An experienced specialist will determine a mammologist. Mammologist appointment. Consultation of a mammologist in the "Complex Clinic"
Cancer can appear in a person at absolutely any age, and it does not matter at all whether you lead a healthy lifestyle or not. Its main danger lies in the fact that it often develops completely unnoticed. The surest way to detect the disease in time is to conduct preventive studies.
The main thing is to check your health before it's too late. Early diagnosis offers the opportunity to save your life, since most diseases are completely treatable in their early stages. Po must be an extra-class professional.
What does mammology study?
Mammology deals with the study, treatment, and prevention of diseases of the mammary glands. Breast cancer is no less common than other cancers. For high-quality observation, as well as for treatment, patients need, first of all, to find a good specialist. Below is a list of the most successful doctors in the field of mammology, recognized as qualified specialists in Moscow, and find out what patients who leave their reviews on the Internet think about them.
Novikova Larisa Andreevna
This is an oncologist-mammologist. Carries out diagnostics and surgical treatment of neoplasms of the mammary glands and skin, using modern minimally invasive techniques, which are considered sparing. Provides consultations to patients who suffer from oncological diseases of any localization. Over the years of her practice, she has provided high-quality and qualified specialized assistance to thousands of her patients. Her merits as an oncologist-mammologist in Moscow are highly valued.
Reviews
Many patients believe that if everyone were doctors like this one, then surely few people would get sick at all. According to patients, the doctor always speaks specifically and to the point. Takes only those tests that are necessary. During appointments, he tries not to upset patients, although, unfortunately, he rarely manages to please them.
In addition, in their reviews, patients call Larisa Andreevna an excellent doctor, consider her attentive and professional. In addition to neoplasms already present in patients, it is often able to detect and identify new ones. As a rule, all patients are encouraged to contact other specialists in case of detection of other malignant tumors. Patients are prescribed various measures, which the doctor must agree and discuss, explaining all the nuances. Therefore, those who turn to Larisa Andreevna for medical help usually like the way she receives her patients suffering from one or another ailment in the field of mammology. According to patients, the consultations are friendly and competent.
In addition to attentiveness, patients also note a warm and trusting attitude towards them. The doctor creates such conditions under which patients tell everything frankly and without concealment. Many women who come to this doctor with their health problems, who have already gone through many mammologists in their lives, opt for this specialist. The doctor not only conducts consultations, but, if necessary, attends an ultrasound scan herself in order to be able to competently and efficiently control the entire treatment process.
Mikhailenko Anatoly Nikolaevich
This specialist is an oncologist-mammologist with the highest qualification category. He carries out prevention, diagnostic studies, as well as the treatment of all diseases associated with the mammary glands, in addition, he treats surgical and oncological diseases. The doctor receives patients with mastitis, mastopathy, lactostasis, as well as malignant and benign neoplasms of the mammary glands at different stages of their development.
People say about this specialist that he, as a rule, justifies all their expectations, and also listens attentively to his patients and conducts thorough examinations. Therefore, women are very satisfied with the consultations of this oncologist-mammologist in Moscow. Reviews confirm this.
Some say that they absolutely trust this doctor and are always sure that he will not harm them. As a rule, Anatoly Nikolaevich does everything necessary very quickly and efficiently. Comfortable conditions are created for patients, women feel confident and are not embarrassed, it is quite normal to perceive this specialist as a doctor, without focusing on the fact that he is a man.
Many patients choose this doctor based on reviews on the Internet. Consultations for patients are quite fast, competent, informative and accessible, and besides, they are to the point. According to people, the appointments with this doctor suit them and they are very grateful.
The rest of the patients emphasize the professionalism of the doctor in their comments and declare that you come to one of the oncologists-mammologists as if for an exam, and this one is like their own for them.
Baryshnikova Olga Sergeevna
Mammologist Olga Sergeevna has extensive experience in diagnosing malignant and benign tumors of the breast. It is distinguished by conservative methods of treatment, including hormonal therapy, as well as the selection of the most appropriate scheme for analgesia with pronounced pain syndromes. She is an active participant in international conferences that are dedicated to palliative as well as symptomatic care for patients in the field of oncology.
There are rumors about Olga Sergeevna that she is able to literally lift a person to his feet. Patients who have been in bed for half a year and could not get up, thanks to the treatment of this mammologist, begin to get out of bed and feel much better.
Patients do not doubt the professionalism and competence of Olga Sergeevna, although sometimes the first impression that develops from visiting this doctor, as they say, turns out to be twofold. And this is a really good oncologist-mammologist.
Patients do not always receive answers to all their questions, and some in their comments cannot confidently say that they were satisfied with their visit to this specialist.
Nevertheless, patients like that Olga Sergeevna can explain everything very intelligibly, and in addition, they note the kind human attitude of the doctor towards people.
According to those who applied, the doctor professionally examines his patients and devotes enough time to them, they consider this mammologist a qualified specialist with vast experience and it is for this reason that they come to her. Usually, women get advice from this doctor with comprehensive information in an understandable language.
Vasiliev Alexander Petrovich
Renowned mammologist. He possesses methods of ultrasound and clinical examination in the area of the mammary glands, interprets the results of mammography and performs a puncture biopsy of neoplasms. He performs surgical treatment of cysts, intraductal papillomas, lactational mastitis, fibroadenomas and, in addition, conducts conservative treatment of lactostasis among nursing mothers. The practical list of this doctor should also include radiosurgical treatment and diagnosis of neoplasms of the skin.
From Alexander Petrovich, patients always have a positive impression. According to patients, the doctor has a very friendly attitude, women feel the experience and professionalism of a specialist. Consultations are also quite productive and do not raise any questions.
All patients like the doctor, they characterize him as the most experienced specialist and call him a great professional in his field, and besides, a conscientious person.
Information from visitors
According to reviews, there are no comments on this oncologist-mammologist in Moscow. Patients believe that he speaks everything to the point, and most importantly - in an understandable language. Alexander Petrovich does not prescribe anything superfluous and even more expensive, but prescribes only the necessary procedures. The ability of the doctor to clearly explain what is possible for patients and what cannot be done as part of the treatment is also noted. Women write that not every specialist manages to shed light on a professional explanation of the nuances relating to their illness in an understandable language, as this particular mammologist does. Therefore, patients note that Alexander Petrovich is very qualified and treats their questions with due attention. He additionally accompanies his patients during ultrasound, and many emphasize that they are ready to undergo treatment only with this doctor and do not intend to turn to anyone else.
