Fibrous mastopathy of the mammary gland symptoms. Fibrous mastopathy is a disease of the XXI century. Methods for removing neoplasms in the breast

Among the diseases of the female mammary glands, mastopathy is the most famous. There are many varieties of this pathology. They are characterized by the formation of multiple seals. Feeling them in her chest, a woman is always in shock, as she is afraid that she has discovered signs of cancer in herself. However, benign and malignant pathologies have distinctive features. Most often, with fibrous mastopathy, a woman experiences chest pains, which is not typical for cancerous tumors in the early stages. It is important to diagnose pathology in a timely manner.

Mastopathy can occur in women of any age, but most often it is encountered during the period of the full functioning of the reproductive organs. At this time, a woman's health is affected by many negative factors, the main of which is the regular restructuring of the hormonal background.

Depending on what changes occur in the structure of the gland, the following types of fibrous mastopathy are distinguished:

Fibro-adenomatous. Connective and glandular tissues grow, with the latter predominating. In this case, connective tissue scars are formed. On palpation, shapeless seals are felt.
Fibrous fat. At the same time, less and less ducts and lobes (glandular element) remain in the chest. Their place is taken by overgrown fibrous fibers and adipose tissue. This process is called mammary involution. It is natural during the aging of the body, when the reproductive function fades away, the need to produce breast milk disappears.
Fibrocystic. The outer shells of the ducts and lobes, as well as the partitions separating them, consist of connective tissue cells. Pathological growth leads to the formation of voids (cystic cavities), a decrease in the number of elements involved in milk production.
Fibro-glandular. Seals appear in the chest, consisting mainly of overgrown connective tissue with elements of modified ducts and lobes. This changes the shape of the breast. Such neoplasms sometimes degenerate into cancer.

There are nodular fibrous mastopathy and diffuse. With a nodular form, a group of small seals are grouped into a separate focus. It may be single, it may be several. The nodular form of mastopathy is considered precancerous, since the likelihood of malignant degeneration in this case is higher. The diffuse form is characterized by the random distribution of small seals throughout the volume of the gland.

The disease can be unilateral (occurs in one breast) or bilateral (occurs on both sides at once). Manifestations of mastopathy are expressed in varying degrees. It is customary to distinguish 3 forms: mild, moderate and pronounced.

Causes of pathology

The main cause of fibrous mastopathy of the mammary glands is hormonal failure in a woman's body. There are many factors that lead to hormonal imbalance.

endocrine disorders. They are caused by pituitary tumors, cysts and tumors of the ovaries, diseases of the thyroid gland, adrenal glands. The cause and effect of endocrine disorders and improper metabolism are obesity, diabetes mellitus. With these diseases, the likelihood of mastopathy is increased. Fibrous mastopathy refers to estrogen-dependent diseases. Seals of this type appear when there is an excessive content of female sex hormones estrogen in the body.

Inflammatory and infectious diseases of the ovaries and uterus. They cause disturbances in the processes of the menstrual cycle and a malfunction in the production of estrogens and progesterone.

Artificial termination of pregnancy leads to forced inhibition of the processes of hormonal adjustment occurring in the body after conception.

Physiological disorders. Irregular sex life, lack of pregnancy in a woman, refusal to breastfeed after childbirth can cause a shift in the ratio of female sex hormones and the development of breast diseases.

Heredity. In some women, the predisposition to such diseases is inherent in the genes, observed in close relatives.

Ultraviolet irradiation. Exposure to UV rays (during topless sunbathing or staying in a solarium) provokes atypical development of cells, the appearance of fibrous mastopathy, tumors, including malignant ones.

Stress and bad habits contribute to the occurrence of hormonal failure and the development of pathologies in the female breast.

Video: How mastopathy manifests itself. Importance of self-examination

Symptoms and signs of pathology

At an early stage, when the seals are small, the woman does not notice their appearance, does not pay attention to the symptoms. On the eve of menstruation, breast swelling and the appearance of aching pain are not surprising. It is observed in almost all women and is explained by the peculiarities of physiology, the appearance of premenstrual syndrome (PMS).

Signs that a woman should pay attention to are:

intensification of pulling pains, the occurrence of a tingling sensation in the chest, the pain becomes constant, aggravated during menstruation;
feeling of pressure, fullness in the chest;
swelling of one or both glands, change in shape due to the formation of lumps;
the appearance of seals, freely moving on palpation of the chest.

Sometimes a clear, white, dark or pinkish liquid is released from the nipples, which indicates a violation of the structure of the ducts, the occurrence of an inflammatory process, and damage to blood vessels. Sometimes there is also an increase in the lymph nodes under the armpits and above the collarbones from fibrous mastopathy.

Addition: It is possible to distinguish such seals from cancerous tumors by some signs: they are not soldered to the skin, they are painful. On the surface of the chest above them there are no changes in skin color and the appearance of irregularities on it.

Video: Causes, diagnosis and treatment of mastopathy

Diagnostics

The primary diagnosis of mastopathy, which is carried out by a mammologist, is to examine and palpate the mammary glands. At the same time, it is possible to notice a change in their size and shape, an external difference from one to the other. By squeezing the nipple, the doctor determines if there is any discharge from it. By sequentially probing all areas of the chest, the presence of seals can be detected. The state of the nearest lymph nodes, as well as the skin of the chest, is being studied.

To clarify the size, nature of the location of the seals, ultrasound and x-rays (mammography) are used. Ultrasound is a less informative method, but has no restrictions in use, since harmful radiation is not used here. It is more often performed when examining women who are under 35 years old. It is not harmful for pregnant women either.

Mammography(X-ray of the mammary glands) allows you to detect the characteristic manifestations of fibrous mastopathy, to establish the degree of tissue change and the form of pathology. For greater accuracy, pictures are taken in different projections.

Ductography This is a mammogram with a contrast agent. This method is used in the presence of discharge from the nipple, it allows you to detect changes in the milk ducts (intraductal papillomas, impaired patency).

Tissue is also taken from the seals (biopsy) and a smear from the nipples is examined, which allows the detection of atypical or cancerous cells. If necessary, an MRI and blood tests for hormones and tumor markers are prescribed.

Examination of young women is usually carried out immediately after menstruation, when the tension in the chest is the least. In phase 2, the chest is denser, the pain is stronger. Therefore, getting an accurate result is more difficult.

Treatment

The method of treatment for fibrous mastopathy is selected depending on the severity of the symptoms of the disease and its form. The easiest way to deal with the disease at an early stage. This must be kept in mind in order to understand how important the role of self-diagnosis of the mammary glands is.

Most often, with early detection of pathology, it is possible to confine ourselves to conservative treatment. If the disease develops, the seals increase, they become larger, the symptoms worsen, you have to resort to a surgical operation.

Medical therapy

Treatment is carried out in order to eliminate hormonal disorders and pathologies that caused mastopathy. Means are also used to relieve painful symptoms and inflammatory processes.

