Diffuse fibrous fam. Fibroadenomatosis of the mammary gland. How to detect and treat it. Basic forms and typical features

Women know that there are various types of tumors of the mammary glands, but when they find a seal in their breasts, they naturally hope that this is not cancer. There are many benign breast diseases. They are successfully treated in most cases. But if you do not pay attention to ailments for a long time, postpone a visit to the doctor, then the condition will worsen, as some of these diseases turn into cancer. And here the probability of a cure will directly depend on its stage. Therefore, it is important to have an idea of what signs should not be ignored.

Content:

What is breast fibroadenomatosis. Types of this disease

This is one of the benign pathologies associated with abnormal changes in the breast tissues. Fibroadenomatosis is a type of diffuse mastopathy. This disease occurs when there is a pathological proliferation of connective tissue, due to which cysts appear in the breast.

Note: There are other types of fibrocystic mastopathy, for example, breast adenosis. This disease is characterized by the growth of glandular tissue (lobules).

There are several types of fibroadenomatosis:

lobular - proliferation of connective tissue, leading to an increase in the number of lobules;
ductal, in which the network of ducts becomes more branched, they expand;
fibrous, when the connective tissue grows into muscle (fibrous), while the structure of tissue fibers is disturbed;
cystic - the formation of a large number of cystic cavities of different sizes;
proliferative - with the growth of the epithelium in the area of \u200b\u200bformed cysts, as well as milk passages.

With the proliferative form of fibroadenomatosis of the mammary gland, fusion of the partitions separating individual cysts is possible. Outgrowths are formed, which can increase in size, fill the entire cavity. Small growths in large numbers occur in the gaps between the cysts and ducts. There is a formation of several layers of such growths, lining the entire inner surface of the cyst or dilated duct (in this case, the duct is completely blocked).

A diffuse form of fibroadenomatosis is possible, in which many cysts are scattered in the gland. With a local form, the lesions are located in a group. The seal is easier to feel. If there is a fusion of several cysts, then a painful knot is formed (the so-called nodular form of fibroadenomatosis).

Fibroadenomatosis occurs most often in the upper part of the chest, from the outside. Lumps that look like dense cakes can appear in both mammary glands at once. This benign disease most often occurs in women 35-40 years old.

Symptoms of fibroadenomatosis

Due to the formation of voids and growths in the tissues, women may experience stabbing pains in the chest, especially before the onset of menstruation. During this period, swelling of the glands occurs. Pain is caused by the overflow of cysts, the elasticity of the walls of which is reduced due to the presence of growths that compress the nerve endings. There is a burning sensation in the chest, there is a feeling of fullness of the gland. It becomes denser, as edema forms in the connective tissue.

When pressing on the chest, fluid may flow out of the nipple (sometimes it comes out in a jet). Discharge from the chest is transparent or painted in pink, green, black. There may be an increase in axillary lymph nodes. In the area of \u200b\u200bthe mammary gland affected by fibroadenomatosis, a seal occurs, which cannot always be detected on palpation, since it has a rather soft texture. Chest pain becomes stronger during physical exertion or after a nervous strain.

A woman shows side symptoms: the regularity of menstruation is disturbed, there are signs of neuropsychiatric disorders (depression, anxiety, obsessive thoughts about death). Pregnant women may have a miscarriage.

Video: Seals in the chest, how to conduct a self-examination

Causes of fibroadenomatosis

The main cause of most diseases of the mammary glands in women are hormonal disorders. Especially sharp changes in the ratio of hormones occur during pregnancy, as well as during its artificial interruption, refusal to breastfeed after childbirth.

The cause of fibroadenomatosis is a violation of the ratio of levels of estrogens, progesterone and prolactin. It can occur with an increased content of estrogens in the body, reduced production of progesterone.

An imbalance of hormones can be the result of diseases of the endocrine system (pituitary, pancreas and thyroid glands), long-term use of hormonal contraceptives. Elevated estrogen levels are observed after hormone replacement therapy with drugs containing estrogens. In order to reduce the risk of breast diseases, drugs are prescribed with the addition of progesterone, which helps suppress estrogen synthesis.

The occurrence of hormonal imbalance contribute to diseases of the ovaries and other reproductive organs. Refusal of breastfeeding or its abrupt cessation not only causes an imbalance of hormones, but can also cause milk stagnation, blockage of the milk ducts, and inflammation. In liver diseases, the flow of biochemical reactions associated with the synthesis of hormones is disrupted, which also leads to an imbalance.

Diagnostics

The doctor, when asked by the patient whether fibroadenomatosis of the mammary gland threatens health, will explain that this is a benign tumor, there is no immediate danger, but an examination is mandatory. During the examination, it will be found out what the nature of the changes in the tissues is, whether there is a tendency to increase the number and size of cysts, whether it is necessary to be treated or it is better to remove them immediately. The presence of inflammatory processes and abnormal development of cells can cause precancerous conditions.