We have studied the list of the best oncologists-mammologists. Reviews about them are given.
Mammologist- Medical specialist in diseases mammary glands. Mammologist ( from the Latin word "mamma" - mammary gland) deals with inflammatory, dyshormonal and neoplastic diseases of the mammary gland.The need for a doctor who would deal exclusively with the pathology of the mammary gland arose, first of all, in connection with the prevalence of breast cancer, which was most often found at a stage when treatment was ineffective.
This medical specialty is not officially registered in Russia. To qualify as a mammologist, in addition to higher medical education, a doctor must have a major specialty in one of three areas - gynecology, surgery, oncology.
After that, the doctor undergoes retraining on the topic "Mammology" and receives the right to work as a mammologist. Thus, the services of a mammologist are provided by doctors who constantly encounter breast pathology in their work.
Among the mammologists, the following specialists are distinguished:
- oncologist-mammologist– is engaged in the prevention, diagnosis and treatment of malignant tumors of the breast;
- breast surgeon- deals with breast pathology, which require surgical intervention ( benign tumors, nodular mastopathy, mastitis and other diseases);
- gynecologist-mammologist– deals with dyshormonal diseases of the mammary gland;
- radiologist-mammologist- Carries out diagnostic tests such as mammography and tomosynthesis ( X-ray examinations of the breast);
- Ultrasound mammologist– conducts ultrasound procedure ( ultrasound) mammary gland.
Mammologist works in the following institutions:
- Women's consultation- as an obstetrician-gynecologist, who underwent a thematic improvement in breast pathology;
- cancer centers ( institutions) – as an oncologist, surgeon, radiologist or ultrasound specialist ( sonographer) who work in the breast department;
- breast centers– highly specialized medical centers where mammologists-surgeons, mammologists-oncologists, mammologists-gynecologists work ( including gynecologists-endocrinologists), as well as diagnosticians ( radiologists and sonographers).
What does a mammologist do?
A mammologist is engaged in the identification and treatment of various pathologies of the mammary gland, carries out the prevention of malignant tumors of the mammary gland, as well as the rehabilitation of women after treatment. Some breast surgeons also deal with aesthetic problems associated with the mammary gland, perform plastic surgery and prosthetics. The duties of a mammologist include:
- identification of risk factors for breast cancer;
- complete preventive examination of the mammary glands ( breast screening);
- training women in self-examination of the mammary glands;
- medical examination ( registration and active surveillance- women with any pathology of the mammary gland;
- early detection of cancer;
- carrying out clarifying diagnostics ( radiologists and sonographers);
- treatment of breast diseases in women;
- treatment of dyshormonal diseases of the mammary glands in men.
- benign breast tumors lipoma, fibroadenoma);
- intraductal papilloma;
- lipogranuloma;
- breast cysts;
- mastopathy ( benign breast dysplasia);
- mammary cancer;
- Paget's cancer;
- gynecomastia;
- galactorrhea;
- mastodynia ( Cooper's disease);
- ductectasia;
- mastitis;
- breast injury;
- congenital anomalies in the development of the mammary gland;
- problems associated with lactation milk secretion) and breastfeeding;
- Mondor's disease.
Benign breast tumors
Benign breast tumors occur most often between the ages of 15 and 35. They consist of tissues that are present in the mammary gland, do not affect the general condition of the female body in any way, and do not form again after their removal.The main cause of benign tumors is considered hormonal imbalance, since there are many receptors in the mammary gland ( sensory nerve endings), which are very sensitive to any excess levels of hormones, especially estrogen, progesterone and prolactin.
Benign breast tumors include:
- adenoma- a tumor of the glandular tissue that secretes breast milk;
- fibroma- connective tissue tumor constituting the supporting frame of the organ);
- fibroadenoma- a tumor that consists of glandular and connective tissue in equal proportions;
- lipoma- a tumor of their adipose tissue ( wen).
Intraductal papilloma
Intraductal papilloma ( wart) is a benign tumor that develops from epithelial ( lining the inside) cells of the ducts of the mammary glands. Intraductal papilloma has its own characteristics. It is almost impossible to detect during palpation of the mammary gland, but it is manifested by frequent spotting of their nipple, which is very frightening for a woman. Because of this symptom, intraductal papilloma is called "bleeding mammary gland." Lipogranuloma of the breast
Lipogranuloma ( oleogranuloma) is a non-inflammatory necrosis limited from healthy tissue ( necrosis) fatty tissue of the mammary gland. Often occurs after a bruise of the mammary gland, surgery or injections into the gland. Sometimes observed in systemic connective tissue diseases ( rheumatoid arthritis, systemic lupus erythematosus).Depending on the prevalence, mastopathy is:
- nodal– one or more nodes are detected;
- diffuse- changes occur in the entire mammary gland.
- fibrous- mastopathy due to the growth of connective tissue in the gland;
- adenous ( adenomatous) - an increase in lobules, that is, mastopathy due to the glandular component;
- cystic- mastopathy, with the formation of grape-shaped cavities with liquid inside.
Most often there are mixed forms.
Mammary cancer
Breast cancer is a malignant tumor that mainly has a hereditary cause and develops in the presence of favorable factors ( risk factors).There are the following risk factors for developing breast cancer:
- maternal breast cancer, especially if it occurs before the age of 60;
- breast cancer in two relatives;
- detection of mutations in the BRCA1 and BRCA2 genes ( Breast Cancer - breast cancer);
- the onset of menstruation before the age of 13;
- first birth after 30 years;
- lack of childbirth;
- frequent abortions;
- refusal to breastfeed;
- menopause up to 50 years;
- the presence of a benign breast tumor;
- the presence of diseases of the female genital organs;
- alcohol consumption.