Hormonal correction

If the tests showed that a correction of the hormonal background is required, the following types of drugs are prescribed:

Increasing the content of progesterone in the body. This leads to a decrease in the concentration of estrogen. Drugs such as utrozhestan, duphaston, norkolut or birth control pills (zhanin, yarina) are used.
Drugs that suppress the production of pituitary hormones, such as danazol. The tool has the properties of androgen. By suppressing the production of FSH and LH, this drug reduces the production of female sex hormones, which leads to the cessation of the development of fibrous mastopathy, suppression of the process of cell division.
Means for reducing prolactin (bromocriptine, cabergoline) - a hormone responsible for lactation and proliferation (division) of cells of the milk ducts and lobules.
Drugs that suppress the sensitivity of estrogen receptors (tamoxifen). At the same time, the harmful effects of hyperestrogenism in the body are neutralized.
Hormonal substances that accelerate cell repair and tissue regeneration (anabolics, such as retibiol).

Warning: Hormones are prescribed only by a doctor after a special blood test. The consequences of uncontrolled use can be metabolic disorders, obesity, as well as the development of tumors of various organs.

Elimination of symptoms

Non-steroidal analgesic drugs (diclofenac, indomethacin), as well as analgesics (baralgin) are used. Antispasmodics also help relieve pain in fibrotic mastopathy (improve blood circulation and relieve muscle tension).

Askorutin or pantokrin are used. To relieve swelling in the chest, diuretics (lasix, hypothiazide) are used. To improve the psychological state of patients, sedatives are prescribed (seduxen, novo-passit, tinctures of valerian, mint, motherwort).

Multivitamins are prescribed to strengthen the immune system, as well as hepatoprotectors to protect the liver and eliminate the harmful side effects of drugs. Patients are advised to review the diet: reduce the consumption of animal fats, give up coffee, chocolate, strong tea, alcohol, fried meat.

Surgery

The operation of sectoral resection of the area of the mammary gland, in which mastopathy nodes are grouped, is performed in the case when the puncture of the neoplasms has shown that there is a high probability of cancer. The operation is performed under general or local anesthesia, depending on the size and location of the seals, as well as the condition of the patient.

Folk remedies

It is impossible to cure a woman from fibrous mastopathy only with their help, but in combination with drug therapy, they help reduce pain, relieve swelling and inflammation in the tissues of the mammary glands. For this purpose, compresses from squeezed leaves of cabbage or burdock, as well as from the pulp of pumpkin, are applied to the sore chest.

Infusions and teas of medicinal herbs are used as a means of calming and diuretic action.

Fibrocystic mastopathy is a common disease of the mammary glands that occurs in reproductive age. It is characterized by a disturbed ratio of epithelial cells and connective tissue fibers in the mammary gland, which leads to a change in its histological structure and the formation of cysts of various sizes.

The basis for the development of fibrous mastopathy is a hormonal imbalance, characterized by an increased level of estrogen, incl.their metabolites and a decrease in the progesterone saturation of the woman's body.

Reasons for the development of fibrous mastopathy

Fibrocystic mastopathy is considered as one of the manifestations of hormonal disorders in the female body. Its development is often associated with psycho-emotional stresses that affect the central link in the regulation of the menstrual cycle.

As a result, the formation of FSH and LH is disrupted, which predisposes to progesterone deficiency (absolute - the total progesterone content in the body is reduced, or relative - the total progesterone content is normal, but it is reduced in percentage terms, while estrogens are increased). This leads to the development of the pathological process of fibrous mastopathy in the tissues of the mammary gland.

Normally, progesterone has a significant effect on the condition of the breast. This hormone has a number of physiological effects:

Prevention of increased capillary permeability, which is caused by estrogens;

Reducing the swelling of connective tissue fibers (elastic and collagen) that develops in the second phase of the cycle;

Inhibition of cell division.

The effects of estrogens are in many ways the opposite of those discussed above. These hormones (especially estradiol):

Increase the activity of cell division in the ducts and in the connective tissue of the mammary glands, leading to hypertrophy (increase in size) and hyperplasia (increase in number);

· Increase blood supply and stimulate the growth of new vessels, causing increased swelling of the tissue;

Enhance hydration of connective tissue.

Increased proliferation in the mammary gland associated with excess estrogen (absolute or relative) is realized through the following mechanisms:

Immediate direct stimulation when the hormone binds to the corresponding receptors located on the surface of the cell nucleus;

· Induction of formation of growth factors;

· Suppression of the activity of proliferation-inhibiting factors.

Therefore, therapeutic measures aimed at reducing the production of estrogens and blocking their binding to receptors are quite effective in the treatment of fibrocystic mastopathy. They affect the main pathogenetic mechanisms of this disease. Its hormonal nature is also confirmed by such facts as:

Spontaneous regression of fibrocystic mastopathy after the complete cessation of menstrual function (menopause);

Re-development of cystic and fibrotic changes in the mammary gland in case of taking estrogen-containing drugs during menopause.

Suppression of proliferative signs when a progesterone component is added to them. Therefore, modern drugs for replacement therapy are always combined (estrogen + progesterone).

Excessive cell division within the ducts leads to their obstruction. The alveolar epithelium continues to produce a secret, but it remains inside the lobules, because. is not output due to an existing mechanical obstruction. This leads to an increase in the size of the lobules and the formation of cavities (cysts). In the case of accession of the bacterial flora, an abscess develops (purulent inflammation).

Symptoms of fibrous mastopathy

Up to a certain point, fibrocystic mastopathy is asymptomatic. However, trouble in the female hormonal system can be suspected by the presence of an irregular cycle or other menstrual disorders:

- profuse menstruation;

long-lasting menstruation;

Severe pain during menstrual days;

intermenstrual spotting or bleeding.

These symptoms indicate an excess of estrogen and a lack of progesterone in the female body. An objective assessment of these disorders allows a blood test to determine the level of hormones.

Fibrocystic mastopathy also has specific symptoms:

· Pain in the mammary glands, especially pronounced on the eve of menstruation. They are associated with increased vascularization observed against the background of progesterone deficiency;

Increased breast density;

Swelling of the mammary glands;

Isolation of a pathological secret (not determined in all patients with this diagnosis).

In some cases, pain in the area of the mammary glands is not associated with their pathology. This can cause diagnostic errors when osteochondrosis, periarteritis of the humeroscapular and other diseases occur under the guise of mastopathy. It is possible to make a differential diagnosis according to the clinical picture. In these pathological processes, pain is characterized as follows:

Character - burning, shooting or stabbing;

There is no connection between pain syndrome and menstrual phases;

Increased pain after psycho-emotional stress and physical activity.

Diagnosis of mastopathy

Diagnosis of fibrocystic mastopathy consists of 3 main stages. The first is an ultrasound scan of the breast (ultrasound). It is recommended for women every year, especially after 35 years. A local increase in acoustic density is regarded as an ultrasound criterion for fibrocystic mastopathy.To improve diagnostic accuracy, it is recommended to carry out ultrasound scanning in different phases of the cycle (for dynamic study of the picture).

