often experience stressful situations at work or at home?
  • You periodically have inflammation of the appendages;
  • You are overweight;
  • Your thyroid gland is out of order;
  • Do you smoke;
  • Your sex life is irregular -

there is a high probability that you will get sick, or have already become ill with mastopathy.

And, as you know, women suffering from mastopathy are prone to such a dangerous disease as breast cancer.

The mammary gland is a hormone-dependent organ. Therefore, everything that disrupts the activity of the endocrine system is reflected in it. And a lot of factors can lead to a violation of the hormonal balance, which in parallel cause other changes in the body, and those, in turn, rebound again on the balance of hormones.

Let us consider in more detail some of the factors leading to the development of mastopathy, because they give an idea of ​​where to start the prevention and treatment of this disease.

Hello! I am 22 years old, I was diagnosed with diffuse mastopathy when I was 15 years old. In the glands, you can feel small seals, soreness and engorgement of the glands before menstruation worries, but I'm already used to it. All these years I have been seeing a gynecologist, visited a mammologist, did an ultrasound of the mammary glands, but I was not prescribed any treatment, except for the periodic intake of antioxycaps with selenium. It doesn't get worse, but it doesn't improve either. I am very disturbed by the idea that if one treats this disease so calmly, then this can lead to some terrible consequences. My gynecologist says that there is no need to do anything, that when I give birth and breastfeed the child, it will be like a treatment and everything will pass. But I am not going to have children in the coming years, and in general, when I myself am unwell, how can I think about children? Can you give me some advice?

We do not get tired of repeating that mastopathy is a disease of the mammary glands, which indeed, in many cases does not require urgent medical (or even surgical) treatment, but only constant monitoring and monitoring in dynamics. Our body is a complex self-regulating system that is in a constant transforming process.

Throughout life, people change a variety of health parameters, including hormonal levels. Actually, this is called autoimmune regulation, when the body's reserves are constantly replenished completely independently, when the system compensates for those shortcomings that arise due to some external influences.

Since the reader who asked the question regarding the lack of full-fledged treatment for the diagnosis of mastopathy is at a fairly young age, it is quite logical that the doctor recommends that she simply observe the course of the disease.

It must be understood that compensatory and self-regulating mechanisms in the body cannot work at lightning speed. Sometimes, the body needs quite a long time to restore its functions or some hormonal surges that occur in the natural course of life.

By the way, doctors consider timely pregnancies to be such health-improvingly useful hormonal bursts. We have already written more than once that pregnancy (or even pregnancy) and subsequent breastfeeding has the most beneficial effect on the entire body of a woman.

In general, the body of an average woman is programmed by mother nature for several successful pregnancies. When, due to various circumstances (in modern conditions, women are in no hurry to give birth, wanting to make a career, see the world, etc.), timely pregnancies do not occur - the body does not receive the necessary hormonal surge - certain problems arise with the mammary glands.

It is pleasant to realize that at the same time, when pregnancy nevertheless occurs after a while, the body has time to adapt to new circumstances, fully restoring its functions.

Actually, therefore, most gynecologists are in no hurry to treat the initial stages of mastopathy in young patients, realizing that a possible early pregnancy will do this much better and faster.

After all, the most important thing in any treatment is to do no harm. And when prescribing any drug treatment and, in particular, hormonal or surgical treatment, some side effects can always occur.

Only one thing can be advised to our reader, not to worry and not to think about the imminent onset of some terrible consequences of this disease.
Indeed, according to statistics, more than half of all women who live with such a diagnosis to advanced years suffer from this disease. At the same time, no more than 10% of patients with a similar diagnosis may have problems requiring surgical intervention. Moreover, operations are usually carried out strictly according to indications for:

  • With aggressive and steady growth of benign tumors in the mammary gland.
  • In the presence of other dangerous concomitant diseases.
  • With suspicion of malignancy of the process.