Paget's cancer
Paget's cancer is a malignant tumor of the nipple and adjacent pigmented skin ( areola) mammary gland. The tumor is manifested by redness, eczema ( itching, rash, burning, weeping) and ulceration of the nipple. Sometimes scales form that resemble psoriasis. This type of cancer occurs in both women and men.Galactorrhea
Galactorrhea is a milky discharge that occurs in non-pregnant women and men. The reason for such secretions is hormonal changes associated with the pituitary gland, thyroid gland or adrenal glands. Sometimes galactorrhea is a side effect of certain medications. The result of all these diseases is the same - a high level of the pituitary hormone prolactin, which stimulates the formation of milk in the mammary glands. Gynecomastia
Gynecomastia is an enlargement of the mammary glands in men. This pathology is a consequence of endocrine disorders, therefore, endocrinologists and andrologists are most often involved in it, however, due to the risk of developing breast cancer in men ( usually in old age), gynecomastia is also included in the scope of the mammologist.Mastodynia ( Cooper's disease)
Mastodynia is a feeling of fullness in the mammary glands that occurs during the premenstrual period and disappears after the onset of menstruation.Ductectasia
Ductectasia is an extension ( ectasia) large ducts ( ductus) of the mammary gland located closer to the nipple. The reason for the expansion is a chronic inflammatory process. Ductectasia is more often observed in women of advanced age, when involutive processes begin in the mammary gland ( regression of an organ).Mastitis
Mastitis ( from the Greek word "mastos" - breast, nipple) - inflammation of the breast. The cause of mastitis is an infection that penetrates the mammary gland ( usually through the nipple). Sometimes breast cancer occurs under the guise of mastitis ( inflammatory form of cancer).Mastitis can be caused by the following pathogens:
- non-specific microorganisms- staphylococci and streptococci;
- specific microorganisms- pale treponema ( the causative agent of syphilis), mycobacterium tuberculosis, actinomycetes ( fungi that cause actinomycosis).
Problems associated with lactation ( milk secretion) and breastfeeding
They also turn to a mammologist if, after childbirth, the process of breastfeeding is difficult or causes pain. In this case, the woman is observed by a mammologist-gynecologist who works in the antenatal clinic at the maternity hospital. Lactation disorders include:
- milk fever ( lactational mastitis) - develops on the 3rd - 5th day after childbirth due to stagnation of milk, which begins to be absorbed back. The milk sucked back has pyrogenic properties, that is, it can cause a rise in temperature. Unlike infectious mastitis, the mammary gland does not thicken.
- Hypogalactia ( galactos - milk) - insufficient amount of milk in a woman;
- Agalactia- complete absence of milk in the mammary glands after childbirth;
- Cracks in the nipples- small linear defects or tears in the skin of the nipple and around it. Cracks occur if the skin of the nipples is overdried by some cosmetics ( alcohol based), or the nursing mother does not follow the rules of hygiene before and after feeding.
Congenital malformations of the mammary gland
Breast malformations are usually dealt with by breast surgeons, as they require surgery to correct them.Congenital malformations of the breast include:
- amastia- both mammary glands are absent;
- monomastia- there is only one mammary gland;
- polymastia- there are additional nipples or lobes of the mammary gland.
Breast injury
A breast injury is a soft tissue contusion, that is, it causes swelling, cyanosis and pain in the breast. In some cases, hemorrhage occurs in the mammary gland ( hematoma), which quickly spreads throughout the gland, due to the weak ability of the organ to limit this process.Mondor disease
Mondor's disease is an inflammation of the superficial veins of the anterior or lateral sections of the chest, as well as in the area of the mammary gland. This pathology is of interest to a mammologist, since, when inflamed, the veins and the skin over them tighten, which resembles the tightening of the skin over the mammary gland in cancer.How is the appointment with a mammologist?
Reception mammologist held in women on certain days of the menstrual cycle. A woman should make an appointment with a mammologist so that the day of the visit falls on the 5th - 12th day of the cycle ( should be counted from the first day of menstruation). The fact is that after ovulation ( 13-14 days after the start of menstruation) the mammary glands swell somewhat and become slightly denser than usual, which is associated with hormonal changes. Examination these days can lead to false positive results. This rule applies to women of reproductive age. After menopause, you can apply any day. At the appointment, the mammologist performs the following actions:
- asks the patient about her complaints;
- asks questions to find out if she has risk factors for breast cancer;
- conducts examination and palpation of the mammary glands;
- appoints the necessary tests;
- directs to the necessary instrumental research.
The mammologist at the reception asks the following questions:
- At what age was the first menstruation?
- When was the last menstruation?
- What is the duration and regularity of the menstrual cycle?
- At what age did menopause start?
- How many pregnancies were there?
- How many births?
- How many abortions have there been?
- At what age were the first births?
- Was enough milk produced in the mammary glands during breastfeeding?
- Has a family history of breast cancer?
- Has the woman experienced or currently has conditions such as ovarian cysts, uterine fibroids or polyps, endometriosis, ovarian dysfunction, or infertility?
- Has the woman had breast surgery?
- Did the woman have mastitis or breast bruises?
- Does the woman take birth control pills or hormones?
- Has the woman experienced in the past or does she currently have) severe stress associated with personal life, family, work and so on?
- Does the woman drink alcohol heavily and/or regularly?
Inspection and palpation of the mammary gland is carried out in a standing and lying position ( for this, there is a couch in the mammologist's office). In both positions, the symmetry and size of the gland are visually assessed. The mammologist palpates the mammary gland with the palmar surface and the pads of four fingers folded together ( thumb slightly abducted).
The mammologist uses the following models of breast palpation:
- by quadrants- the mammary gland is conditionally divided into four quadrants ( equal areas), which are examined in turn, starting from the upper outer quadrant, after which the upper inner, lower outer and lower inner quadrants are palpated;
- in a spiral– palpation is carried out in a circle, starting from the center ( pacifier) in conditional circles;
- along radial lines- the mammary gland is felt along conditional lines coming from the nipple in the form of spokes in a wheel;
- up and down movements- a mammologist feels the gland along imaginary vertical lines from bottom to top and top to bottom.
Feeling is carried out in the following positions:
- the patient's hands are located on the hips, relaxed in the shoulder joints- in this position, the pectoral muscles relax, and it is easier for the doctor to feel deeply located formations and lymph nodes;
- the patient's arms are raised and wound behind the back of the head- in this position, the ligaments of the mammary gland are stretched, and areas of skin retraction over the gland can be seen ( is a sign of cancer, but can also be observed in non-malignant processes).