It should be noted that the isolated presence of small cysts in the breast tissue is not a variant of pathology. It can also be seen as normal. If cysts of minimal size are found, the mammologist should not make a diagnosis of mastopathy. The revealed signs in the conclusion are interpreted as "cystic" changes.

At the second stage, mammography is shown - an x-ray examination of the mammary glands. From this study, a diagnostic search can begin in women over 40 years of age, for whom it is recommended once a year. The information content of mammography is lower in women with increased physiological density of the mammary glands. However, their density depends not only on individual characteristics, but also on the menstrual phase. So, it rises in the luteal phase (after the 15th day of the cycle and before menstruation). Therefore, it is better to perform mammography in the follicular phase, i.e. up to the 15th day from the start of menstruation. The same is true with ultrasound.

Histological examination is the third stage, which is not recommended for all patients. It is necessary for the final diagnosis of a benign pathological process (benign changes, precancerous or malignant). However, to obtain the most reliable results, a biopsy should be performed on certain days of the cycle. The optimal time is the same follicular phase (after the end of menstruation and until the 15th day). It is not characterized by cell division, programmed cell death and edema of the stroma. These processes, observed in other phases of the menstrual cycle, can cause an increased percentage of diagnostic errors.

Types of fibrotic mastopathy

Fibrocystic mastopathy is a group of heterogeneous diseases. Based on the x-ray picture (mammography), they are classified into 6 forms:

1. Adenosis, in which there is a predominance of the glandular component. This form is most common in young women (20 to 27 years old).

2. Diffuse fibrosis - connective tissue stroma predominates. It increases the number of collagen fibers, and elastic almost completely disappear. The alveoli are “immured” with a dense stroma, which is not able to stretch if necessary (for example, during lactation). Therefore, with this form, breast compaction is most pronounced. Diffuse fibrosis is often diagnosed in women with diabetes mellitus, in which oral hypoglycemic drugs are ineffective (insulin-dependent type). In the English-language literature, this condition has received a separate name - fibrous diabetic breast disease.

3. Cystic form, which is characterized by diffuse compaction of the glands, combined with local. Cysts are well demarcated from the surrounding tissue, they have clear boundaries and a smooth surface (tuberosity is suspicious in relation to the malignancy of the process).

4. Mixed form - a combined increase in glands and stroma with the formation of small cysts. It is diagnosed in 40% of cases, being the most common in all age groups. The increased interest of doctors in this form is explained by the possibility of malignancy (development of breast cancer). In this case, the risk depends on the degree of proliferation. If it is absent, then the probability of cancer is not more than 0.9%, with moderate proliferation - 2%, and with severe - 31%.

5. Sclerosing adenosis - proliferation of connective tissue in enlarged glands;

6. Nodular form - local accumulations of collagen and elastic fibers.

Treatment of mastopathy

Treatment of fibrocystic mastopathy is still a difficult task. The recommended hormonal preparations are not able to completely normalize the histological picture of the mammary glands. In addition, they are not without side effects, and after their cancellation, intensive cell proliferation (relapse of the disease) is observed. Therefore, scientists of the world are working on the creation of a unique drug mabustin for the treatment of mastopathy, which should have a number of properties:

Effectively suppress uncontrolled cell proliferation and prevent relapse (regardless of further medication);

Do not cause adverse reactions;

Suppress the production of estrogens in the liver;

Reduce the synthesis of estrogens in the ovaries and adrenal glands;

Do not affect the level of your own progesterone;

Do not change the hormonal regulation of organs with the exception of the mammary glands;

Do not cause endometrial atrophy, which develops in the case of long-term use of progesterone drugs (atrophy leads to "breakthrough" bleeding).

One of the tasks of modern mammology is the early detection of mastopathy and the timely appointment of conservative therapy. This reduces the number of operations performed for large breast cysts. However, to date, the frequency of such surgical interventions in this diagnosis is 10-15%. Conservative treatment of mastopathy at the present level is carried out in a complex manner. It includes areas such as:

Normalization of the psychological state of a woman (auto-training, psychological consultation);

· Vitamin therapy;

Enzymes;

· Hormones and their analogues, including biologically active complexes based on indole-3 carbinol;

Anesthesia, if the pain syndrome is accompanied by a violation of the general status of a woman.

Medical treatment is carried out for a long time. One course is from 3 to 6 months. However, after the abolition of hormones in a large percentage of cases, a relapse of the disease is observed within a year. Therefore, great importance is attached to the dynamic monitoring of patients. They should regularly visit a mammologist for early detection of hyperplastic processes in the mammary glands and timely start of a new course of therapy. This will reduce its duration and the total dosage of the drug. At the same time, women should attach great importance to the psycho-emotional background, because its normalization affects the cause of the disease, preventing its development.

According to statistics - studies at diagnosis

According to statistics, almost half of all modern women of childbearing age are diagnosed with mastopathy. One of the varieties of this disease is a fibrous form of lesions of the mammary glands.Treatment of fibrous mastopathy >>>

Fibrous mastopathy - based on a review of the Mabusten Women's Bulletin provided by Bradner Deword GmbH

Mastopathy can be expressed in different forms. They are divided into groups according to the nature of neoplasms, their composition, features of occurrence.

One of the frequent options is diffuse fibrous mastopathy, characterized by the formation of a large number of seals of various sizes and shapes.

In the article we will talk about diffuse mastopathy with a predominance of the fibrous component, what it is and what are the methods of treatment.

From the diet, it is necessary to exclude fatty meat, hydrogenated fats, fried, canned, smoked foods, as well as drinks containing caffeine.

Preference is given to whole grains, fish, poultry, dairy products, fruits and vegetables. Useful vitamin kits and herbal teas. Avoiding alcohol and smoking is required.

Nicotine and tar negatively affect the hormonal background, inhibiting the function of progesterone and provoking an increase in the number of fibroids.

Relationship with oncology

Doctors note a link between the formation of benign fibroids and the possibility of breast cancer.

Too much estrogen is a warning sign. Against its background, degeneration in the tissues of any organs of the female reproductive system is possible. Already existing fibromas do not regenerate, but malignant tumors may well form next to them.

The problem of the diffuse form is that there are a lot of neoplasms and not everything can be detected during a superficial examination. Therefore, you should be especially attentive to your condition, do all the necessary tests and follow the doctor's instructions exactly.

Diffuse fibrous mastopathy is a disease, the treatment of which can be successful only in the case of a complex effect and timely diagnosis. The therapy takes place under the supervision of specialists, only in this case a complete cure and the absence of relapses are possible.

You can find additional information on this topic in the section.

Every third or fourth woman of childbearing age from 30 to 45 years old is faced with a common pathology affecting the mammary glands, with a long and incomprehensible name. Therefore, you should find out in time what fibrocystic mastopathy is from a medical point of view.