In addition, we can recommend women diagnosed with diffuse mastopathy (in its initial forms) not to consider themselves "unhealthy", as our reader writes, and of course plan pregnancy, give birth successfully and breastfeed no less successfully. After all, often, it is this behavior that allows you to forget about the initial diagnosis forever.

Mastopathy is a pathological change in the tissues of the mammary glands, which has a fibrocystic character. Fine-grained seals form in the chest, which are most often painful. The formations are of benign origin, but are regarded by doctors as a risk factor for the development of cancer, since the possibility of malignancy of the process is not excluded.

Mastopathy is a collective term, it combines a whole group of pathologies. All these disorders are associated with changes in the mammary glands, in which there is an imbalance in the ratio between the connective and epithelial tissue. WHO in 1984 classified mastopathy as a fibrocystic disease.

Statistics show that the risk of developing this disease increases significantly after a woman crosses the forty-year age limit. In young patients, mastopathy due to various reasons is diagnosed in 30-45% of the total number of breast diseases. In addition, women with a history of many gynecological diseases suffer from mastopathy in 70-95% of cases.

The development of the disease directly depends on neurohumoral regulation. It is known that numerous hormones are responsible for the development and growth of the mammary glands. The most important in this regard are estrogens, prolactin, progesterone and growth hormone. The state of the female breast directly depends on their ratio in the body. When hormonal imbalance occurs, then the risk of developing mastopathy increases.

Signs and symptoms of breast mastopathy

The severity of the symptoms of mastopathy depends on what form of the disease the woman has. Her emotional state, the presence of concomitant pathologies and even character traits are also important.

    Painful sensations in the chest can be of varying severity, their nature and intensity vary. The initial stages of mastopathy are manifested by pains that occur in the mammary glands only before the next menstruation. Most women do not pay attention to them, considering this phenomenon as part of the premenstrual syndrome. Pain can be dull, aching, pulling, sharp. Sometimes it is even impossible to touch the chest. Painful sensations arise as a result of the fact that blood stagnates in the veins, the surrounding tissues swell, and this leads to an increase in breast volume. In addition, fibrous growths put pressure on the nerve endings penetrating the mammary glands. When the menstruation ends, the pain disappears. As the mastopathy progresses, the pain begins to haunt the woman constantly with a tendency to increase before the next menstruation. This negatively affects the state of health: sleep is disturbed, excessive irritability appears, unmotivated aggression against the background of mental lability. The pain may radiate to the arm or shoulder blade. However, up to 15% of women note that at the initial stage of mastopathy, pain did not bother them. Moreover, they are diagnosed with pathological formations of a significant degree of severity. Scientists attribute this to a different threshold of pain sensitivity and individual characteristics of the branching of the nervous system of the mammary glands in women.

    Breast engorgement in the second phase of the menstrual cycle. This symptom is due to venous congestion in the vascular system of the mammary glands. Connective tissue can swell so much that a woman notes an increase in glands by 15%. At the same time, the breast becomes hypersensitive, the patients react sharply to an attempt at palpation.

    Discharge from the nipples of varying intensity. Perhaps their appearance only after pressure on the nipple. But sometimes the discharge is quite pronounced, and to detect them, no effort is required. As for consistency, it varies. The color may be white, greenish, brown, bloody or absent altogether - in this case, the discharge is transparent. Of particular danger are the secretions containing blood impurities. They may indicate malignant processes occurring in the gland. However, even transparent discharge should not be ignored - if they are found, it is necessary to consult a doctor. A woman needs to remember: normally, there are no discharges from the nipples (if there is no pregnancy and lactation). Any discharge from the breast in another period indicates that the milk ducts are involved in the pathological process.

    The appearance of nodes - one or more. If a seal is detected during palpation of the breast, this is the reason for an immediate appeal to a mammologist.