A mammologist describes the following features of a breast tumor or node:
- The size. The size is estimated not subjectively, but with the help of a centimeter tape or a plastic compass.
- Localization. Descriptions of the location of pathological changes are carried out according to the scheme of the clock face ( e.g. 6 o'clock, 12 o'clock) or indicate the name of the quadrant of the mammary gland, where the formation is palpable ( upper inner, upper outer, lower outer, lower inner).
- Soreness. If the pathological focus "hurts", then most likely it is of a benign nature ( cancer at an early stage does not cause pain).
- Consistency and compaction. It is believed that the cancerous tumor has a stony density, but in some cases it can be defined as a focus with a jelly-like consistency. If a soft, easily compressible formation is palpated, then most likely it is a cyst.
- The form. To describe the shape, the mammologist evaluates the evenness or unevenness of the contours of the formation. The more irregularities along the edges, the more likely it is that the node is malignant.
- Communication with surrounding tissues. The connection is determined by the mobility of the node, that is, the ability to displace it during palpation. Malignant nodes are characterized by immobility.
- Changes in the skin over the mammary gland. Changes such as redness, cyanosis, swelling, retraction or ulceration of the skin are described.
The mammologist prescribes the following tests:
- General blood analysis. With the help of this analysis, a mammologist can suspect a hidden malignant process in the mammary gland. The presence of cancer can be indicated by such changes as a pronounced increase in the number of leukocytes, an increase in the erythrocyte sedimentation rate ( ESR) or anemia ( low hemoglobin and/or red blood cells). These are nonspecific signs, that is, they can be observed in various pathologies.
- Blood chemistry. The mammologist pays special attention to the activity of liver enzymes, the level of bilirubin and blood proteins. A change in these indicators may be a consequence of liver pathology, and it is not only involved in regulating the activity of female sex hormones, but also the first one "takes the hit" in breast cancer ( breast cancer primarily metastasizes to the liver).
- Blood test for hormone levels. Almost all hormones that are secreted in the body act on the mammary gland. Some act on the gland directly, since it has receptors for these hormones, while others indirectly, that is, through an increase or decrease in the level of those hormones that can directly affect the mammary gland. The main information about hormonal diseases of the mammary glands is given by estrogen, progesterone and prolactin, however, it is important to exclude any endocrine pathology, so a mammologist can prescribe tests for other hormones. Also important is the level of globulin that binds sex hormones ( sex steroid-binding hormone), which is produced in the liver.
- Analysis for mutations in the BRCA1 and BRCA2 genes ( Breast Cancer - breast cancer). Normally, these two genes are responsible for curbing the processes of excessive division of breast cells, especially during puberty and pregnancy. When these genes are “broken”, cell division is poorly controlled, and the process of natural death of obsolete cells is disrupted. As a result, cells with "broken" chromosomes are not removed from the gland. This chromosomal instability leads to breast cancer.
- Serological blood test. The analysis reveals the presence of antibodies to pathogens of specific mastitis, that is, mastitis caused by syphilis, tuberculosis and actinomycosis.
- Bacteriological research. Bacteriological analysis is a sowing of material obtained during a diagnostic or therapeutic puncture ( puncture of the gland with a needle), on a nutrient medium. The study allows you to identify a specific causative agent of mastitis and determine its sensitivity to antibiotics.
Breast screening has its own characteristics depending on the age of the patient. Until 2012, age groups were divided into women under and over 40 years old, but every year cancer “gets younger”, so even young women began to be careful, especially if they have risk factors for breast cancer. Women with risk factors should be examined by a mammologist 2 times a year, in the absence of risk factors up to 35 years - once a year or once every 2 years. For women over 35 - 40 years old, a visit to the mammologist is obligatory once a year, even in the absence of complaints.
Activities carried out by a mammologist during mammological screening
| What does breast screening for women under 35 include? | What does breast screening for women over 35 include? |
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What are the symptoms of turning to a mammologist?
Not only women who have complaints from the mammary glands turn to a mammologist, but also those who have no pain. The last group of patients makes up the vast majority of women who are treated by a mammologist. This is precisely the specific job of this specialist - to identify the disease before the onset of symptoms. The fact is that the presence of obvious manifestations of breast tumors basically means that the disease has already “taken root”. In addition, many tumors, both benign and malignant, "do not give out" themselves, that is, they proceed without complaints. It is important to know that a mammologist can and should be contacted not only at the age of 35-40 and if there are problems, but also during puberty, since the mammary gland requires the same attention as the menstrual cycle.
The fact is that the mammary gland responds to any hormonal change in the body, especially in women in whom this organ has not yet fulfilled its main function - feeding the baby. From this point of view, going to a mammologist is equivalent to going to a gynecologist.
Symptoms that should be addressed to a mammologist
| Symptom | Origin mechanism | What studies are performed to diagnose the causes of the symptom? | What disease can the symptom indicate? |
| Pain or tenderness in the breast |
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| breast seal |
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| The presence of education in the mammary gland
(according to palpation) |
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| Asim- mammary glands |
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| Milk-like discharge from both nipples |
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| Discharge from one or two nipples
(colorless, yellowish, green, brown) |
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| Bloody discharge from the nipple |
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| Nipple retraction |
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| Retraction of the skin over the mammary gland
("Orange peel") |
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| Change in skin color of the breast |
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| Thickening, ulceration of the skin of the breast and/or nipple area |
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| Breast enlargement in women |
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| Male breast enlargement |
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What research does a mammologist do?