The main methods for diagnosing fibroadenomatosis are:

Palpation. The doctor palpates the mammary gland to detect seals, their location. The number and shape of seals, consistency and the presence of clear boundaries are important. Palpation is carried out with the woman in a horizontal and vertical position. Usually seals are felt better on about 7-10 days of the cycle, when the breast is softest.
Mammography. An x-ray of the breast is taken in two projections.
Ductography. X-ray to study the state of the milk ducts by introducing a contrast agent into them.
ultrasound. This study complements mammography. On the screen, you can clearly see the presence of modified areas in the tissues, their approximate location and shape.
Color Doppler sonography is an ultrasound examination of the vascular system of the glands. A color image is obtained showing the branching of the vessels and the presence of an anomaly.
Biopsy of tissues from the lesion node and their examination under a microscope to study the nature of changes in cells, detect an atypical structure, and the presence of precancerous diseases.
Laboratory tests for estrogens, progesterone, prolactin, and hormones produced by the thyroid gland.

A gynecological examination is also carried out to identify diseases of the genital organs, consultations with the participation of an endocrinologist.

Video: Types of breast diseases, their diagnosis and treatment

Treatment of fibroadenomatosis

In the case of fibroadenomatosis of the mammary gland, ailments and fears associated with possible consequences reduce the quality of life. Treatment is prescribed taking into account the age of the woman, the type and stage of the disease. The results of tests for hormones, the presence of endocrine and other diseases are taken into account.

Surgical removal is carried out only in the case of the formation of large cysts localized in a specific place. The affected area is exfoliated. Sometimes a sectoral resection is performed, that is, a separate sector of the gland affected by large cysts is removed. In rare cases, when they are located throughout the volume, atypical cells are found in the tissues, the mammary gland is completely removed (mastectomy).

In the presence of small cysts in a small area, drug therapy (conservative) is used. First of all, the treatment of diseases that could cause fibroadenomatosis is carried out. To improve the hormonal composition, agents are used that have the following effect:

elimination of hypo- and hyperthyroidism, treatment of thyroid diseases (euthyrox);
suppression of estrogen production in the ovaries (tamoxifen, fareston);
a decrease in the level of pituitary hormones that stimulate the production of estrogens by drugs containing androgens (danazol);
decrease in the concentration of prolactin in the blood (bromocriptine);
restoration of the cycle of menstruation (zhanin);
increase in the level of progesterones (progestogel, duphaston).

Be sure to prescribe vitamin complex preparations, which include vitamin A (weakens the effect of estrogens in the body), B6 (reduces prolactin levels), vitamin E (increases the effect of progesterone), as well as vitamins that strengthen blood vessels and improve blood circulation (C and PP).

If necessary, sedatives are used. In addition, plant-based preparations with anti-inflammatory and analgesic effects (mamoklam), as well as agents for improving liver function (Essentiale, Karsil) are used.

Note: After agreement with the doctor, folk remedies and methods are often used in addition to these medicines to help reduce inflammation and pain, improve hormonal levels (with the help of phytoestrogens) and compensate for the lack of vitamins.

Prevention measures

Strengthening the body's defenses is the most important measure for the prevention of fibroadenomatosis. Strengthening the immune system is facilitated by fortified nutrition, as well as the additional intake of vitamin complexes containing iodine (to support the functioning of the thyroid gland), selenium (anti-cancer effect) and other elements important for the body.

It is necessary to avoid chest injuries, wear a comfortable bra. An important role is played by a normal lifestyle, quitting smoking and other bad habits. It is necessary to protect the nervous system.

Prevention of hormonal disorders contributes to the correct contraception and refusal of abortion, regular sex life, prolonged breastfeeding. Of great importance is self-examination of the breast (once a month), as well as a preventive check of the condition with the help of a mammologist.

Video: Fibrocystic mastopathy. Prevention measures

In reproductive age, a woman's body is at risk, since pathological changes can be observed not only in the genital area, but also in the field of mammology. In 30% of all clinical pictures, a disappointing diagnosis prevails - diffuse FAM of the mammary glands, what it is, you need to find out in advance.

For those who do not know what diffuse FAM of the mammary glands is, it must be reported that the course of the pathological process is accompanied by the growth of glandular tissue and the formation of cystic-fibrous neoplasms in the breast. These cysts are filled with fluid and are benign. And, nevertheless, one should not exclude the fact that in the absence of effective therapy, the tumor mutates and becomes malignant, requiring immediate resuscitation.

Etiology of pathology

transferred stresses or severe emotional upheavals;
ovarian dysfunction in the female body;
impaired blood flow in the pelvic organs;
hormonal imbalance;
refusal of a newborn or infant from lactation;
reduced sexual activity;
genetic predisposition.