Signs of mastopathy may vary depending on its form:

    Diffuse fibroadenomatosis. Most often, this type of mastopathy is diagnosed in women at a young age. During the examination, enlarged mammary glands with sagging are found. In addition, fine graininess is palpable. The chest is often painful, its lobulation is strongly pronounced. A woman may need analgesics to relieve pain.

    Nodular mastopathy. If diffuse mastopathy has not been subjected to timely treatment, then it turns into a nodular form. During palpation, individual seals or cystic formations are palpated. Seals do not have clear boundaries, lobulation is not palpable.

Sometimes quite large nodes are found, up to 70 mm. The cyst is indicated by the presence of a clear border with clear contours, moreover, there is no connection between the formation and the surrounding tissues. The shape of the cyst is often oval or round.

Causes of mastopathy


All etiological factors that influence the development of the disease are to some extent associated with the hormonal imbalance that occurs in the body of a woman. First of all, this is a lack of progesterone, ovarian dysfunction, as well as an increase in estrogen levels to extremely high or relatively high values. After all, it is estrogens that contribute to the growth of the epithelium by dividing it in the milky passages and alveoli of the glands. In addition, estrogens have an effect on enhancing the activity of fibroblasts, which also provoke the division of the stroma of the glands.

In the mechanism of development of mastopathy, an increased level of prostaglandins and hyperprolactinemia are important. Prolactinemia makes breast tissue more receptive to estrogen.

It is important to understand that even with the existing hormonal imbalance, breast mastopathy will not begin to develop rapidly. For the manifestation of the disease, several years of constant influence of risk factors and their interaction with each other will be required.

The reasons that can provoke mastopathy include:

    Early puberty and early onset of menstruation. Menarche that occurs before the girl reaches the age of 12 is especially dangerous. This can provoke accelerated hormonal changes, which ultimately will negatively affect the condition of the mammary glands.

    Late onset of menopause. As a rule, if a woman's period stops at the age of over 55, this negatively affects the tissues of the mammary glands. Pathological processes are provoked by too long exposure to hormones.

    Violation of the natural course of pregnancy - its termination. This leads to the fact that in the body of a woman there is a sharp decline in hormones and a complete restructuring of the hormonal background. And it doesn’t matter how exactly the abortion happened: the woman had a miscarriage, or she had an abortion.

    The complete absence of pregnancy and childbirth during life.

    Refusal to breastfeed a child, or a short period of lactation with its artificial completion.

    hereditary factor. Of particular importance in this regard is the presence of any breast disease (benign or malignant) in the mother or maternal relatives.

    The woman is over 35 years of age.

    Having bad habits.

    Stress resulting in endocrine disorders.

    Any inflammatory processes, the localization of which is the mammary glands.

    Injury to the chest, wearing a bra that is not suitable in size - tight or uncomfortable.

    Diseases associated with iodine deficiency.

    Taking inappropriate hormonal birth control pills. Any drug containing hormones should be prescribed exclusively by a doctor after a thorough examination.

    Gynecological diseases caused by hormonal disorders. These include anovulation, amenorrhea, uterine fibroids, endometriosis, and infertility.

    Diseases of the thyroid gland and liver.

    Overweight. The fact is that adipose tissue is the base for storing estrogens. The more it is, the more hormones accumulate in the body. And this leads to corresponding violations.

    Tumors of the hypothalamus and pituitary gland.

    Irregular sex life. This leads to congestion in the pelvic organs. Circulatory failures, in turn, provoke ovarian dysfunction and, as a result, hormonal imbalance.

What is dangerous mastopathy of the mammary glands?


Mastopathy of the mammary glands is a disease that does not go away on its own. He needs to be treated. The main danger of mastopathy is degeneration into breast cancer. Therefore, doctors regard any form of mastopathy as a precancerous condition, although initially it has a benign nature.

The risk of developing cancer increases when cystic changes are observed. In addition, the degree of proliferation of the epithelium of the mammary glands - ductal and intralobular, as well as the presence of signs of calcification, is of great importance.