Fibrocystic disease or fibrocystic mastopathy of the mammary glands (FCM) is a focal formation with a non-malignant condition of breast tissues, which is formed against the background of an imbalance of hormones produced by the body, in which cystic formations and nodes of various shapes, structures and sizes appear. In this case, an abnormal relationship is observed between the epithelium and connective tissue in the gland, both due to proliferation (growth) and due to atrophy (reduction).

To understand what fibrous mastopathy and cystic mastopathy of the mammary glands are, you need to imagine the structure of the gland.

The mammary gland is formed by three types of tissue, the ratio of which is directly affected by age, hormonal fluctuations, and the state of the reproductive organs. What are these fabrics?

The parenchyma is directly the glandular tissue itself, divided into lobes.
Stroma is a connective frame tissue that is located between the lobes and lobules.
The stroma and parenchyma are enveloped and protected by adipose tissue.

Most often, cystic and fibrotic changes in the mammary glands are observed in the parenchyma, less often under the influence of hormones, stromal fibrosis occurs.

The diffuse process is defined in medicine as extensive, affecting a large array of breast tissue.

Fibrous - means an abnormal growth of the connective tissue of the mammary gland. Such stromal fibrosis can disrupt the structure of the lobes and ducts, leading to the appearance of abnormal structures in them.

The term cystic denotes the appearance characteristic of mastopathy.

Causes

The main causes of fibrocystic mastopathy of the mammary glands are due to an imbalance of hormones - a lack of progesterone, an abnormally high production of estradiol, prolactin, somatotropin and prostaglandins. Deviations from the normal ratio between the amounts of these hormones lead to fibrocystic changes in the mammary gland.

Glandular mastopathy appears after a sufficiently long period of time, since a combination of provocative factors of hormonal disorders and their long-term influence is required.

Such factors provocateurs of fibrocystic changes include:

premature puberty in girls, because early (up to 11-12 years old) menarche (the first menstrual cycle) gives too high a hormonal load on the body, which also affects the condition of the mammary glands;
menopause later than 55 years due to prolonged exposure to hormones on fibrous adipose tissue;
frequent abortions and miscarriages (due to abrupt hormonal changes);
lack of childbirth and pregnancy in general;
gynecological diseases depending on hormonal disorders (endometriosis, menstrual dysfunction);
a short period of feeding the baby with breast milk, refusal of breastfeeding in general;
hereditary factor (on the mother's side);
age over 35 - 38 years;
frequent or prolonged stressful situations, often provoking endocrine disorders;
obesity (hormonal activity of adipose tissue leads to hyperproduction of estrogen);
neoplasms in the hypothalamus, (these tumors can disrupt the proper production of estrogen, FSH and LH);
diseases of the liver, genitourinary organs, thyroid gland (hypo- and hyperthyroidism, thyrotoxicosis), diabetes mellitus;
trauma, compression, inflammation of the mammary glands;
uncontrolled intake of hormonal drugs, birth control pills;
iodine deficiency;
sluggish intimate life, lack of orgasms (blood stagnation occurs in the vessels of the reproductive organs, causing ovarian dysfunction and subsequent changes in hormonal levels).

General symptoms

The severity of symptoms of fibrous mastopathy is determined by the form of pathology and concomitant internal diseases.

The following main features dominate in diagnosing mastopathy of the mammary glands:

Mastodynia (soreness of the mammary glands).

At the first stage of the disease, every tenth woman has pain in the mammary glands before menstruation, and this manifestation is falsely considered as a sign of premenstrual syndrome.

The pain is moderate, intense, has a different character (stabbing, aching, jerking), which is associated with the depth and activity of the process. With severe pain, it is sometimes impossible to touch the chest. After menstruation, the pains subside, but as the mastopathy deepens, they become permanent, and their degree depends on the phase of the monthly cycle.

Swelling of the mammary glands (engorgement) associated with stagnation of blood in the veins.
Discharge from the breast.

This characteristic symptom of the disease manifests itself only in half of the patients, indicating the defeat of the fibrocystic process of the milk ducts.

Most often, the amount of discharge from the mammary gland is insignificant, and the fluid appears spontaneously or when the nipple is squeezed. The contents resemble watery colostrum. Greenish, yellow color indicates the development of infection. A menacing symptom is the appearance of a brownish bloody fluid from the nipple, which raises the suspicion of possible damage, capillary lesions, tumor development and requires immediate examination.

Enlargement, soreness and tension of the lymph nodes closest to the chest. This symptom is usually mild.
Depression, tearfulness, emotional instability, irritability (especially often manifested in pain).
The appearance of mobile and fixed seals, nodes in the thickness of the mammary gland, on palpation of which the diagnosis of fibrocystic mastopathy is made during a routine examination by a mammologist.

Do you use folk remedies?

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Forms and types of mastopathy

The classification of glandular mastopathy of the mammary gland provides for the allocation of the main forms of pathology: and nodular.

Initial stage for both forms

The primary stage of the disease is characterized by the development of limited processes in the chest.

When painful changes are limited to a certain area, focal breast fibrosis is diagnosed. In this case, seals with dimensions of 20-30 mm (more often single ones) of a round, oval shape are usually formed in the upper outer and inner quadrant (zone) of the gland.

It is in this area that the thickness of fibrous-adipose tissue is especially pronounced, a large number of lymph nodes and large vessels are located, around which inflammatory and tumor processes occur. Such local fibrosis of the mammary gland is considered as the initial stage of deep multiplication of fibrocytes (stromal cells).

The leading causes of such a pathology are considered to be an excessive release of estrogens and a lack of progesterone, as well as a violation of neurohumoral regulation (the relationship between metabolic processes and neurogenic activity).

Fibrous form and its types

Adenosis, in which hyperplasia (growth) of the glandular epithelium of the lobes and milk ducts is pronounced. At the same time, the tissue of the organ retains its structure, and the excessive growth of the parenchyma is characterized by a significant increase in the size of the breast.

Manifestations of adenosis of the mammary glands can be moderately tolerable (in girls) and pronounced, which manifest themselves in the development of a sclerosing variety of adenosis. It is characterized by damage to the breast by accumulations of microcalcifications (salt deposits), with a certain degree of probability of the appearance of potential foci of cancerous degeneration of cells.

Fibroadenomatosis is a fibrous mastopathy of the mammary glands, in which the fibrous component dominates. It is characterized by growths of the stroma, and in a later stage - multiple appearance. This is a benign cystic formation of the mammary gland - round, mobile, with a fairly clear contour and density, the appearance of which means that the disease has passed into a nodular form.

Fibrous pathology includes periductal fibrosis (plasmocytic), more common in women during menopause. With it, growths in the form of infiltrates (clusters) of plasma cells form around the milk ducts. Perivascular fibrosis is a type of periductal fibrosis in which there is an abnormal growth of stroma around the milk ducts, blood and lymphatic vessels in the form of seals of collagen fibers.

Separately, it is necessary to highlight the state of fibro-fatty involution (reverse development). This is a physiological (not pathological) process in the mammary glands when a woman reaches the age menopause in normal terms. The essence of the ongoing structural changes is the replacement of parenchyma cells with connective and adipose tissue cells.