A mammologist conducts instrumental and laboratory research methods not only if he detects changes during examination and palpation, but also as part of mammological screening. If a mammologist has revealed obvious symptoms of breast cancer in a woman or manifestations that cause suspicion of cancer, then a mammologist must conduct a complete examination of the woman within 8-10 days. What kind of study the mammologist will prescribe depends on the age and the presumptive diagnosis, which is to be clarified or excluded. A mammologist may prescribe several instrumental studies. Studies prescribed by a mammologist
| Study | What pathologies does it reveal? | How is it carried out? |
| Mammography |
| Mammography is an x-ray examination of the breast. Mammography is performed in the first phase of the menstrual cycle, somewhere between days 5-6 and 12 of the cycle, since in the second phase the mammary glands swell and become painful. The study is carried out in the vertical position of the woman ( standing or sitting). Each mammary gland is alternately pressed between two plates of the mammograph ( mammography machine). The image can be saved in two forms - film ( the image is immediately printed on film) or digital ( the image is sent to the computer). |
| Breast ultrasound |
| Ultrasound is best performed in the first week of the menstrual cycle to avoid false positive results associated with hormonal changes in the mammary glands after ovulation ( into the second phase). During the study, the woman lies on the couch, a gel is applied to the mammary glands, which facilitates the sliding of the ultrasound probe. An ultrasound transducer is placed over the skin of the mammary gland, moving it to obtain images of different sections of the mammary glands. Ultrasound also allows you to assess the condition of local lymph nodes. |
| Ductography |
| Ductography is an x-ray examination of the ducts of the mammary gland after the injection of a contrast solution into them through the nipple. Before the introduction of the substance, the area of \u200b\u200bthe areola and nipple is treated with alcohol. A drop of secreted from the nipple is used to find the opening of the milk duct and a needle is inserted to a depth of approximately 5 mm. A contrast agent is injected through the needle verografin or urografin), after which a series of x-rays is taken, which shows the entire path of the passage of the substance through the ducts. |
| Tomosynthesis |
| Tomosynthesis is an x-ray study in which x-rays irradiate the mammary gland in an arc. As a result, after computer processing, the mammologist receives thin sections of the gland. During the examination, the woman stands or sits, each breast is alternately pressed between the glass and the signal receiver, while the discomfort from compression is much less than with mammography. |
| Diagnostic puncture |
| Diagnostic puncture is a puncture of the breast tissue under ultrasound control. The purpose of the puncture is to obtain material for cytological examination. The resulting material is squeezed onto a glass slide and sent to the laboratory. |
| Cytological examination | As a material for a cytological examination of the mammary gland, discharge from the nipple or punctate can be used ( fluid obtained during a diagnostic puncture). To collect secretions from the nipple, the mammary gland in the areolar ( pigmented) areas are squeezed with one hand between the thumb and forefinger. With the other hand near the nipple hold the glass slide at a short distance. To take a smear-imprint, a glass slide is applied to the ulcerated surface of the nipple. The purpose of the study is to reveal the composition of the obtained liquid. In malignant formation, atypical ( cancerous) cells and erythrocytes, with intraductal papilloma - erythrocytes, with mastitis - leukocytes and fibrocytes. | |
| Breast biopsy |
| A biopsy is an intravital tissue sampling for histological examination. A biopsy can be done with a scalpel or scissors under local anesthesia if the tumor has grown into the skin ( incisional biopsy). If the formation is located deep, then the skin and subcutaneous tissue are dissected, and after the isolation of a part of the tumor, sutures are applied ( open biopsy). A biopsy can be done with a special thick needle ( trephine needle), which is injected with rotational movements to the tumor ( trephine biopsy). The resulting material is placed in formalin and sent to the laboratory. |
| Histological examination | For histological examination, you can use the material obtained during the biopsy ( biopsy) or the tumor itself, which was removed during the operation. Histological examination may be urgent if performed within 30 to 60 minutes ( during the operation) or planned, if the conclusion is received in 7-10 days ( more informative). | |
| Magnetic resonance imaging
(MRI) |
| During the study, the woman lies face down on the diagnostic table-couch. A special coil is placed under the mammary glands, which has holes, thanks to which the mammary glands hang down and are not pressed. MRI is used to identify metastases ( secondary tumors) breast cancer or to diagnose the nature of the tumor formation. To distinguish between different types of breast tumors, tissue contrast enhancement with intravenous gadolinium is often used. |
| tumor markers |
| Tumor markers are substances that are secreted by a malignant tumor or are its protein fragments ( antigens). Tumor markers in breast cancer are cancer-embryonic antigen ( CEA), ferritin, CA 15-3 antigen ( serum mucin glycoprotein) and mucin-like cancer antigen ( MCA). To detect these tumor markers, a blood test is taken. |
| Mammoscintigraphy |
| Mammoscintigraphy is a diagnostic method using radioisotopes that tend to accumulate in cancer cells, enhancing their glow on the screen. The drug is administered intravenously. During the study, the woman lies on the couch, a gamma camera is brought to her chest, which registers the radiation of the drug. The study is carried out on the 5th - 7th day after menstruation. |
If a woman has breast cancer, then a HER-2 test is performed before starting treatment. HER-2 is a receptor ( cell wall sensitive protein), which binds to growth factors - substances that can enhance cell division. This analysis is performed only for women who have been diagnosed with breast cancer. A cancer cell is used as a material for analysis, or rather its DNA obtained during a biopsy or after tumor removal. If a woman has this protein, then this is referred to as "positive HER-2 status", requiring the use of a drug that blocks this receptor.
What methods does a mammologist treat?