The doctor's task is to find out what is the cause of the progressive diagnosis and eliminate it from the prevailing clinical picture. Such an action will speed up the healing process, since nothing in the body will interfere with the applied conservative therapy.

Symptoms

If diffuse FAM progresses, then the first thing the patient feels is unpleasant and even painful sensations in the mammary glands. On palpation, this alarming symptom only increases its intensity, and it is difficult for a woman to move, lie down and turn around. At night, the pain becomes unbearable, so medical attention is definitely required.

Among the additional symptoms, it is worth highlighting the engorgement of the mammary glands, and in some cases, cysts can be easily felt even at home. Such a method of palpation and its results should definitely alert, and a visit to a therapist with a subsequent referral to a mammologist should be immediate.

If you do not pay attention to the problem in a timely manner, then the chest will eventually become “stone”, the skin will turn red, and acute pain syndrome, even at rest, will not only disrupt the usual rhythm of life, but also shake the balance of the nervous system. Operable participation is already close there, and complications of surgical manipulations can be the most unpredictable.

Diagnosis and effective treatment

If there is a suspicion of FAM of the mammary glands, the first step is to contact a mammologist and perform a mammogram. The results of the clinical examination will clearly demonstrate the presence of fluid-filled cavities within the mammary glands. The doctor determines their visual size and composition, and also indicates a potential threat to the female body.

To determine the etiology of the pathological process, it is also important to visit a gynecologist, endocrinologist, neurologist and therapist. It may be necessary to conduct an ultrasound scan of other internal organs, and such an integrated approach to the problem will allow timely and competently to proceed to effective therapy.

Treatment in such a clinical picture can be medical and operable, but doctors perform any surgical procedures only in exceptional cases. As for taking medications, this is most often hormone replacement therapy to increase the level of estrogen in the blood. Medications are selected individually, based on the characteristics and age of the female body, the stage of the disease and the degree of its spread.

The operation is performed only when the results of mammography aroused suspicion, and the puncture determined the presence of cancer cells in the cysts. To prevent metastases from spreading to neighboring organs and systems, the tumor is excised with the preservation or removal of the affected mammary gland.

Diet becomes an additional, but no less effective treatment, and doctors first of all recommend completely getting rid of all bad habits. Strong coffee and tea, chocolate and sweets are also banned, but the presence of vegetables and fruits is mandatory. Such nutrition only speeds up the healing process, contributes to its flow in a lighter form.

In order to timely detect a problem in the female body, it is recommended to perform an ultrasound of the mammary glands once every 6 months for prevention purposes. Otherwise, the diagnosed disease may prevail in an already advanced form, and, alas, it is not subject to final recovery.

Tagieva Lena

25-10-2006, 11:01

Went yesterday for a breast ultrasound. This very fibroadenomatosis was revealed (I don’t know if I wrote it correctly). Has anyone experienced this? Is it worth it to go to a mammologist with this or can you forget about this matter and not pay attention? The ultrasound doctor said that you can live with this, every second woman has it, but he is still not a mammologist ... I would not pay attention, but I got painful sensations.

25-10-2006, 11:12

I have this ... True, periodically. At first, when she got married, such sensations appeared. The doctor prescribed powders for me - I remember there was papaverine, all sorts of vitamins. Got better. Then again after a few years it appeared. Again I went to Komsomol - there both an ultrasound scan and a mammologist looked at me. Has appointed or nominated Algiklam-it on the basis of seaweed. Type of iodine is missing. I drank - it also helped .. But it periodically arises ... Probably, these hormones are already acting up ... We need to deal with this globally. On the other hand, anyway, it's time for something to break, I'm sorry ... For 35 already .... Just don't start if something serious ....

25-10-2006, 11:14

Go to a mammologist. He will prescribe and prescribe medications. There's nothing to worry about...:) For example, the doctor only looked at me with her hands. It is necessary within 10 days first mens. cycle to come. I think that if something was serious, then the sonographer would have noticed. And you need to go to a specialist.

25-10-2006, 12:11

Lena, just in case, go to an oncologist. I don't want to scare you, but it's better to be safe. At one time, both the ultrasound specialist and the mammologist made the same diagnosis for me and prescribed some kind of ointment, and then it’s good that I managed to see the oncologist surgeon in time, I almost was late

25-10-2006, 12:22

Went yesterday for a breast ultrasound. This very fibroadenomatosis was revealed.
Hmm ... and who doesn't have it? In my opinion, now every second woman, unfortunately, can "boast" of such a diagnosis.
It is advisable to visit a mammologist at least once a year (preferably every six months), because. for benign changes that are found during a banal self-examination, you can miss something malignant. Therefore, ultrasound is desirable at each visit. After 45 - mammography. IMHO.

