What are the diseases of the mammary glands. What are the diseases of the mammary glands in women and the causes. Inflammatory diseases of the female breast

Most modern women are well aware that the issue of their health is a matter of paramount importance. You can take care of your fitness, proper nutrition, while following simple recommendations that will help keep your mammary glands healthy. It should be remembered that every woman is primarily responsible for her own health. A doctor can help you, but only if you are focused on recovery.

The last two decades are characterized by a significant increase in breast diseases both in our country and in most economically developed countries. Every year, thousands of women develop tumors in their breasts. Finding a tumor in yourself is always disturbing, no matter what this tumor eventually turns out to be. There are a lot of questions: Is it cancer? Do I need an operation? Will I lose my breasts?

Breast cancer is the most common oncological disease in women in the United States and Europe, including Russia. The tumor occurs in 11% of women during their lifetime, while the incidence continues to grow, increasing annually by 1.2%. Approximately 1 in 2000 pregnant or breastfeeding women also develop breast cancer. Breast cancer also occurs in men, but it is quite rare - less than 1 out of every 180 cases of the disease.

This form of cancer ranks third among all causes of death among the female population of Russia after diseases of the circulatory system and accidents in all age groups.

Fortunately, the majority of detected breast tumors - 80% - are benign (not cancerous) and do not pose a serious medical problem. Thus, most women are not at risk of developing breast cancer during their lifetime. However, according to statistics, 1 in 9 women will develop breast cancer.

The only real way to successfully cure and reduce mortality from breast cancer at present is the detection of tumors in the early stages and timely surgical treatment. Modern diagnostic technologies make it possible to detect malignant tumors at very early stages, when they are small and can be successfully treated.

You should know that:

Most breast tumors are self-diagnosed by women.
The majority of detected breast tumors - 8 out of 10 are benign and not life threatening. But you cannot be sure of the nature of this or that neoplasm until you have been examined by a specialist.
Breast cancer can be cured in 9 out of 10 cases if diagnosed early enough. This is why early detection of tumors is so important.

What is a breast tumor?

A tumor or neoplasm is a pathological growth of tissue consisting of qualitatively changed cells of the mammary gland. The nature of the tumor must be determined on a case-by-case basis.

There are benign and malignant tumors.

Benign breast tumors

Painful breast engorgement a few days before menstruation is usually the result of a benign pathology - fibrocystic mastopathy. The opinion about the dishormonal nature of this pathology is shared by many scientists. These influences determine the complex interactions between the hormones of the ovaries, the adrenal cortex, and the pituitary gland.

Benign tumors grow by pushing the surrounding tissue apart. They do not spread beyond the breast and do not affect other organs and tissues. They usually heal easily.

Benign tumors can have a different shape, texture and size.

A cyst is a fluid-filled, thin-walled tumor. Usually defined as an elastic or taut-elastic, rounded formation with clear boundaries.
Fibroadenoma is a tumor of the connective tissue and glandular epithelium of the gland. To the touch, the tumors look like solid balls with clear boundaries, mobile and painless.
Intraductal papilloma. In cystic dilated large ducts located near the nipple and behind the areola, papillomatous growths of the epithelium may occur. These formations cause spontaneous serous or bloody discharge from the nipple.
Mastitis is the most common inflammatory process in the breast during lactation and feeding.

Malignant tumors of the breast

The growth of malignant tumor cells is uncontrollable. These tumors require urgent treatment. With untimely diagnosis and treatment, rapidly growing cells of these neoplasms can grow beyond the gland into the surrounding tissues and spread through the blood and lymphatic vessels to other parts of the body. Having fixed there, they grow, forming new tumors - metastases.

The size of the tumor and the spread of the tumor process determine the stage of the disease (from I to IV), which in turn affects the choice of type of treatment. Different stages require different treatments, and when the process is advanced, the number of treatment options decreases. This is why it is so important to diagnose the tumor as early as possible, since early treatment offers the best chance of a successful cure.

What is your chance of getting breast cancer?