A mammologist uses both medical and surgical methods for the treatment of breast pathology. Gynecologists-mammologists adhere more to the so-called conservative approach, that is, they use medications. This tactic is due to the fact that gynecologists-mammologists deal mainly with hormonal diseases of the mammary gland. Oncologists-mammologists and surgeons-mammologists actively use surgical methods. For some benign tumors, mammologists may not take therapeutic measures, monitoring the formation with regular breast ultrasound, intervening if the tumor is enlarged. Treatment methods for breast pathology
| Pathology | Treatment method | Mechanism of therapeutic action | Approximate duration of treatment |
| Fibroadenoma | Surgical removal | During the operation, the sector of the mammary gland in which the tumor is located is removed. | For the operation, it is required to be under the supervision of a doctor in the hospital for several days, since the patient can be discharged after receiving data from a histological examination of the removed tumor. |
| Lipoma | Surgical removal | Small lipomas are removed under local anesthesia, and large ones under general anesthesia. An incision of the required depth is made on the mammary gland, after which the lipoma is cut off and removed along with the fatty membrane. | Depending on the scale of the operation, a woman can spend in the hospital from several hours to a day. |
| Puncture-aspiration removal | The content of the wen is pulled out with a needle, which pierces the mammary gland to the wen. With this method, the incision is not made. | Manipulation lasts 15 - 20 minutes, after which the woman can go home. | |
| Intraductal papilloma | Surgical removal | During the operation, the sector of the mammary gland in which the papilloma is located is removed. | For the operation, you need to be under the supervision of a doctor in the hospital for several days, during which the data of the histological examination of the removed papilloma are obtained. In the absence of indications of a malignant tumor, the patient is discharged. |
| Lipogranuloma | Surgical removal | To remove lipogranuloma, an incision is made and the affected sector of the mammary gland is removed under general anesthesia. | The hospital stay is several days. The patient is discharged in the absence of signs of a malignant tumor according to histological examination. |
| Breast cysts | Under ultrasound guidance, the cyst is pierced with a needle and aspirated ( pull out) its contents into a syringe, after which a substance is injected into the cyst cavity, causing adhesion of the cyst walls and its scarring. The introduction of sclerosing agents is necessary so that the fluid in the cyst does not form again. | The procedure is carried out under local anesthesia, so the woman is discharged after the procedure if malignant cells are not found in the fluid ( cytological examination). | |
| Surgery | Removal of the cyst is carried out together with the sector in which it is located. | The length of hospital stay depends on the number of cysts, but a minimum of 3 days is required. | |
| Breast cancer, Paget's cancer | Radiation therapy | Irradiation causes the destruction of the DNA of cancer cells, they stop dividing and die. | Breast irradiation is carried out 5 times a week until the woman receives the total dose. The number of radiation therapy sessions to reach the total dose depends on the single dose that is assigned to each session. |
| Surgery | Depending on the size, shape, and extent of the cancer, the tumor is removed within healthy tissue ( with small sizes) or together with the mammary gland and local lymph nodes. | After the operation, the woman must remain in the hospital for further treatment. | |
| Chemotherapy
(anticancer antibiotics, taxanes, alkylating agents) | All chemotherapy drugs interfere with cancer cell division by acting either on the genes that regulate this process or on cell structures ( microtubules) that are formed during fission. | The drugs are taken every 3-4 weeks ( 1 cycle). | |
| Monoclonal antibodies | Monoclonal antibodies bind to the HER-2 receptors of cancer cells, which makes it impossible for this receptor to come into contact with a substance that stimulates tumor growth. As a result, cancer growth is inhibited. | The drug is administered every 3 weeks or once a week. | |
| Antihormonal drugs | Reduce the production of estrogen hormones, which stimulate the uncontrolled formation of new cells in the mammary gland ( effective in hormone-dependent forms of cancer). | The drugs are used for a long time. | |
| Mammalgia
(Cooper's disease) | Hormonal drugs | Normalize the balance of female sex hormones in the body, eliminating the premenstrual swelling of the gland. | The drugs are taken for 3 months, take a break for 2 - 3 months, then repeat the course. |
| Homeopathic preparations | affect the central organs in the brain) regulates the menstrual cycle. | ||
| Reduce swelling of the mammary gland, thereby eliminating the cause of pain and swelling. | Non-steroidal anti-inflammatory drugs are taken for 1 to 2 weeks before menstruation. | ||
| Diuretic | Eliminates fluid retention in the body that occurs during the premenstrual period. As a result, swelling and tenderness of the breast are reduced. | Take during the second phase of the cycle. | |
| Mastopathy | Antihormonal drugs reduce the production of prolactin, estrogen, or pituitary hormones that stimulate estrogen release. Hormonal drugs replace the deficiency of progesterone and thyroid hormones. Normalization of hormonal balance eliminates pathological stimulation of the growth of mammary gland elements. | Treatment is carried out for at least 6 months. | |
| Non-steroidal anti-inflammatory drugs | Drugs reduce swelling and pain in the mammary glands. | The drugs are taken in the second phase of the menstrual cycle before the onset of menstruation. | |
| Homeopathic preparations | Affect the brain centers for the regulation of hormone production ( hypothalamus-pituitary gland). | The course of treatment is 3 - 6 months. A longer duration may be required. | |
| Iodine preparations | The drugs compensate for the lack of iodine in the body, which helps to increase the level of thyroid hormones. | ||
| Aspiration and application of sclerosing agents | With cystic mastopathy, the cysts are punctured and their contents are sucked off, after which solutions are injected into the cavity of the cysts, causing their sclerosis, that is, scarring and gluing of the walls. | The operation is not complicated, so the woman is discharged within 1-2 days. | |
| Surgery | Under general anesthesia, dense nodes and the sector in which they originated are removed. | After the operation, the woman is in the hospital for 7 days until the results of the histological examination are received. | |
| Gynecomastia | Hormonal and antihormonal drugs | Antihormonal drugs inhibit the formation of female sex hormones in the male body. Hormonal drugs restore testosterone levels. | Treatment is carried out within 1.5 - 2 months. |
| Surgery | The mammary glands are removed using an open operation or an endoscopic method ( insertion of a catheter with a camera through the hole in the armpit). | The length of the recovery period after surgery depends on the method used to remove the mammary gland. | |
| Galactorrhea | Hormonal and antihormonal drugs | Antihormonal drugs inhibit the production of prolactin in the pituitary gland. Hormonal drugs replace the deficiency of hormones, thereby normalizing the work of the pituitary gland. | The duration of drug treatment is at least 6 months. |
| Ductectasia | Medical treatment
(antibiotics, non-steroidal anti-inflammatory drugs) | Drug treatment prevents further expansion of the ducts in the presence of an infection ( antibiotics) and the inflammatory process ( non-steroidal anti-inflammatory drugs) in the mammary gland. | Antibiotics are prescribed in the presence of a bacterial infection ( according to analysis of discharge from the nipples) within 7-10 days. Non-steroidal anti-inflammatory drugs are taken until the symptoms disappear ( breast pain and fever). |
| Surgery | Dilated ducts are partially excised within healthy tissue. If a malignant tumor is found along with the dilated ducts, then the mammary gland is completely removed. | After the operation, the woman must be in the hospital under the supervision of doctors for about a week. | |