25-10-2006, 12:24

I would not pay attention, but got painful sensations.
Go to a mammologist after all. He will prescribe medications for you (you can also use homeopathic ones) just for these painful sensations.

25-10-2006, 15:18

here I found a link about mastopathy (I won’t post the text, it’s big)
http://www.breast-cancer.ru/benign/mastopatia.html
and here is a diagram of violations in mastopathy and directions of treatment (I understand that it is homeopathy there)
dachshund, the scheme is not laid out, I will give a link

http://phyto.boom.ru/articles/pract/fito_cur.htm

Tagieva Lena

25-10-2006, 15:23

I, too, am more inclined towards homeopathy, I think homeopathy should help with this problem ... But does mastopathy and FAM turn out to be the same thing?
Thanks for the links, I'm off to read.

25-10-2006, 15:53

yes, it's the same thing.
Somehow they found me too, they said, it is necessary to give birth and feed, and there will be happiness :)
But I would still go to the doctor.

Tagieva Lena

25-10-2006, 16:02

And I have all the problems with the mammary gland just after the birth and began ... There was SUCH a cyst, horror, the doctors baptized me, sent me to an oncologist on Berezovaya and looked at me like that, as if I was no longer a tenant ... And to operate wanted ... And then she disappeared somewhere, maybe a short course of resolving therapy helped, she didn’t finish it due to allergies, maybe something else. No one can understand where the cyst has gone, the doctor said some kind of nonsense. Only this FAM remained.
And it’s time for me to check my hormones for a long time, only I can’t find a doctor, I forgot on what day of the cycle what they take.
I’m afraid to give birth to a second child just because of a problem with my chest, I won’t survive the second such nightmare.

25-10-2006, 19:11

I've had it for almost 13 years now! Do not be afraid of anything, the main thing is to take care of yourself: be sure to go for an ultrasound scan once a year (for the faint of heart, you can do it once every six months, everything is visible there) on the 10th day of the cycle. You can go to a mammologist, or you can immediately go to a mammologist oncologist - they feel with their hands and prescribe herbs to drink, apply a cabbage leaf for pain. It doesn't help me for some reason: 005: So, in principle, you can get by with one ultrasound. The main thing is to make sure that there are no redness, blue spots on the chest, the nipple is not retracted and no liquid comes out of it. And as for childbirth, it all started after them, and all these years the doctors say: "Give birth, it will be easier later, and maybe everything will go away." Now I am pregnant. Let's see, of course I would like it to pass: 017:

25-10-2006, 21:22

Tagieva Lena

26-10-2006, 12:59

And because of fibroadenomatosis, I couldn’t even feed, it hurt so much that I fed and cried (even blood was coming, horror), it didn’t get better after giving birth.

26-10-2006, 15:32

Lena, I was at Chaugnav's today (they praised him here). Oncologist-mammologist. The same nonsense. He prescribed me vitamins and mastodinone. And advised to give birth. Personally in my version. The doctor experience is the best. I advise. :)

26-10-2006, 17:19

So I also suffered, and the child was without milk, and I have blood from my chest. I don’t know why doctors say that after childbirth it will be better. I will not be able to feed the second child as well as the first, I decided not to give birth, so as not to torment.
Sorry sa Off, but most of all it infuriates me when a doctor with a smart face advises to give birth and feed, I tell her that I am bleeding, and at least she henna, they got it all together and that's it. And as soon as I drank Dostinex, having suffered for 2 weeks with hellish pain (at the end my child no longer ate milk, but blood), I immediately became a bad mother, I didn’t give the child a full meal !!! Straight infuriates. Sorry, it hurts.:010::015:

26-10-2006, 18:47

Hmm, this is how it turns out.
I, too, are all encouraged to give birth for these purposes.

26-10-2006, 19:46

Is it in LadyMed on Kosciuszko? How much does a consultation cost? And how did he diagnose, without an ultrasound? They never had an ultrasound.

Consultation on Kosciuszko costs 700 rubles. Tuesdays from 18-20. Live queue. Mammography went to M. Teresa, hospital of the Russian Academy of Sciences, t.293-99-12. That's where his main job is, I understand. Paid reception 600 rubles. They won’t do the weather for me 100 re, they’ll leave for the road. Therefore, Kosciuszko is closer.
I have small cystic fibromatosis(?). If I understand his handwriting correctly. Nothing serious, I'll live. I have a bad heredity, so I decided to turn to him.

26-10-2006, 22:31

About "give birth for these purposes." Can someone and helped childbirth and GV. Not for me. After childbirth and breastfeeding for up to a year, it was a little easier, now my daughter is 3, the problem has arisen again.
It hurt, but she fed, helped her daughter, podtsezhival right when feeding, otherwise it hurts terribly.
Maybe if you feed it for up to 5 years, it will help, but I'm not sure.