Just being female and getting older puts you at risk for breast cancer. The risk of developing a tumor is individual and depends on a combination of exogenous and endogenous factors predisposing to its occurrence. If you have at least one of the following factors, you need to visit a mammologist more regularly.

Age. The older you are, the more likely you are to get sick. A sharp increase in the incidence is noted after 40 years, reaching a maximum by 65 years.
Accumulation of cases in the family; in the presence of the disease in the mother, sisters, the risk of cancer increases.
First birth after 30 years.
Early onset of menstruation - before 12 years of age
Pre-existing breast disease.
An inherited form of cancer (5-10% of all cases of the disease), the cause of which is an inherited mutation of a single gene. Some women are carriers of the recently discovered pathological genes BRCA1 and BRCA2 (breast cancer associated genes), which are associated with a high risk of developing this disease and, according to the literature, are 44-80% and 55-85%, respectively. Among men who carry the BRCA2 gene, this risk is 6%. In addition, a group of mutations in the p53 gene, also associated with predisposition to breast cancer, has been identified.

Currently, a number of factors are being studied in terms of their possible influence on the occurrence of breast diseases. These include: high-fat diets, alcohol abuse, and hormonal contraceptives and hormone replacement therapy for perimenopausal disorders.

How can you be sure that you do not have breast cancer or detect it at a very early stage?

No matter what your risk of developing the disease, it is important for every woman to take three simple, but quite affordable and effective steps that will take care of her breast health and identify any pathology in herself long before the onset of clinical symptoms. This is a monthly self-examination of the mammary glands, regular observation by a mammologist and a mammogram.

As world experience shows, self-examination, mammography and professional examination by a mammologist are indispensable components for the timely detection of any pathology at the stage when it can be successfully cured.

Learn how to do a breast self-exam

The mammary glands of each woman are as individual as fingerprints. All women should learn how to perform breast self-examination - this is the best way to self-identify any pathology in the gland.

The state of the mammary glands is functionally related to the sexual sphere of the body. In various age periods of a woman's life, the glands have characteristic structural features, undergoing numerous specific changes, which are determined primarily by the functional state of her genital area, the influence of ovarian hormones.

When should you examine your breasts yourself?

Every month around the same days. Young women - a week after the end of menstruation.

IT IS IMPORTANT!

You should tell your doctor about any changes you find. If you think that you have discovered any pathology or discomfort in yourself, then the words “do not delay” should not cause you to panic, and you should immediately contact a specialist.

Symptoms of breast diseases

Common symptoms of breast disease are tension, pain, discharge from the nipple, changes in the skin of the breast area, and changes in the nipple and areola. In this case, complaints may be absent in the presence of one or another pathology of the mammary gland.

Self-examination is desirable for all women, but this procedure cannot replace a professional examination and consultation with a specialist mammologist.

Examination of the mammary glands by a specialist

Observing yourself on your own, you need to visit a mammologist once a year for a professional preventive examination of the mammary glands, which will allow you to competently assess your condition and give the necessary recommendations. An examination by a specialist is your guarantee that you have not missed or overlooked anything during independent monthly examinations.

For an examination, you should contact a mammologist or an oncologist-mammologist (the name of the specialty comes from the Latin word mamma - mammary gland), who has special knowledge and training in the field of breast diseases, and not doctors of other specialties who are not well versed in this pathology. A mammologist of a specialized institution with the necessary technical equipment will professionally examine you, perform diagnostic procedures if necessary, and give medical recommendations.

Methods for diagnosing breast tumors

Used diagnostic research methods help the doctor to determine the nature of the tumor. The examination also helps in choosing the optimal treatment method for you. With the help of mammography, breast cancer can be detected at a very early stage, when 9 out of 10 cases can be successfully treated.

Mammography is an x-ray examination of the internal structure of the mammary glands, performed on a special apparatus - a mammograph. This is the most informative, accessible and safe method that allows you to detect breast disease, including tumors, at the earliest stages of development, even in cases where they cannot yet be found during examination.