| Mastitis | Antibiotics | Antibacterial drugs destroy the cell wall of the causative agent of mastitis or disrupt the process of microbial division. | The duration of taking the drugs depends on the severity of mastitis. In mild forms, medications are taken for 7 to 10 days, in severe forms, until the signs of infection and inflammatory reaction disappear. |
| Non-steroidal anti-inflammatory drugs | These drugs, when applied topically in the form of ointments, eliminate inflammatory edema and reduce pain. When taken orally, they also contribute to the normalization of body temperature. | ||
| Surgery | With purulent inflammation, the purulent focus is opened, pus and dead tissue are removed and drained. With a widespread purulent lesion, a part of the mammary gland is removed; in very severe cases, the entire gland can be removed. | The length of the hospital stay depends on the severity of the condition. With purulent mastitis, hospitalization is required for 1 to 2 weeks at least. | |
| Congenital malformations of the mammary gland | Surgical correction | Additional nipples and lobes of the mammary gland are removed, and in the absence of one or both mammary glands, prosthetics or other types of plastic correction are performed. | The length of the hospital stay depends on the size of the operation. |
| Medical treatment | It is used for additional lobules that increase in the type of mastopathy. The prescribed treatment with hormones and antihormones reduces the volume of the lobules. | The duration of treatment is at least 6 months. | |
| Breast injury | bandaging | A bandage applied to the chest fixes the injured mammary gland, reducing pain. | Complete resorption of the hematoma hemorrhages) lasts 1 - 1.5 months. |
| Antibiotics | Antibacterial drugs are prescribed to prevent inflammation at the site of injury and hemorrhage. | ||
| Local treatment
(compresses and ointments) | Dry heat and anti-inflammatory ointments promote the resorption of accumulated blood. | ||
| Surgery | To remove accumulated blood from the gland, use a closed aspiration method ( needle puncture and drawing blood) or an open operation. | ||
| Problems associated with lactation and breastfeeding | Compliance with feeding technique | After feeding, you need to express milk and massage the breasts to stimulate the formation of new portions of milk and prevent its stagnation. | These rules should be followed during the entire period of breastfeeding. |
| Emollient ointments | Ointments containing vitamin B and lanolin help heal cracked nipples and prevent skin from drying out. | ||
| Proper nutrition | Food should be high in calories, contain proteins and vitamins in order to stimulate the production of milk. | ||
| Physiotherapy | Physiotherapeutic procedures improve blood circulation and metabolic processes in the mammary gland, resulting in increased milk production. | Physiotherapy sessions are held for 5 to 10 days. | |
| Hormonal treatment | A woman is injected intramuscularly with the pituitary hormone prolactin, which stimulates the production of milk in the mammary glands. | Prolactin is administered for 7 days. | |
| Mondor disease | Anti-inflammatory drugs | Eliminate the inflammatory reaction in the vein wall, reduce pain. | Treatment is carried out within 1 month ( sometimes longer). |
| Local treatment
(compresses and ointments) |
|||
| Physiotherapy | |||
| Surgery | With a long course and closing of the veins with blood clots, the affected veins are excised. |
On the mammologist's appointment every woman should come every year, from the age of 18 to old age. A visit and a basic examination does not take much time, but it allows you to timely detect diseases such as fibroadenoma, fibroma, and breast cancer.
The latter is one of the most common forms of cancer in women. Oncological tumors of the breast every year cause the death of tens of thousands of women, and it is possible not to become part of this sad statistics if you undergo a preventive examination in a timely manner, which allows you to detect a tumor at an early stage. This guarantees successful treatment in most cases.
When to visit a mammologist
There are a number of signs that indicate the onset of breast disease. Every woman should know them. In order not to miss the onset of the disease, you need to pay attention to the following signs:
- Pain in the region of the mammary glands. Unpleasant sensations and pain in the mammary glands can be a sign of many diseases. They are localized in one place or spilled, but both require consultations.
- The appearance of formations. If during palpation of the breast you find a seal in it, you must urgently come to an appointment with a mammologist.
- Change of size . If the breasts of an adult woman began to change size or shape, this is a sign of the disease, especially if the growth is asymmetrical, i.e., one breast increases.
- Nipple change . An alarming factor, if the nipple is deformed, bent, retracted, a platform appears if the nipples are asymmetrical.
- Discharge from the nipples . Any discharge from the nipples that is not associated with pregnancy and lactation requires additional diagnosis.
- Enlarged lymph nodes . Often, diseases of the mammary glands manifest themselves, including an increase or soreness of the axillary lymph nodes.
- Skin change . If an area appears on the breast skin that is too smooth, wrinkled, retracted, covered with an "orange peel" or in any other way different from normal, it is better to consult a doctor.
In addition to the above cases, you should visit a mammologist at least every year for the purpose of prevention, at the stage of preparation for pregnancy, during and after breastfeeding.
What happens at the appointment with a mammologist
The mammologist's appointment may differ depending on the purpose, but it always begins with a survey. The doctor finds out the reasons for the visit, subjective symptoms and complaints, finds out the family and personal history. After that, he proceeds to a visual examination of the mammary glands, paying attention to the color and condition of the skin, size and symmetry.
The most informative part of the reception is the palpation of the gland. The doctor probes her tissues in search of possible formations. If any suspicious areas are found, then an additional examination may be required: conducting and mammography. After receiving their results, the doctor will be able to determine their condition in more detail.
Where to go for an appointment with a mammologist?
Today, mammologists are part of the permanent staff of many private medical institutions, and making an appointment is not difficult. The main thing is to choose a clinic with suitable conditions.
And if you have any difficulties with this, you can solve it using the site "Your Doctor". This service allows you to collect and analyze information about the working conditions provided by various private clinics as simply and quickly as possible, and then make an appointment at any of them.
In most cases, a mammologist deals with the study, diagnosis and treatment of breast problems associated with hormonal disorders in the body or the growth of a malignant tumor. The competence of a mammologist includes the treatment and prevention of such diseases:
- Mastopathy;
- Fibrocystic disease;
- Adenoma and fibroadenoma;
- Lipoma;
- Inflammatory diseases of the mammary glands in nursing mothers;
- Tumors of the mammary glands of a malignant nature.
It is recommended to visit the mammologist's office at least once a year, thus, any modifications of gland tissues, seals and diseases will be detected at an early stage of development. Timely treatment is the key to a successful outcome of the disease.
When do you need a consultation with a mammologist?
Every woman should be able to conduct a breast self-examination. You need to do this every month soybeans in front of a mirror with a bare chest. One hand is raised up, and with the fingers of the second hand clockwise, you need to gently palpate the mammary gland, first in a circle, and then from top to bottom. In conclusion, the nipple should be squeezed between the fingers; normally, there should be no discharge from the ducts. Self-examination should not cause pain or other uncomfortable sensations in a woman.