27-10-2006, 11:47

My mammologist prescribed mastodinon to drink and vit. group B inject 2 times a year. Helped. And during feeding, there were also problems from time to time.

30-10-2006, 17:02

I was given FAM in 2001 (at less than 20 years old) at the GDC on Siqueiros. No major complaints.
The pains appeared in 2002 and after a while they left.
In April 2004, I ended up in the hospital with non-lactational mastitis (I haven't given birth yet, and I haven't even gotten pregnant yet).
Now I drink OK and I am observed at the gynecologist. On the last visit, she felt something with me, I need an ultrasound, but I'm already shaking. But you still have to...

01-11-2006, 00:51

They put FAM at the age of 17 + a single cyst. They did not write anything out, every six months a trip to the oncologist, ultrasound + palpation.
They promised that after the birth it should pass, has not yet been.

Smart Elsa

02-11-2006, 20:57

I have FAM since I was 19 years old. At first there were pains, with the start of taking Logest, the pains disappeared, but two years later a large cyst appeared. On the advice of a mammologist, I drank mastodinon + triovit + klamin + new passit according to the scheme, it became better. Now I do an ultrasound once a year and visit a mammologist. However, each time - different. For a long time I could not find a good doctor, I liked the most the woman who had the last time - a mammologist-oncologist at the Andros clinic (but her main place of work is the city oncology dispensary). She looked at me very attentively and talked to me very kindly. She advised me to do an ultrasound exactly on Berezovaya, she said that they are very, very attentive there. She said this about her treatment:
The main thing is regular sex life and orgasms, and only the background can be treated, mastopathy itself is not treated.
And the main treatment: diuretic herbs (or mastodinon), aevit (or triovit), klamin (or something else like that) and soothing.

05-11-2006, 03:01

What is klamin? And yet, tell me, please, what institution is located on Berezovaya, where ultrasound is carefully done?

Tagieva Lena

05-11-2006, 15:36

Klamin is a dietary supplement based on seaweed. On Berezovaya I went to the oncology dispensary (Berezovaya 5 or 3). They say there are better experts. I went free of charge after childbirth in the direction of the consultation or from any doctor from the clinic. Appointment by phone. But you can come for a fee.
She herself recently did a 3-dimensional ultrasound in the 2nd maternity hospital. It costs 1070 rubles.
I was at a consultation today, not only on FAM, but I also asked about this. I will treat with homeopathy.

Smart Elsa

06-11-2006, 18:38

Yes, klamin is a supplement based on seaweed, and there is a city oncology center on Berezovaya. And they recommended that I do an ultrasound in the inpatient department, I will go there in December.

06-11-2006, 21:48

Thanks for the info.

09-11-2006, 10:33

I have been in therapy for 7 years now. Once a year I go to the mammologist and do an ultrasound. They said the same thing, give birth, everything will pass. Due to FDM, I breastfed for 3 months. For 3 months stagnation was 4 times!!! There was not enough milk and she exhausted herself and the child. When the stagnation happened for the 5th time, she stopped feeding. Now the child is 10 months old. She did an ultrasound and was stunned. Everything is okay. I don't know if this is temporary or not. I think the same thing, I can go to a mammologist and ask if I need to somehow support this norm? And it's scary, all of a sudden everything is formed again.

Tagieva Lena

09-11-2006, 13:14

MELISA, if everything is normal, you just need to do an ultrasound once a year to check, but you don’t need to specifically support it.
It’s simple for me and after giving birth, this FAM has not gone anywhere.

09-11-2006, 22:46

I'm wondering: when I did an ultrasound a year ago, they told me that my seals are concentrated in the outer quadrants of the breast; I remember because the doctor said it was not typical. When I walked now, the seals were already in the center. And the conclusion literally repeats last year's one, except for this moment. Interesting: do they move?

Walrus mother

12-11-2006, 21:06

This March I operated on chronic fibroadenomatosis. This is a benign tumor that can outgrow ... I do not want to scare. But before the operation, I saw doubts on the faces of the doctors when they examined me. F-ma was 15 years ago, I knew about her, checked, they said, give birth, it will resolve. She gave birth, it didn’t resolve. In short, I recommend running to a mammologist. The operation cost 11600 in March. 3 days hospital. Remove it in figs, and live in peace

12-11-2006, 23:01

Tagieva Lena

13-11-2006, 10:57

As far as I know, fibroadenomas and fibroadenomatosis are two different things. The latter is characterized by a diffuse lesion. Or at least multiple.

Yes, these are different things.

13-11-2006, 17:18

Remove the fig, and live in peace
how to delete something? :009: Fsu M.Zh. something to delete???? :015: Fibroadenomas can be removed, they are solitary. And fibroadenomatosis means a lot of small formations.