Leading signs of fibrous mastopathy:

change in color and sensitivity of the skin over the affected area;
heaviness, bursting;
colostrum-like discharge from the nipple (colorless to colored);
moderate pulling pains, aggravated before "menstruation" with a possible return to the armpit and shoulder;
determination by palpation of enlarged, tense mammary glands with a noticeable allocation of lobes and fine granularity.

cystic form

With cystic mastopathy, small cavity structures form in the mammary gland.

The main signs of fibrocystic mastopathy in this form are:

single and multiple small neoplasms in the form of dense blisters, well defined when probing in a vertical position;
tension of the mammary glands;
sometimes - significant soreness of the seals when probing;
a slight increase in formations with this type of mastopathy and axillary lymph nodes before menstruation;
the formation of dense strands (linear stranded fibrosis).

According to the intensity of changes, fibro-fatty and glandular-cystic mastopathy is divided into degrees: minor, moderate and severe, and its types depend on the nature of structural changes in the tissues.

The cystic form often includes fibroadenomatosis with a dominant cystic rather than fibrous component, as well as linear (interlobular) fibrosis, in which nodes and strand structures are formed against the background of stroma growth between the lobes and inside the ducts. At the same time, clear echo signs of fibrocystic mastopathy are revealed on ultrasound.

Mixed form of fibrocystic mastopathy

This type of mastopathy often occurs in a mixed form, differing in a combination of fibro-fatty and cystic forms of the disease and their characteristic features. Fibrous disease of the mammary gland is well defined independently and can be seen on the pictures during mammography.

Nodular mastopathy

Nodular mastopathy or localized adenomatosis in most cases is a further development of the disease. of this type is a focal form of the disease, which in oncology is considered as a precancerous process. Knots in the tissues are easily palpable.

The types of nodular mastopathy include:

cystic formations;
fibroadenoma with a dominant cystic component;
papillomas inside the milk ducts;
leaf-shaped tumors;
hamartoma, lipogranuloma, lipoma, angioma.

Features of nodular formations

If the nodes are of cystic origin, then they have a dense elastic structure, clear contours and a shape delimited from adjacent tissues.
Nodes in the form of foci of seals are probed as formations with pronounced lobes without obvious boundaries.
The dimensions of the foci of seals reach 60 - 70 mm.
The pain syndrome is either insignificant or absent.
They can be single, multiple, detected on one or both sides (two-sided FCM).
Before the menstrual cycle, seals may increase, swell, and become painful.
It is difficult to palpate if the patient is in a horizontal position during examination.
Peripheral lymph nodes are not enlarged.

Bilateral mastopathy

The defeat of the fibro-fatty and glandular tissue of both glands means that bilateral fibro-cystic mastopathy develops, indicating a persistent and serious hormonal disorder. Therefore, treatment involves the mandatory normalization of the level and ratio of hormones, as well as identifying the cause of such an imbalance, including dysfunction of the ovaries, the pituitary-hypothalamus system, the thyroid gland, and the adrenal glands.

The bilateral process almost doubles the risk of cancerous degeneration of diseased cells.

What is dangerous fibrous mastopathy

Initially, glandular mastopathy was not considered as a condition with a high risk of oncology.

But medical practice and research have revealed that breast fibrosis should be considered and treated as an intermediate precancerous condition that can, with varying degrees of probability, lead to malignancy (acquiring the properties of a malignant tumor by cells).

At an early stage, the disease responds well to therapy, so it is recommended that all diagnostic procedures be performed by a mammologist as soon as possible and begin treatment of fibrocystic mastopathy without waiting for complications.

Nodular pathology can be proliferating (progressive) and non-proliferating.

The proliferative form is more often unfavorable, when the tissue actively grows with the formation of neoplasms in the milk ducts and on the inner walls of the cavity structures, with the further development of cystadenopapillomas. Such changes carry the threat of malignant degeneration.

Diagnostics

Before prescribing diagnostic measures, the doctor will examine, palpate the chest and take an anamnesis. Already during the initial examination, the patient can be diagnosed with asymmetry of the mammary glands, edema, venous pattern, changes in the position and shape of the nipples.

Palpation of the chest should be carried out in the first phase of the monthly cycle. Probing is carried out in two positions - standing and lying down. This is due to the fact that some neoplasms can be detected only in one of the positions of the body. Also, during the examination, the doctor may squeeze the nipples to determine the presence or absence of discharge.

To confirm the diagnosis, the following studies may be prescribed:

mammography;
Ultrasound of the mammary gland and pelvic organs;
puncture. Puncture biopsy is necessary in order to differentiate FCM from, cancerous tumors and other formations. During this procedure, the specialist will take a fragment of the neoplasm, which will later be sent for histological examination;
determining the level of hormones;
blood chemistry;
ductography;
pneumocystography;
thermography;
MRI or CT.

Medical treatment of FCM

In order for the treatment of mastopathy to be as effective as possible, it is necessary to conduct a thorough diagnosis, based on the results of which the doctor will prescribe complex therapy. Conservative treatment can be carried out with the help of non-hormonal or hormonal drugs.

Non-hormonal drugs that are used to treat FCM:

Vitamins. Vitamin A has an antiestrogenic effect, vitamin E enhances the effect of progesterone, vitamin B6 reduces the concentration of prolactin, vitamin P and ascorbic acid strengthen the walls of blood vessels, relieve swelling of the gland, improve blood circulation in it. All of these vitamins have a positive effect on the functioning of the liver, namely, estrogens are inactivated in it.
Iodine preparations normalize the functioning of the thyroid gland, and also participate in the synthesis of its hormones. In this connection, doctors prescribe Iodine active, Iodomarin.
Sedatives and adaptogens. Sedatives - valerian, motherwort, peony tincture improve the psycho-emotional state of a woman, minimize the effect of stress on the body. Adaptogens (Rhodiola rosea, Eleutherococcus) increase immunity, have a positive effect on metabolism and normalize liver function.
Phytopreparations (Mastodinon, Remens, Cyclodinon) stabilize the hormonal background, reduce the production of prolactin, stop pathological processes in the mammary gland.
Non-steroidal anti-inflammatory drugs (Nise, Indomethacin, Diclofenac) relieve swelling and reduce pain by reducing the concentration of prostaglandins.
Diuretics (kidney tea, lingonberry leaf or Lasix) relieve pain by removing excess fluid from the body, which leads to a decrease in swelling.

Hormonal Therapy:

Gestagens (Pregnil, Utrozhestan, Norkolut, Dufaston). Preparations of this group reduce the production of estrogens in the second phase of the menstrual cycle. Experts recommend taking these drugs for at least 4-6 months. Also, gestagens are prescribed for local use (Progestogel gel). This gel must be applied to the mammary glands for several months. This use provides 90% absorption of progesterone and eliminates the possible side effects observed with oral administration.
Prolactin production inhibitors (Parlodel). It is prescribed for overt hyperprolactinemia.
Androgens (Danazol, Methyltestosterone, Testobromlecit). They are prescribed for older women.
Antiestrogens (Tamoxifen).
Combined oral contraceptives (Rigevidon, Marvelon). These medications are recommended for women under 35 who have irregularities in the second phase of the menstrual cycle.