In addition to the risk of malignancy of the process, it is worth noting the likelihood of developing a background inflammatory process and subsequent infection of the cystic formation with its further suppuration. There is also a risk of violation of the integrity of the cyst.

How to treat mastopathy?


Therapy of the disease is a prerequisite for the detection of mastopathy.

Medical tactics depend on several factors, including:

    The age of the woman in need of treatment for mastopathy;

    Existing comorbidities - endocrine, extragenital, gynecological;

    The nature of menstrual irregularities.

Conservative treatment of mastopathy is possible if a diffuse form of the disease is detected. The appointment of drugs occurs after consultation with a mammologist and a thorough examination of the patient.

With regard to fibrocystic formations, conservative therapy is possible, however, surgical intervention may also be required. With a confirmed suspicion of a malignant tumor, its removal is mandatory.

Sectoral resection of the mammary gland is used as the optimal surgical technique. At the same time, the woman's breast is preserved, and the fibroadenoma itself and part of the glandular tissue are excised. The operation is performed under general anesthesia. The marking of the performed incisions is applied in advance. Everything is done under the control of ultrasound, which minimizes the cosmetic defect.

List of medicines for mastopathy

Medicines designed to save a woman from this disease should be prescribed only by a doctor.

Hormonal drugs

    Antiestrogen drugs. Their main task is to reduce the level of estrogen in a woman's body.

    Most often, doctors prescribe the following drugs:

    • Fareston. This drug has a minimum list of contraindications. The result of its use will be noticeable after the first 30 days from the start of therapy. The course of treatment for fibrocystic form of mastopathy can last up to six months. The minimum period is three months. Most often, women complain of side effects associated with the antiestrogenic action of fareston: hot flashes, increased sweat glands, vaginal discharge, nausea, skin rashes, and depressive mood. Serious side effects from taking the drug are rare.

      Tamoxifen. This drug helps to eliminate the pain caused by mastopathy, normalizes the menstrual cycle, and reduces the risk of cancer. The effect, as a rule, occurs after 8-12 weeks from the start of administration. As for side effects, they are also most often associated with the suppression of estrogen production. In addition to hot flashes, feelings of heat and increased sweating, women note an increase in body weight, alopecia, itching in the genital area. In addition, at the initial stages of therapy, an increase in the volume of soft tissue formations of the breast, accompanied by the appearance of skin erythema, may occur. However, after two weeks, these symptoms self-destruct, so treatment should not be interrupted.

    Drugs belonging to the group of oral contraceptives. These pills are most often prescribed to women whose age does not exceed 35 years. Hormonal contraceptive pills effectively protect against the occurrence of unwanted pregnancy and at the same time normalize the menstrual cycle. Against the background of their intake, the signs of fibrocystic mastopathy are significantly reduced.

    Among the most popular drugs in this group:

    • Femoden, produced in tablet form. It contains gestodene and ethinyl estradiol. During the reception, the menstrual cycle is normalized, the pain of menstruation decreases, the risk of developing anemia decreases.

      Silest. The drug is also available in tablets. Its active ingredients are ethinylestradiol and norgestimate. While taking this oral contraceptive, the production of gonadotropins is suppressed, the viscosity of the mucus of the cervical canal increases, and the menstrual cycle normalizes.

      Marvelon and its analogue Mercilon. The composition also includes ethinylestradiol, and the second active ingredient is desogestrel. While taking these drugs, the ovulatory ability is suppressed and the menstrual cycle is normalized. Pain preceding the onset of menstruation decreases, bleeding becomes less profuse. (read also:) In addition, there is evidence to reduce the risk of developing ovarian and endometrial cancer in women who regularly take Marvelon or Mercilon.

    Androgenic drugs. To get rid of breast mastopathy, it may be recommended to take drugs with androgens. Their therapeutic effect is due to the fact that they are estrogen antagonists, that is, they are able to suppress the excessive activity of the latter.