My experience - FAM experience of 12 years. What they didn’t treat me with: homeopathy and vitamins, and dietary supplements, and mammoleptin and mastodinone, hormones separately and in combination with previous methods, externally and internally. TOTAL - ZERO. Pregnancy and breastfeeding did not save, but rather exacerbated the situation. Endless lactostasis, obstruction of cysts, blood (as mentioned above), 4 mastitis, the last one - surgery. I will not even try to feed the second child with GM, bromocriptine immediately after childbirth.
My mother fed both me and my brother for a long time (I was up to 2 years old, my brother was almost 3 years old), FAM did not resolve, moreover, now she is a cancer patient in remission (a year ago she was diagnosed with stage 2 breast cancer on the left , breast removal surgery, chemotherapy, radiation therapy, hormone therapy).

Women's health is a necessary condition for the birth of offspring. That is why medicine pays special attention to it. Various screenings are carried out annually, which make it possible to identify pathological conditions at an early stage. Unfortunately, women's diseases continue to rise. This is due to the influence of various environmental factors, as well as bad habits. One of the most common pathologies is diffuse fibroadenomatosis of the mammary glands. This disease refers to benign neoplasms. Due to the fact that the process can develop into breast cancer, timely diagnosis and treatment are necessary. Diffuse fibroadenomatosis of the mammary glands is otherwise called mastopathy and occurs in most women of young and middle age. Most often, this disease develops after a period of breastfeeding, as well as insufficiency of thyroid hormones. If it is detected in time, then dangerous consequences and surgical treatment can be avoided.

Factors contributing to the development of fibroadenomatosis

Diffuse fibroadenomatosis of the mammary glands is a benign neoplasm that can capture both one and both breasts. The reasons for the development of this disease are not known. However, there are a number of factors that affect breast tissue. These include: physical, chemical and hormonal effects. There is an assumption that fibroadenomatosis occurs in girls who often wear underwear that squeezes the mammary glands. Also, benign degeneration is associated with the influence of chemicals, since the development of mastopathy in women working in hazardous industries occurs much more often. Ladies with bad habits belong to the same category. The main one is hormonal failure. Excessive influence of estrogens on the body is observed in various diseases of the female genital organs, early onset of menstruation, late development of menopause. Hormonal disorders can occur with improper use of oral contraceptives, frequent childbirth, or, conversely, their absence. Another risk factor is hypothyroidism.

Types of fibroadenomatosis of the breast

Diffuse fibroadenomatosis of the mammary glands can be homogeneous and mixed. It depends on which tissue in the breast has undergone overgrowth. Depending on this, fibrous and cystic mastopathy are distinguished. In the first case, we are talking about connective tissue. Diffuse cystic fibroadenomatosis develops with growth. Most often, a mixed variant develops. In addition to diffuse proliferation of breast tissue, there are local changes. Solitary fibroadenomas must be differentiated from breast cancer. Their only treatment is surgical removal.

Breast changes in fibroadenomatosis

The density of the breast during palpation depends on which type of mastopathy prevails. If it takes up most of it, then the gland will be denser, with nodular formations (lumps). Their size may differ from each other. Diffuse cystic fibroadenomatosis of the mammary glands is characterized by the fact that softer formations are palpated in the chest - sacs filled with liquid. They can also vary in size and location. In order to notice changes in breast tissue, it is necessary to conduct a monthly examination. Every woman can do it on her own. To do this, you need to carefully feel the chest around the entire circumference, and then more carefully - in each quadrant.

Having noticed signs of diffuse fibroadenomatosis, you need to consult a mammologist. An additional examination will help determine the type of mastopathy.

Methods for diagnosing fibroadenomatosis

The main method for detecting fibroadenomatosis is palpation of the mammary glands. Every woman should own the technique of its implementation. In addition, palpation can be performed by a mammologist, gynecologist or therapist. Unfortunately, it is not always possible to detect moderate diffuse fibroadenomatosis, since the formations with it can be very small. In order to clarify the type of mastopathy, as well as determine the tactics of treatment, it is necessary to conduct a number of instrumental studies. Currently, mammography is a widely used X-ray method. In addition, an ultrasound examination is performed, which is more preferable for young women.

Treatment of diffuse fibroadenomatosis

In order to get rid of mastopathy, it is necessary to find out the main reason for its appearance. Only the elimination of the damaging factor will help to completely defeat diffuse fibroadenomatosis. Treatment of the thyroid gland, genital organs, avoidance of harmful influences (smoking, chemical production, uncomfortable underwear), as well as the correct use of contraceptives are considered the main methods. In addition, symptomatic therapy is used. It includes the use of Tamoxifen, Fareston. In addition, herbal decoctions and diet are recommended.

Prevention of neoplasms of the mammary glands

To avoid it is necessary to constantly examine and palpate the chest. Women over the age of 40 must undergo a mammogram, regardless of whether they have complaints or not. In addition, you need to avoid adverse factors and hypothermia, eat right and wear comfortable underwear. When using hormonal contraceptives, it is necessary to be observed annually by a gynecologist and mammologist.