The reasons for an urgent consultation with a mammologist are the following conditions:
- The presence of painful seals in the chest;
- One mammary gland is much larger than the other;
- From the nipple, when pressed, the chest is released; the body temperature is increased to 39 degrees, and the mammary gland itself is hot to the touch and sharply painful;
- Modification of the nipple (retraction, deformation);
- Discharge of blood or fluid from the nipple when pressed;
- Chest pain, colostrum secretion not associated with lactation.
In addition, without waiting for the appearance of clinical symptoms, a mammologist should appear if a woman has received a chest injury or bruise of the mammary glands.
Where can I find a good mammologist?
A good mammologist in the capital can be found on our website. We have compiled a list of the best mammologists in Moscow for visitors, who have a high rating and work experience.
In order not to waste precious time, but to immediately choose the best doctor from the list of specialists, go to the reviews section. There you can get acquainted with the true impressions about the mammologist of other patients who have already been at the reception.
A mammologist sees patients by appointment, therefore, as soon as a choice is made in favor of a particular doctor, contact the administrator of the medical center and discuss a convenient time and date for you.
A mammologist is a doctor who specializes in diseases of the mammary glands. In Russian medical practice, doctors involved in the diagnosis, treatment and prevention of diseases of this organ have a basic specialization in gynecology, surgery or oncology.
Pathology of the mammary glands can occur in both women and men, but in women it is detected much more often. This is due to the fact that the female mammary glands are much more developed, as well as their dependence on hormonal fluctuations. All major changes in a woman's life inevitably affect the condition of the breast. The breast is formed during puberty. With the advent of menstruation, the mammary glands begin to respond to the course of the menstrual cycle. A significant restructuring occurs during pregnancy: the body prepares for the fact that breastfeeding will follow the birth of a child. Despite the fact that breastfeeding is inherent in nature, it carries its own risks - mechanical damage, lactostasis (blockage of the milk ducts). The decrease in hormonal levels associated with the decay of reproductive function, however, like other age-related changes, also affect the state of this organ.
The female breast is very vulnerable. The biggest threat is breast cancer. Cancer of this localization is currently considered the most common among oncological diseases. It is detected in every eighth woman over 45 years old. At the same time, it is curable in the early stages, and the earlier the pathology is detected, the less damage to the body will be treated. The selection of a mammologist as a separate medical specialty is connected precisely with the need to achieve the widest possible early diagnosis.
Breast cancer also occurs in men, only less often (cases of the disease in men and women are correlated as 1:100). Therefore, doctors recommend that men contact a mammologist if disturbing symptoms appear, and women over 35 years of age should undergo an annual preventive examination.
If you need an appointment with a mammologist in Moscow, please contact JSC "Family Doctor". Below you can choose the most convenient polyclinic for you and check the prices for doctor's services. You can make an appointment through the call center, mobile application or the patient's personal account.
What should I contact a mammologist
The competence of a mammologist includes all diseases of the mammary glands. There are two main groups of diseases:
inflammatory
non-inflammatory character.
The first group includes mastitis: lactational and non-lactational.
Lactational mastitis occurs during lactation and is usually associated with lactostasis. If the milk is not completely sucked out of the breast, it stagnates, which leads to the development of inflammation.
Non-lactational mastitis is an inflammation that is not associated with lactation.
A group of non-inflammatory diseases are neoplasms, which can be benign and malignant.
Benign formations include:
mastopathy (a pathological change in the tissues of the gland, which is fibrocystic in nature. It manifests itself in the form of fine-grained seals, usually painful);
fibroadenoma (a tumor that develops from glandular tissue);
cyst (formation in the form of a cavity with liquid contents);
intraductal papilloma (caused by the human papillomavirus);
lipoma (popular name - "wen", is formed from adipose tissue).
Mastopathy is considered a precancerous condition. Other formations can also be malignantly reborn - fibroadenomas, cysts, intracurrent papillomas. Therefore, any seal in the gland should be the reason for contacting a mammologist and undergoing an examination.
The competence of a mammologist also includes gynecomastia in men (a pathological increase in the size of the mammary glands), as well as malformations and injuries of the mammary glands in women.
When is a Mammologist Appointment Needed?
Doctors recommend every woman once a month to conduct a self-diagnosis. Self-diagnosis consists in a visual examination of the breast in front of a mirror, palpation (each breast and armpits are probed in turn), squeezing the nipple (checking for discharge). It is best to conduct a self-examination within a week after the end of menstruation.
If you find disturbing signs, you should contact a mammologist as soon as possible. These signs may be:
changes in the size and shape of the breast or nipple
hardening or redness;
soreness or a feeling of tension in the area of \u200b\u200bthe gland;
discharge from the nipple.
However, if the examination did not reveal anything alarming, it is still necessary to go for an annual preventive examination. The sensitivity of instrumental diagnostic methods is much superior to your hands. Particularly vigilant should be those who belong to the risk group:
nulliparous women over the age of 30. The risk is even higher if you have a history of miscarriages or abortions;
with a history of chest trauma;
women with high levels of estrogen in the blood.
A preventive examination is best done on the 5-6th day of the menstrual cycle, at which time the mammary gland experiences the least effect from the hormonal background. Women in menopause can make an appointment with a mammologist regardless of the time.
Diagnostic methods in mammology
At the appointment, the mammologist will perform an examination, which necessarily includes palpation (palpation), ask about complaints, find out if gynecological pathology was previously detected, or if close relatives had cases of oncology.
The survey standard involves instrumental research. Women younger than 35 are prescribed breast ultrasound; those over this age are referred for mammograms.
Also can be done:
radiothermometry of the breast;
biopsy of the gland tissue with subsequent histological examination
laboratory tests: blood tests for tumor markers, hormones, analysis of discharge from the nipple (in the presence of discharge)
Treatment Methods
Inflammatory diseases are treated with conservative methods. Treatment of mastopathy in most cases also turns out to be conservative.
Cysts, tumors and intraductal papillomas must be surgically removed. In the event that surgery is unavoidable, doctors try to keep the necessary intervention to a minimum. Operations are performed at the Family Doctor Hospital Center.