    Most often, women are recommended to take Danazol. This drug helps to reduce the production of gonadotropic hormone, although so far experiments in this regard have only been carried out with the participation of animals. If we evaluate the effectiveness of this drug in relation to the treatment of mastopathy, then the effect will be obtained in about 2 out of three women. As a result of therapy, the mammary gland is leveled, the risk of formation of large cysts is reduced.

    When prescribing Danazol, the doctor should warn the woman about the risk of developing side effects: amenorrhea, sweating, vaginitis, nervousness, swelling, weight gain and other endocrine disorders. In addition, the contraceptive effect when taking Danazol is low, so additional methods of protection against unwanted pregnancy will be required.

    Gestagens. Drugs in this group are able to have an effect aimed at suppressing the production of estrogen and slowing down the gonadotropic function of the pituitary gland. These drugs are recognized as a means for the treatment of mastopathy with high efficiency. Taking them increases the chances of successfully getting rid of the disease up to 80%. Therapy should be a course with interruptions. The rest time from taking gestagens is determined by the attending physician.

    The most popular in this group are the following drugs:

    • Pregnyl. The composition of the drug contains human chorionic gonadotropin. This hormone contributes to the normalization of the growth and maturation of female gametes, which are involved in the formation of sex hormones. As a result, the woman's hormonal background stabilizes, and mastopathy recedes.

      Norkolut. The drug contains norethisterone. To get rid of the symptoms of mastopathy, you will need to take pills starting from the 16th day of the cycle, and up to the 25th. Norkolut is forbidden to use with an existing oncological disease, therefore, before starting therapy, such a diagnosis should be completely excluded.

      Pregnin. This drug is a synthetic analogue of a progestogen.

      Orgametril. Linestrenol acts as the main active ingredient. It is used to eliminate nodular formations in the mammary glands. Reception should be long. The minimum treatment period is 3 months. The drug is prohibited for use during pregnancy. When it occurs, the therapeutic course is interrupted.

      Progestogel. This is a gel for external use. It is based on micronized progesterone. The main advantage of using this drug is that the woman will not experience the side effects usually caused by oral hormones.

    Prolactin secretion inhibitors. These drugs are prescribed for abnormal lactation associated with elevated levels of the hormone prolactin. The most popular means of this group are:

    • Parlodel. The drug has an effect on the cysts of the mammary glands, contributing to their reduction. The number of formations also decreases, the balance between the production of progesterone and estrogen is normalized. The function of reproduction improves and the production of prolactin decreases.

      Bromocriptine. The drug has a direct effect on dopamine receptors. As a result, the menstrual cycle normalizes, nodules in the mammary glands decrease in size, the intensity of pain decreases. However, this drug is not allowed to be used in cases of suspected cancer.

    Gonadotropin releasing hormone analogues or LHRH. Drugs from this group are prescribed to women who have been diagnosed with a fibrocystic form of mastopathy, and only when other drugs are ineffective.

Non-hormonal drugs

Drugs of non-hormonal origin in the treatment of mastopathy are used in order to reduce the symptoms of the disease and to combat comorbidities, if any.

It is possible to assign the following funds:


In addition to the above remedies, for the treatment of mastopathy, a woman may be recommended to take the following drugs:

  • Mastopol

    Duphaston

    Utrozhestan

    Zoladex

Answers to popular questions about mastopathy:

    Is it possible to get pregnant with mastopathy? The disease itself is not an obstacle to having a child. With mastitis, you can get pregnant. Therefore, if a woman found out that she was expecting a child, and she was diagnosed with mastopathy, this is not a reason to terminate the pregnancy. In addition, an increase in the production of progesterone during gestation has a positive effect on the course of the disease, up to its complete disappearance. However, it is not always possible for women to conceive a child with mastopathy. This is due not to the disease itself, but to the causes that caused it. First of all, the likelihood of successful conception reduces hormonal imbalance. Therefore, the best option is to plan pregnancy with a complete preliminary examination.