Currently, regular mammograms are recommended to start after age 40. At the same time, the results of most scientific studies indicate the need to perform mammography for women aged 40-49 every 1-2 years. In the age group over 50, a mammogram is recommended every year. In women younger than 30, ultrasound is preferred; the exception is those with an increased risk of the disease.

In addition to examination and mammography, there are a number of other clarifying methods of research, which, if necessary, will be prescribed by the doctor.

In the process of communication, you can see that breast tumors are actually not so rare.

Your diagnosis

Perhaps the most difficult moment is to know your diagnosis.

Additional research may be needed to determine the amount of treatment that is best for you.

If your tumor is benign, that's good news, but you'll still need regular checkups to watch for new tumors.

When a malignant tumor is detected, women are currently offered various treatment options, including breast-preserving operations (the so-called organ-preserving) and restorative reconstructive plastic surgery. There are various options for surgical reconstruction of the breast, which can be applied to most patients after complete removal of the breast - mastectomy due to the disease. Reconstructive plastic surgery allows you to recreate the volume and shape of the removed gland, as much as possible corresponding to the second gland.

Depending on the type of tumor in the postoperative period, other types of therapy may be prescribed.

How to avoid breast diseases?

Despite the fact that the development of breast cancer is not yet completely preventable, it is quite possible to reduce the risk of this tumor. To do this, first of all, you should follow these preventive measures, lead a healthy lifestyle. Reducing the intake of animal fats and high-calorie foods, maintaining a normal body weight, being physically active, and eating fiber-rich foods, including whole grains, and fruits and vegetables, will help you reduce the risk of developing a tumor.

Don't forget about the 3 steps to staying healthy: regular self-exams and mammograms, and follow-up with a mammologist.

At the same time, early detection of a tumor and treatment carried out at the initial stages of the disease mean not only the safety of your mammary gland, but also saving your life!

The study of the physiology of the breast and the processes occurring in it is the science of mammology. Thanks to the development of modern medicine, it became possible to diagnose breast diseases at an early stage, which greatly simplifies the subsequent treatment. Any, even the most insignificant breast disease, needs timely treatment. Otherwise, the risk of developing breast cancer increases.

The main cause of most breast diseases lies in hormonal disruptions. An imbalance of steroid hormones in a woman's body often leads to pain, discomfort and seals. The thing is that the development and normal operation of the reproductive organs and the entire system as a whole depend on this balance.

Many hormonal surges occur throughout a woman's life: puberty, menstruation, pregnancy, menopause. All processes are physiologically necessary, and slight discomfort at this time is considered the norm.

Hormonal imbalance can occur for several reasons. The most common are: abortion, the use of hormonal contraceptives, the absence of pregnancy and lactation in childbearing age.

Disturbances in the endocrine or reproductive system can cause some diseases of the mammary glands. Heredity also plays a significant role in this matter. Plus, the presence of bad habits, stressful situations and excessive exposure to ultraviolet rays can cause the development of female breast disease.

Inflammatory diseases

The classification of pathologies of the mammary glands in women includes two main varieties: inflammatory and tumor. The first type includes mastitis, which in turn is divided into lactational and non-lactational. The cause is usually bacteria that penetrate through cracks in the nipples and subsequently enter the mammary gland through the milk ducts.

Lactational mastitis is the most common. Diagnosed in breastfeeding mothers. Its occurrence is often explained by the development of lactostasis - milk stagnation. Other reasons for the development of mastitis are hypothermia of the glands and weakened immunity of the mother. Lactostasis is possible provided that the child does not completely suck out milk from the breast - it stagnates, the fermentation process begins, which smoothly flows into mastitis. Symptoms can be different: severe chest pain, fever, redness of one or both mammary glands, discharge from the nipples, swollen lymph nodes in the armpits.
Non-lactating mastitis is much less common. Its appearance has nothing to do with lactation. At the slightest sign of the disease, you need to contact a specialist to determine the exact cause.

In its earliest stages, mastitis is easily treatable. It is enough to organize a full decantation, use compresses and other home remedies to relieve inflammation, and the disease recedes. Physiotherapy is also an effective assistant in the fight against mastitis. In severe cases, stopping breastfeeding and taking antibiotics is recommended. Sometimes surgery is required to remove pus from the breast.