Methods for removing neoplasms in the breast

An operation to remove fibrocystic mastopathy is rarely prescribed. Surgical intervention is advisable in the absence of a positive effect from conservative treatment or in the case when there is a suspicion of a malignant process in the mammary gland.

Also, the removal operation is indispensable in the following cases:

a woman or girl is diagnosed with nodular fibrocystic mastopathy in the late stage;
the presence of painful sensations that interfere with the patient;
inflammatory process;
suppuration of neoplasms in the chest or their rupture.

Operations to remove fibrocystic mastopathy are carried out in the following ways:

Enucleation. In this case, surgeons remove the neoplasm itself, while healthy breast tissue is not affected.
sectoral resection. Together with the formation, part of the affected tissue is removed.
Radical resection (the mammary gland is completely removed).

With fibrocystic mastopathy, enucleation is often used. This intervention lasts no more than an hour, after which the woman is left in the hospital for several hours for medical supervision. If no complications have arisen during this period, then she is discharged home. Postoperative sutures are removed after 10-12 days.

Consequences and recovery after surgery

In the recovery period after surgery, it is recommended to strictly follow all the recommendations of the attending physician:

Regularly change the dressing and treat postoperative sutures to speed up the healing process of wounds and prevent infection.
Take all medications prescribed by your doctor. These can be antibiotics, hormonal agents, agents for accelerating tissue regeneration, anti-inflammatory drugs.
Keep calm. Bed rest must be observed for at least 4-5 days to prevent the sutures from coming apart.
Eat properly and fully, follow a diet prescribed by a specialist.

At the time appointed by the doctor, the patient must undergo a medical examination, during which the stitches will be removed and a further course of therapy will be prescribed.

As a rule, the recovery period after removal of fibrocystic mastopathy passes without complications. The trace after the operation remains hardly noticeable, it can be quickly eliminated with the help of modern medical cosmetology.

But even after the operation, it is necessary to regularly undergo examinations by a mammologist, since the risk of cell degeneration into a malignant tumor still exists.

Since the removal of fibrocystic neoplasms in the chest is still an operation, it can provoke the following complications:

bleeding;
the appearance of a hematoma in the chest cavity;
inflammation and suppuration of the wound;
asymmetry of the mammary glands;
atrophy of the pectoral muscle;
nerve or vascular injury.

A recurrence of the disease can be observed in the presence of foci of pathologically altered tissue, which can occur with an incorrectly defined border of surgical intervention.

If the disease is not treated in a timely manner, the consequences of FKM can be very serious. The most dangerous complication of the disease may be breast cancer. The initial stages of the malignant process are usually non-invasive, and important organs are not affected, so the early stages are treated quite successfully. But in medicine, there are cases when cancer is invasive, and then the following forms of oncology may occur:

Ductal cancer, which is localized in the wall of the duct. Characterized by rapid growth. The tumor in a short time can spread outside the lactiferous duct.
Lobular cancer initially affects the breast tissue, but gradually extends beyond it.
Inflammatory cancer is rare. It has a similar clinical picture with mastitis, which is why differential diagnosis is so important.
Ulcerative form of cancer (Paget's cancer).

Prevention and contraindications

First of all, the prevention of fibrocystic mastopathy is to eliminate the underlying diseases that give impetus to its development. It is also necessary to exclude external provoking factors.

Every woman must regularly conduct an independent examination of the mammary glands and, if the shape of the breast changes, soreness, discharge from the nipples and other alarming signs appear, immediately seek advice from a mammologist.

It is important for girls to choose the right bra - it is desirable that it be made of natural fabrics, and also that it does not deform or strongly compress the mammary glands.

Good prevention of fibrocystic mastopathy is childbirth and a long period of breastfeeding. It is necessary to avoid abortions, live a full sexual life, try not to react to stressful situations, eat right and lead an active lifestyle. Patients are advised to give up coffee, strong tea, flour and sweets. Many doctors associate the occurrence of fibrous structures in the chest with abnormalities in the work of the intestines, so girls should eliminate constipation, normalize the bacterial flora.

In the presence of fibrocystic mastopathy, it is not recommended to drink alcohol, smoke and heat the mammary glands (visit saunas and baths).

Fibrocystic mastopathy is a pathology that requires immediate treatment. Delay and uncontrolled medication can only worsen a woman's condition and lead to the transformation of a benign neoplasm into a malignant one.

Update: December 2018

It is known that most women suffer from this pathology, and the peak incidence is observed in childbearing age (about 30-45 years). Fibrocystic mastopathy is considered one of the most common diseases in women, and its frequency of occurrence is 30-40%, in the case of concomitant gynecological diseases in the fairer sex, this pathology reaches 58%.

Definition of the term

Fibrocystic mastopathy or fibrocystic disease is such a benign dyshormonal pathology of the mammary glands, in which both proliferative and regressive changes in their tissues are noted, as a result of which a pathological ratio of epithelial and connective tissue components is formed.

The structure and regulation of the mammary glands

The mammary gland belongs to paired organs and is represented by three types of tissues. The main one is the parenchyma or glandular tissue, in which ducts of various diameters pass, the glandular tissue is divided into lobules and lobes (there are about 15-20 of them). The lobules and lobes are separated by stroma or connective tissue, which makes up the framework of the mammary gland. And the third type of tissue is adipose, it is into it that the lobules, lobes and stroma of the mammary gland are immersed. The percentage of parenchyma, stroma and adipose tissue is directly related to the physiological state (age) of the reproductive system.

During gestation, the mammary glands reach morphological maturity. Their size and mass increase, the number of lobules and ducts increases, and milk secretion begins in the alveoli (the morphomolecular unit of the mammary gland). After childbirth, due to the production of milk, the mammary glands increase even more (milky sinuses form in the ducts of the lobes, in which milk accumulates). And after the cessation of lactation, involution occurs in the mammary glands, and the stroma is replaced by adipose tissue. With age (after 40), the parenchyma is also replaced by adipose tissue.

Both growth and development of the mammary glands are regulated by numerous hormones. The main ones are , and . The role in the regulation of the development of the mammary glands and somatotropic hormone has also been proven. The parenchyma is subject to the main changes in the mammary glands under the action of hormones, and the stroma is subjected to hormonal effects to a lesser extent. The state of the mammary glands depends on the ratio of the content of these hormones. When the hormonal balance is disturbed, mastopathy of the mammary glands develops.

Forms of mastopathy

In modern medicine, there are a large number of classifications of this disease. The most convenient in clinical work is the following:

Diffuse mastopathy

Nodular mastopathy

lipoma;
fibroadenoma;
breast cyst;
lipogranuloma;
intraductal papilloma (roughly speaking, a wart in the milk duct);
hematoma of the mammary gland;
angioma.