    Is it possible to breastfeed with mastopathy? Doctors strongly recommend not to refuse breastfeeding with mastopathy. If the disease occurs in the first trimester of pregnancy, then most likely it is caused by hormonal changes in the woman's body. Refusal to breastfeed after the birth of a child or short-term breastfeeding (less than 3 months) can adversely affect the course of the disease. In the event that the pathology was diagnosed before pregnancy, but not completely cured before the baby was born, doctors recommend that women breastfeed the baby for as long as possible. Nevertheless, although it is possible to reduce the severity of mastopathy during lactation, no one can give a guarantee of a complete cure. Therefore, medical supervision and the passage of mammograms are mandatory measures.

    Is it possible to massage the back and chest with mastopathy? Massage of the back and chest with mastopathy is contraindicated. It should not be done with soreness of the mammary glands, as it will not help get rid of the problem. Mastopathy is a hormonal pathology, and only correction of the hormonal background can lead to recovery. As for the back, the massage of this area should also be abandoned. The fact is that when exposed to the cervical-collar region, the pectoralis major muscle is captured. This, in turn, can lead to serious complications, up to the rapid progression of mastopathy.

    Is it possible to bathe in a bath with mastopathy? Steaming with mastopathy is strictly prohibited. Any mechanical and thermal effect on the diseased mammary gland can lead to an aggravation of the problem.

    Is it possible to sunbathe with mastopathy? With mastopathy, you should not sunbathe, since any thermal effect contributes to the malignancy of a benign formation. In addition, you should always be aware of the risk of developing skin cancer. Modern medicine has established a clear relationship between oncological diseases of the dermis and exposure to ultraviolet rays. In order not to expose your body to additional risk, you need to protect your skin from direct sunlight and remember the rules for spending time in the sun.

Dr. Evdokimenko - Academician of the Academy of Medical Sciences of the Russian Federation, will talk about mastopathy, how to treat it, myths:

Program guest: Travina Marina Lvovna, Associate Professor, Candidate of Medical Sciences, Mammologist, Head of the Mammological Department of the National Medical Research Center for Children's Health of the Ministry of Health of the Russian Federation


Education: completed residency at the Russian Scientific Cancer Center named after N.N. N. N. Blokhin” and received a diploma in the specialty “Oncologist”

- pathological fibrocystic changes in the breast tissue, characterized by the appearance of dense, often painful, fine-grained formations. Concerned about engorgement, soreness of the gland, more pronounced before menstruation, serous, sometimes bloody discharge from the nipple. Has a tendency to relapse, is a cancer risk factor. Diagnosis of mastopathy requires mammography, ultrasound of the mammary glands, if necessary - diaphanoscopy, MRI of the mammary glands, pneumocystography, puncture biopsy. Treatment of mastopathy is carried out by conservative methods. If there is a danger of malignancy of nodular mastopathy, the node is surgically removed.

General information

- a concept that combines a group of diseases of the mammary glands, characterized by the development of pathological changes in the gland tissue with a violation of the ratio of epithelial and connective tissue components. According to the WHO nosological classification of 1984, mastopathy is understood as fibrocystic disease of the mammary glands. The incidence of mastopathy of various etiologies in young women ranges from 30-45% and increases markedly after 40-45 years.

Mastopathy is a benign change in the tissue of the gland, which is directly dependent on neurohumoral regulation. This means that the factors in the development of mastopathy are both pathologies associated with disorders of the state of nervous regulation (stress, neurosis, depression), and a disorder in the hormonal balance and internal homeostasis of the body.