Localized mastopathy is a frequent disease of the mammary glands, which poses an oncological danger. Timely diagnosis and appropriate treatment of localized mastopathy are a reserve for reducing the incidence of advanced forms of breast fibroadenoma cancer and improving the quality of life of women.

Localized mastopathy (localized fibroadenomatosis)

Localized mastopathy is such a process in the mammary gland, in which the formation of proliferate nodes in this organ occurs.

They are characterized by a disturbed relationship between epithelial and connective tissue, which is reflected in the morphological structure of the mammary glands. The prevalence of localized mastopathy in the modern world is 30-40%, and in the presence of gynecological pathology it reaches 85%. The maximum frequency of detection of localized pathology occurs at the age of 45 years, while in the perimenopausal age it decreases. The minimum number of cases of nodular localized mastopathy occurs at the age of 75 years. However, an inverse relationship is characteristic of fibroadenoma and breast cancer, the detection of which increases in menopausal women (the older the patient, the more cancer risk factors she has).

Therefore, the mammary gland in all age categories requires close attention from the woman and the doctor.

Hormones and the mammary gland

The mammary gland is a hormone-dependent organ. It is this position that underlies the development of mastopathy. This disease is characterized by a hormonal imbalance. Estrogens and progesterone have the greatest influence on the functional and morphological state of the mammary glands. However, the role of hormones such as:

Prolactin;

Somatotropin;

· Glucocorticoids;

Insulin;

Thyroxine and triiodothyronine.

Treatment of localized fibroadenomatosis >>>

Hormones have the greatest influence on the glandular structures of the mammary gland, and less on the stroma. Hyperplasia (overgrowth) of the latter usually occurs under the influence of excess estrogens. The adipose tissue of the breast is currently regarded as a depot for progesterone, estrogen and androgens. Its cells (adipocytes) do not form these substances, they capture them from the bloodstream and accumulate. Over time, certain estrogen fractions, estrone and estradiol, are formed from androgens with the participation of aromatose (moreover, a monotonous concentration of estrone is the most dangerous). This is an additional factor for the development of mastopathy. This circumstance also explains why the frequency of breast cancer increases with age (over time, the amount of deposited estrogens increases, which provokes cell division without subsequent proper differentiation).

Forms of localized mastopathy and morphological structure

From a practical point of view, it is customary to distinguish between two types of localized mastopathy:

1. Proliferating

2. Non-proliferating

Proliferation leads to the appearance of papillomas. If they are localized inside the milk ducts, then they are called intraductal, and if they are inside a cystic formation, then cystadenopapillomas. The danger of these changes lies in the fact that sometimes they can be accompanied by atypia and malignancy. Thus, proliferating mastopathy is considered as a background condition for the development of cancer.

Localized mastopathy may be characterized by a predominant proliferation of either connective or glandular tissue. But in practice, combined options are most often found. In contrast to diffuse mastopathy, with localized fibroadenomatosis, the formation of 1-2 areas with characteristic pathological changes is observed, the rest of the breast tissue is intact, i.e. has a normal structure. Clinically, this leads to symptoms such as:

The formation of focal seals that do not have clear boundaries, which are not soldered to the skin (unlike cancer);

Education are dynamically changing - on the eve of menstruation, they increase, and after it ends, their size decreases;

Pain (in comparison with diffuse mastopathy in this form, it is more pronounced). The pain often radiates (spreads) to the shoulder blade or shoulder;

Sometimes there is an increase in axillary lymph nodes. In this case, careful differential diagnosis is required, carried out with breast cancer.

Causes of the disease

A decisive role in the pathogenesis of localized mastopathy belongs to conditions that are characterized by a decrease in progesterone, as well as functional disorders of the ovaries with the development of hyperestrogenemia (elevated estrogen levels). The latter position is confirmed by several circumstances:

· Increased proliferative processes in the epithelium under the influence of estrogens;

· Increased activity of fibroblasts and associated proliferation of connective tissue;

Frequent detection of mastopathy in patients with dysfunctional bleeding from the uterus, fibroids and endometriosis, follicular ovarian cysts, anovulatory form of infertility. In all these conditions, there is an excess of estrogen in the body.

However, the presence of a normal menstrual cycle does not at all exclude the possibility of developing localized mastopathy. This confirms that in the development of this disease, the most important role is played not by the level of hormones in the blood plasma, but by the state of the receptors, which can be much higher than normal.

Clinical phases of mastopathy

The clinical phases of local mastopathy reflect the degree of progression of the disease. It is customary to distinguish three phases. The features of the first phase are:

Most often it is observed at the age of 20-30 years;

The menstrual cycle is regular, but more often shortened (its duration ranges from 21 to 24 days);

Clinical signs appear a week before menstruation, the rest of the time they are absent;

· The most common symptoms are breast engorgement and tenderness, breast tissue becomes dense, and palpation is sensitive;

Morphological changes are diffuse in nature, there are no local nodes (diffuse mastopathy).