In the case of damage to both mammary glands, they speak of bilateral fibrocystic mastopathy, and with the development of a process in one gland, one-sided (for example, a cyst of the left mammary gland).

Depending on the severity of clinical manifestations, the disease can be mild, moderate and severe.

In addition, both diffuse and nodular mastopathy can be proliferating and non-proliferating forms. Prognostically unfavorable is fibrocystic mastopathy (FCM) of the first form. In this case, there is a proliferation of the epithelium of the lactiferous ducts, which leads to the formation of intraductal papillomas or proliferative changes in the epithelium of the inner walls of the cysts, which leads to the development of cystadenopapilloma.

All the described changes are fraught with malignant transformations and dangerous occurrence.

A special form of the mammary gland is also distinguished at the end of the second phase of the cycle, which is called mastodynia or mastalgia. Mastodynia is caused by cyclic engorgement of the gland due to venous stasis and edema of the stroma, which leads to a sharp increase and soreness of the mammary gland (more than 15%).

The reasons

Etiological factors and the very mechanism of the development of the disease are due to hormonal imbalance. The leading role in the formation of mastopathy is given to conditions in which there is a deficiency of progesterone, impaired ovarian function and / or absolute or relative hyperestrogenism. This is due to the fact that estrogens promote the proliferation of the epithelium in the alveoli, lactiferous passages, increase the activity of fibroblasts, which causes proliferation and stroma. Also, in the mechanism of the formation of the disease, hyperprolactinemia and an excess of prostaglandins are also important (they call for mastodynia, and then mastopathy). For the development of hormonal imbalance, the action of provoking factors is necessary. But even with their existence, mastopathy does not develop immediately, since their long-term influence (several years) and the “layering” of one factor on another are needed. These provoking factors include:

early menarche (early puberty, up to 12 years, leads to rapid hormonal changes, which also affects the state of the mammary glands);
late menopause (cessation of menstruation after 55 years is also unfavorable for the mammary glands due to prolonged hormonal effects on their tissues);
termination of pregnancy (a sharp hormonal decline after an abortion or miscarriage leads to hormonal disorders and the development of mastopathy);
pregnancy and childbirth were absent altogether;
a short lactation period or a categorical refusal to breastfeed;
heredity (benign and malignant breast diseases in women on the maternal side);
age (over 35);
stress as a cause of endocrine pathology;
bad habits;
mammary gland injuries, chest compression with a tight and uncomfortable bra;
inflammatory processes of the mammary glands;
hormone-dependent gynecological diseases (cycle disorders, anovulation and fibroids, endometriosis);
lack of iodine;
pathology of the liver, thyroid gland;
obesity (adipose tissue acts as a depot of estrogens, and their excess leads to hormonal disorders);
tumors of the hypothalamus and / or pituitary gland (failures in the production of FSH and LH lead to hyperestrogenism);
irregular sex life or dissatisfaction in sex, which contributes to stagnation of blood in the pelvic organs and, as a result, causes ovarian dysfunction and hormonal imbalance.

Symptoms

With mastopathy, the symptoms and their severity depend not only on the form of the disease, but also on the emotional state and character of the woman and on the existing comorbidities. In the clinic of mastopathy, the following symptoms predominate:

Mastodynia or breast tenderness

The pain syndrome can be of a different nature and intensity. In the initial stage of the disease, chest pains appear on the eve of menstruation, which many women regard as premenstrual syndrome. The pain may be dull, aching, or so sharp that it is impossible to touch the chest. The pain syndrome is caused by stagnation of blood in the veins and swelling of the tissues and is described by patients as breast engorgement. Women also note an increase in the volume of the mammary glands (edema). After menstruation, the pain disappears, but as the pathology progresses, the pain becomes constant, only its intensity changes depending on the phase of the cycle. Severe pain has a negative impact on the psycho-emotional state of a woman. In addition to sleep disturbance, mental lability is noted, irritability, aggressiveness and tearfulness appear.

Discharge from the nipples and the presence of seals / formations in the breast

Discharge from the nipples is a characteristic, but not an obligatory symptom of mastopathy. The severity and color of the discharge also varies. The discharge can be insignificant and appear only when the nipple is squeezed or occurs on its own, as evidenced by spots on the underwear. The color of the discharge may be whitish or transparent, or greenish, which indicates the addition of a secondary infection. The appearance of discharge from the chest indicates the involvement of the milk ducts in the process. A prognostically unfavorable sign is the appearance of brown or bloody discharge, which is inherent in malignant tumors.

Diffuse mastopathy

It is more often diagnosed in young women, while palpation determines enlarged and painful mammary glands with coarse heaviness and pronounced lobulation, as well as fine granularity.

Nodular mastopathy

Nodular - is the next stage in the development of the disease, which occurs in the absence of treatment for the diffuse form of pathology. Palpation of the mammary glands allows you to feel with your fingers a separate or separate areas of compaction or cysts. Foci of compaction are palpated as dense nodes without obvious boundaries with pronounced lobulation. Nodes can reach impressive sizes (up to 6 - 7 cm). In the case of the formation of a breast cyst, elastic formations are palpated, round or oval with obvious boundaries that are not connected with the surrounding tissues.

Diagnostics

Diagnosis of the disease begins with the collection of anamnesis and complaints. After the survey, the patient doctor examines and palpates the mammary glands. On examination, the contours of the breast, the presence / absence of asymmetry of the mammary glands, skin tone and venous pattern, the position of the nipples and whether they are deformed are specified.

Next, palpation of the mammary glands is carried out (mandatory in the first phase of the cycle) in two positions: standing and lying down, since some formations may not be palpable in one position. In addition, the doctor squeezes the nipples and determines the presence / absence of discharge from them, and also palpates regional lymph nodes (axillary, sub- and supraclavicular).

Instrumental methods for diagnosing mastopathy include:

Mammography

The essence of this method lies in the X-ray examination of the chest. Mammography is indicated for women at significant risk for breast cancer, as well as for all women 35 years of age and older when undergoing medical examinations. inspection. An x-ray of the mammary glands is performed in the first half of the cycle (7-10 days) and always in 2 projections (direct and lateral). The advantages of mammography include high information content (up to 97%), the ability to detect non-palpable formations.

Ultrasound of the mammary glands

This examination is indicated for women under 35 years of age, as well as for pregnant and lactating women. The advantages of the method are harmlessness and safety, high resolution, the possibility of examining breast implants or with existing trauma and/or inflammation of the breast, the possibility of examining regional lymph nodes. Among the disadvantages of the method: it is impossible to examine the mammary gland as a whole, but only a "slice", low information content in case of fatty degeneration of the breast, subjective evaluation of images (depending on the qualifications and experience of the doctor).

Needle biopsy

If a suspicious area (seal or cavity formation) is detected, a fine-needle puncture of the pathological focus is performed, followed by a histological examination of the contents.