Reasons for the development of mastopathy

There is currently no complete understanding of the causes and mechanisms of development of mastopathy, but there is every reason to believe that the hormonal status plays a significant role in the occurrence of this disease. Factors contributing to the development of mastopathy: early menopause, menstrual disorders (hormonal dysfunctions, polycystic ovary syndrome, improper use of hormonal contraceptives), prolonged absence of childbirth, numerous (more than three) abortions, irregular sex life (or its absence), diseases of the genital organs , lactation for less than three months, endocrine pathologies (hypo - and hyperthyroidism, dysfunction of the hypothalamic and pituitary regulation, the work of the adrenal glands, liver, pancreas), hereditary predisposition.

There is an assumption that the most significant pathogenetic factor in the development of mastopathy is progesterone deficiency with an excess of estrogens. In this case, there is an increase in the proliferation (reproduction) of epithelial cells and connective tissue cellular elements. In addition, the production of prolactin plays a significant role in the pathogenesis of mastopathy. Prolactinemia increases the sensitivity of breast tissue to estrogen.

Classification of mastopathy

The most common classification of mastopathy in clinical practice distinguishes three forms: mastalgia (mastoplasia or mastodynia), diffuse fibroadenomatosis and localized fibroadenomatosis. Mastalgia is characterized by the predominance of a pronounced pain syndrome and is an indication for the appointment of analgesics.

Diffuse adenomatosis is the development of diffuse seals and cysts in the gland tissue. It is divided into two types: fibrous mastopathy, when connective tissue seals are predominantly formed in the gland tissue, and fibrocystic mastopathy, if cysts (fluid-filled cavities) form in the gland in addition to foci of fibrosis.

With localized fibroadenomatosis, pathological changes are detected in a limited area of ​​\u200b\u200bthe gland (segment, quadrant) and do not spread throughout the parenchyma of the organ. The detection of a localized mass in the breast is an indication for a biopsy to rule out a malignant tumor.

Symptoms of mastopathy

The most characteristic symptom of mastopathy is the detection of compaction in the mammary gland during palpation. This hardening can often be painful, and the pain usually gets worse during the second phase of the menstrual cycle and just before a period. The compaction can be single, several nodules can be detected, the entire gland can be felt compacted. Mastopathy is characterized by damage to both glands, mainly their upper sections.

The predominance of the fibrous component is detected by touch as a seal, cystic changes in the early stages may not be detected at all on palpation (microcysts of the ducts). Pain in the mammary glands, as a rule, has a dull, aching or pulling character. Its occurrence is associated with compression of nerve endings in the glandular tissue by fibrous growths, as well as their partial sclerosis. The intensity of the pain syndrome depends on the severity of the pathology, most often the occurrence and intensification of pain is associated with the menstrual cycle (before menstruation at the peak of estrogen production, the pain intensifies). Sometimes there is irradiation of pain in the shoulder blade, arm.

In 10-15% of women, there are no complaints of pain, although on examination, pathological changes of a significant degree are found. This is associated with a different level of pain sensitivity in women and individual branching of the nervous system of the mammary glands. About 10% of mastopathy are accompanied by an increase in lymph nodes in the armpits. Sometimes palpation of the lymph nodes is moderately painful.

An increase in the volume of the mammary gland, their periodic engorgement (in the second period of the menstrual cycle) is associated with the formation of venous congestion in the vascular network of the glands and swelling of the connective tissue. Glands can increase by 15%. This is characterized by a feeling of discomfort and pain on palpation (increased sensitivity of the chest). The combination of these symptoms is called premenstrual syndrome.

You also need to carefully consider the detection of a node (or several). Palpation of a dense limited nodular formation may be a sign of localized nodular mastopathy, and may be developing breast cancer. When identifying nodes suspicious from the point of view of malignancy in the mammary gland, their biopsy is always prescribed.

Diagnosis of mastopathy

One of the most significant elements of the timely detection of pathologies and neoplasms in the mammary glands is self-examination (self-palpation of the mammary glands). To identify formations, determine their shape, size, quantity, as well as to identify diffuse pathological changes in the gland tissue, instrumental diagnostic methods are used.