The second phase of fibroadenomatosis is characterized by a greater severity of symptoms and the development of local changes (local fibroadenomatosis):

They appear at the age of the patient from 30 to 40 years;

· Chest pain becomes constant, it lasts for 2-3 weeks before the onset of menstruation;

In the chest, local seals are determined, characterized by pain at rest and on palpation.

The third phase is the final stage of mastopathy. Its features are:

Predominant development at the age of 40-45 years;

The pain becomes less intense and unstable, so patients often do not go to the doctor for help;

Determined by multiple cystic formations, the diameter of which ranges from 1 to 3 cm;

· Pressure on the areola leads to the secretion of a brownish-green color (it comes from cystic formations that open on the areola).

It should be noted that in 10-15% of cases, local mastopathy can occur without pain. At the same time, examination and palpation of the mammary glands reveals the same changes as in patients experiencing severe pain. Most likely, this is due to different thresholds of pain sensitivity, depending on the level of endorphins in the central nervous system. The mechanism of pain in local fibroadenomatosis is explained by the following circumstances:

Compression of nerve endings by cysts and connective tissue, which has increased in volume due to edema;

Sclerosis of nerve endings;

Involvement of axillary lymph nodes in the pathological process (noted in 10% of women with this diagnosis).

Diagnostic program

The diagnostic program for local fibroadenomatosis is based on such provisions as:

Features of the anamnesis;

· Clinical symptoms;

Inspection and palpation of the chest;

· Special methods of examination.

The basic anamnestic data suggesting the presence of mastopathy are:

· Abortions;

Spontaneous miscarriages;

Prolonged infertility;

· Anovulatory menstrual cycles;

Uterine bleeding of a dysfunctional nature;

Uterine fibroids;

· Ovarian cysts.

To obtain reliable diagnostic information during palpation of the mammary gland, it must be carried out in compliance with certain rules. These include:

Mandatory examination of all quadrants of the chest;

Feeling the glands both in the vertical position of the woman (standing) and in the horizontal (lying down);

On palpation while standing, the patient's hands should first be lowered and then raised;

Squeezing the areola to determine the presence of discharge from the chest and their nature;

· With a regular menstrual cycle, it is best to examine the mammary gland 1 week after the end of menstruation (approximately the 12-15th day of the cycle).

The following special research methods are most often used to diagnose local mastopathy:

· Ultrasound examination, which is preferred in young women under 35;

X-ray without contrast (mammography) - used as screening for women over 35 years of age. It is best, like ultrasound, to be carried out on the 7th day of the cycle;

Contrast x-ray examination;

Thermography - the study of the temperature spectrum of the mammary gland, which changes in many diseases (has a characteristic picture in cancer and mastopathy);

· Study of electrical conductivity of tissues;

Puncture biopsy with a thick needle.

For early detection of mastopathy and possible malignant transformation, mammography is recommended for all women over 40 years old once a year. For patients older than 50 years, this study should be carried out more often - annually. However, between the ages of 66 and 74, the frequency of mammography decreases (again once every 2 years).

Medical tactics

Treatment of local mastopathy with the appearance of clearly defined nodes is carried out only surgically. If the size of the fibroadenoma does not exceed 2 cm in diameter, then the operation can be refrained from. In this case, dynamic monitoring is carried out. It is carried out by a mammologist. A woman should also regularly examine the mammary gland.

Operations that are used to treat local fibroadenomatosis can be divided into 2 types:

Sectoral resection - along with the tumor, adjacent breast tissue (sector) is also removed;

Enucleation, or husking - remove only a local formation, without affecting the tissue of the gland.

However, before surgery, it is necessary to clearly assess the presence of indications. With local fibroadenomatosis, these include:

Suspicion of malignant transformation, which is obtained by examining biopsy material (in this case, a sectoral resection is performed);

Rapid growth of the tumor, which is indicated by a two-fold increase in the last 3 months;

Enucleation of a cyst that developed as a recurrence after its puncture emptying.

Surgical treatment for local mastopathy is performed under local anesthesia. The duration of the intervention rarely exceeds 30-40 minutes. The stitches are removed after 1-1.5 weeks. The course of the postoperative period is usually smooth.

However, it is possible to avoid an operation that causes psychological trauma. For this, it is necessary to detect diffuse forms of mastopathy in a timely manner and carry out conservative treatment. However, after its cancellation, relapses often develop (due to the imperfection of hormonal therapy), so regular follow-up is required for patients. At the slightest suspicion of a relapse, an examination is prescribed, and according to its results, a course of treatment.