Study of hormonal status

First of all, the level of estrogen and progesterone is determined, if hyperprolactinemia is suspected, the level of prolactin, and if necessary, adrenal and thyroid hormones are examined.

Ultrasound of the pelvic organs

It is carried out to exclude diseases of the ovaries and uterus.

Blood chemistry

Liver enzymes, blood sugar and other indicators are examined to exclude concomitant extragenital diseases.

In addition, of the additional methods for examining the mammary glands, ductography (examination of the milk ducts), pneumocystography (examination of abdominal formation), laser and digital mammography, thermography, and magnetic resonance imaging are used (if necessary).

Treatment

If mastopathy is detected, treatment should be carried out without fail and its tactics depend on a number of factors: the age of the patient, the form of the disease, the presence of concomitant pathology, interest in pregnancy or contraception. Fibrocystic mastopathy involves treatment both conservatively and surgically.

Conservative treatment patients are subjected only to a diagnosed form of diffuse mastopathy, and after consultation with a mammologist-oncologist. Conservative therapy is carried out with non-hormonal and hormonal drugs.

Non-hormonal treatments

vitamins

Vitamin A is prescribed, which has an antiestrogenic effect, vitamin E, which enhances the action of progesterone, vitamin B6, reduces the content of prolactin, vitamins PP, P and ascorbic acid, which strengthen the vascular wall, normalize microcirculation and reduce swelling of the mammary glands. In addition, all of the listed vitamin preparations improve liver function, where estrogens are inactivated and, in general, have a beneficial effect on mammary gland tissues.

Iodine preparations

Iodomarin, iodine-active are used, which normalize the functioning of the thyroid gland and participate in the formation of its hormones (see).

Sedatives and biostimulants (adaptogens)

Purpose (motherwort, valerian, peony tincture) normalize the patient's psycho-emotional state, improve sleep and increase resistance to stress. Adaptogens (eleutherococcus, radiola rosea) stimulate the immune system, normalize metabolic processes in the body, improve the functioning of the liver and brain.

Phytopreparations

Mastodinone, cyclodinone or remens are used, which have a beneficial effect on hormonal balance, eliminate pathological processes in the mammary glands, and reduce the concentration of prolactin.

The appointment of drugs such as indomethacin, nise, or not only reduce the pain syndrome by suppressing the synthesis of prostaglandins - "causative agents" of pain, but also relieve swelling and engorgement of the mammary glands.

Diuretic

Diuretic drugs (lasix or: lingonberry leaf, kidney tea,) help to subside swelling in the mammary glands and reduce pain.

hormone therapy

This is the main link of conservative treatment, it consists in prescribing the following groups of drugs:

Gestagens

Taking utrozhestan, duphaston, norkolut, pregnin and other drugs in the second phase of the cycle reduces the synthesis of estrogens and normalizes the level of progesterone, which favorably affects the course of mastopathy. The duration of taking progestogens is at least 4 months. It is also possible to use local progestogens (progestogel) - applying the gel to the surface of the mammary glands twice a day for at least 3-4 months, which contributes to the absorption of 90% of progesterone by the mammary gland tissues and eliminates side effects.

Prolactin production inhibitors

Parlodel suppresses the secretion of prolactin and is prescribed for hyperprolactinemia.

Androgens

Treatment with androgens (methyltestosterone, danazol, testobromlecid) is carried out for women after 45 years for 4-6 months continuously. Androgens inhibit the release of FSH and LH by the pituitary gland, suppress their action on the ovaries and inhibit the production of hormones by the ovaries.

Antiestrogens

Tamoxifen and other drugs in this group are taken continuously for 3 months.

Combined oral contraceptives

Taking Marvelon, Rigevidon and other contraceptives is indicated for patients under 35 years of age with anovulation and violation of the second phase of the cycle.

Surgery indicated in the detection of nodular mastopathy (fibroadenomas or cysts) and consists either in sectoral resection of the mammary gland (removal of the pathological focus along with the breast sector) or in enucleation (husking) of the tumor / cyst. Indications for surgery are: suspicion of cancer according to the histological examination of the punctate, rapid growth of fibroadenoma, recurrence of the cyst after a previous puncture.

Question answer

Is pregnancy allowed with mastopathy?

Pregnancy has a positive effect on the course of mastopathy, since the change (increased secretion of progesterone) during gestation not only stops the disease, but contributes to a complete cure.

Is it possible to breastfeed with mastopathy?

Not only possible, but necessary. Lactation is the prevention of breast diseases, and in the case of mastopathy, it contributes to the normalization of processes in the tissues of the mammary glands (the growth of the epithelium of the glandular tissue increases, which suppresses the reproduction of cells of the pathological formation).

Is it possible to use alternative treatment for mastopathy?

Yes, it is possible to use alternative treatment methods for this disease, but only when combined with drug treatment and after consulting a doctor.

What methods of alternative treatment are used for mastopathy?

One of the effective ways of folk therapy is the use of fresh cabbage. You can attach a fresh cabbage leaf with cut veins to your chest at night, wrapping it in a towel, or you can twist the cabbage and pumpkin (1: 1) through a meat grinder, evenly distribute the resulting mass over the mammary glands, wrap with polyethylene, and then with gauze and leave the compress for 2 hours . Such treatment relieves pain and inflammation, reduces swelling in the mammary glands and is carried out in courses of 7 to 14 days.

Why is mastopathy dangerous?

Complications of mastopathy include recurrence of the disease after drug treatment, which is possible with undiagnosed hormonal disorders, suppuration and rupture of the breast cyst and the degeneration of fibroadenoma into cancer (less than 1% with a non-proliferating form and reaches 32% with severe fibroadenoma proliferation). Therefore, nodular mastopathy must be treated without fail by surgery, without delay.

Is it possible to sunbathe with mastopathy?

Sunbathing, as well as other thermal procedures (visiting a bath or sauna) with this disease is prohibited. It should be remembered that with any form of mastopathy, a woman is at high risk for breast cancer, and insolation and any other type of "heating" of the breast contributes to the transition of diffuse mastopathy to nodular or malignancy of a benign breast tumor.

Is it necessary to follow a diet?

Yes, with mastopathy, one should adhere to the principles of therapeutic nutrition, which excludes the intake of chocolate, coffee, tea and cocoa due to the high content of methylxanthines in them, which not only increase the pain syndrome, but also contribute to the progression of the disease. The diet should be rich in fresh vegetables and fruits (sources of vitamins and coarse fiber, which improves bowel function), grains and bran products, dairy and seafood (sources of calcium and iodine), vegetable oils (vitamin E).

How to prevent disease?

To prevent the development of mastopathy, it is necessary to adhere to several principles:

to refuse from bad habits;
wearing comfortable underwear;
refusal of abortions;
avoid stress (if possible);
adhere to the principles of breastfeeding;
regularly carried out and checked by a doctor;
avoid chest injury;
adhere to a regular sexual life.