Biocontrast mammography is an X-ray examination of the mammary glands. Mammography is best done in the first phase of the menstrual cycle. A picture of the chest is taken in two projections: frontal and lateral. This study is one of the most informative and specific.

In addition, ultrasound of the mammary glands is currently used. As a rule, fibrocystic changes in the tissue of the glands affect the echogenicity of its structures and can be detected and studied quite qualitatively using this technique.

MRI of the breast marks areas of increase and decrease in the temperature of the gland tissues. The technique of diaphanoscopy consists in transillumination of the mammary gland using a light source. In this case, the neoplasm in its thickness will be noted as a darker spot. With the help of ductography, the system of the milk ducts is examined. A contrast agent is injected into the mammary gland through the nipple, after which an x-ray is taken. The picture shows the ductal system, areas of deficiency of filling with a contrast agent may be signs of neoplasms. Pneumocystography is performed under ultrasound guidance. Air is introduced into the cyst cavity using a thin needle, which allows you to straighten the walls and carefully examine them for parietal formations.

When a nodular formation is detected, a biopsy of the mammary gland is performed - extraction by puncturing a tissue sample with a thin needle for histological examination. To identify the etiological factors of mastopathy, methods for studying the hormonal status are used. Colposcopy and cytological examination of the cells of the vaginal epithelium allows us to draw a conclusion about the total hormonal background, since the shape and structure of the cells directly depend on the action of sex hormones.

They directly determine the content of hormones in the blood: progesterone and estrogen, follicle-stimulating, luteinizing hormones, as well as thyroid hormones and thyroid-stimulating hormone, adrenal hormones. Sometimes a test is performed for the presence of autoantibodies to thyroid cells to detect autoimmune thyroiditis. These specialists jointly perform a thorough analysis of the endocrine system and prescribe drugs that correspond to the identified pathologies.

With severe estrogen (and significant pain), drugs can be prescribed that reduce the effect of these hormones on the mammary gland (tamoxifen, toremifene citrate). To normalize the menstrual cycle, oral contraceptives are used (selected in accordance with the hormonal status). For the treatment of functional disorders of the thyroid gland, drugs that regulate the production of thyrohormones are used. Vitamin complexes help to improve liver function and normalize metabolic processes.

Among other things, topical progesterone preparations are used (they act directly on the gland tissue, helping to reduce the proliferation of connective tissue and epithelial cells, removing swelling), homeopathic remedies. Patients suffering from mastopathy are advised to limit the use of coffee and strong tea, stop smoking, enrich the diet with fruits, vegetables, foods high in fiber and vitamins. If a malignant tumor is suspected, surgical removal of the node is performed, in other cases they are limited to conservative treatment.

As a rule, mastopathy is not prone to complications and malignancy. With proper correction of the hormonal state, the prognosis is positive, but hormonal disruptions can provoke relapses.

Prevention of mastopathy

Many factors contributing to the development of mastopathy make it difficult to develop a unified and consistent prevention scheme. However, the most significant factors should be avoided: stressful situations (as a preventive measure, it is recommended to take therapeutic sedatives of natural origin - valerian, motherwort), creating a psychologically comfortable environment, a positive way of thinking.

Proper balanced nutrition without excess calories, prevention of overweight and obesity, however, without being carried away by mono-diets and dubious methods of losing weight, help maintain internal homeostasis and the proper functioning of the neurohumoral regulatory system. One of the components of the diet that negatively affects the hormonal status of women is caffeine. Women should limit, if possible, completely eliminate caffeine from their diet and in no case abuse strong coffee on an empty stomach.

Older women using oral contraceptives should stop smoking. Also useful in terms of preventing breast pathologies will be limiting the use of alcoholic beverages. A significant factor in maintaining a woman's health is regular sexual activity and physical activity.

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