Doctors divide all tumor diseases of the breast into benign and malignant. In the absence of timely treatment, the first can develop into the second. Therefore, it is recommended to undergo all the necessary diagnostic procedures annually.

Breast diseases, a sign of which are benign seals, have a characteristic feature - the absence of tumor growth in neighboring tissues and organs. The development of a neoplasm occurs rather slowly, unlike malignant tumors. In some cases, it is necessary to apply a surgical method of treatment - removal of the affected part of the breast.

Benign neoplasms have the following classification:

Mastopathy

It is characterized by a violation of the hormonal background, namely, an increased level of prolactin in the body. Most often, this pathology occurs in women in childbearing and postmenopausal age. In the latter, the likelihood of its development is much higher due to the reduced production of hormones.

Obesity, diseases of the liver and stomach, diabetes mellitus are factors provoking the development of mastopathy. Mastopathy is divided into four main types: nodular, diffuse, cystic, fibrocystic (mixed). Nodular mastopathy is the mildest form and is easy to treat. But in its absence, it develops into diffuse mastopathy, which can subsequently cause the development of breast cancer.

An increased content of tarragon in a woman's body can become a factor provoking the development of fibroadenoma. Such a seal is characterized by its location in the connective tissue between the ducts. Pathology is most often observed in girls under 30 years old.

Smooth spherical or oval seals can easily move inside the breast. In some cases, entire groups of small neoplasms are found. The risk of developing cancer is high only in the presence of one form of fibroadenoma - leaf-shaped.

Cyst

Cystic neoplasms are not life-threatening if treated promptly. The cyst is a seal, inside which you can find voids filled with fluid. The danger is that the liquid can fester over time. When a pathology is detected, conservative treatment is prescribed in most cases.

Intracurrent papilloma

Papillomavirus can occur in a woman's body, regardless of the age category. In this case, the milk ducts are covered with growths, which can also appear from the outside, i.e. on the nipples.

Lipoma

Violation in the metabolic system sometimes leads to the appearance of a disease such as lipoma. The thing is that the imbalance of metabolism causes the growth of adipose and connective tissue in the chest, leading to the development of compaction.

Benign tumors with a large lesion area are most often subjected to surgical intervention in order to prevent even the slightest risk of developing breast cancer. Diseases of the female breast, characterized by the presence of small neoplasms, can be treated with vitamins, hormonal agents and antibiotics.

Malignant tumors

Some breast diseases also affect tissues of other organs. They are called a malignant tumor - breast cancer. A distinctive feature is the extremely rapid growth of the seal. In this case, the body itself is not able to cope with the process. Due to penetration into the lymph nodes and blood vessels, the tumor spreads to other organs. Regular breast examinations ensure early detection of cancer, which greatly simplifies treatment.

At the moment, there is only one effective way to treat breast carcinoma - removal of the tumor through surgery. Unlike benign seals, breast cancer is characterized by a seal with no clear boundaries and an indefinite shape.

The most common symptoms are breast deformity, discoloration of the skin, inflammation of the lymph nodes in the supraclavicular region and armpits. In some cases, a modification of the nipple is possible.

Breast carcinoma has 5 stages of development, of which only the first three give a high chance of survival. At stages 3 and 4, mortality is more than 90%. That is why it is necessary to constantly undergo diagnostics of diseases in order to identify them at an early stage.

Diagnostics

Several times a month at various stages of the menstrual cycle, each woman needs to conduct an independent examination of the mammary glands. If seals or pain are found on palpation, a specialist consultation is required. Primary diagnosis of diseases is carried out by a gynecologist or mammologist. Initially, the chest is examined and palpated. Further, the doctor, based on the results obtained during the examination, will prescribe the necessary diagnosis.

Modern methods for diagnosing breast diseases include: mammography and ultrasound. The first is recommended for postmenopausal women, the second for young girls of childbearing age. These methods cannot give a complete description of the picture of the development of pathology, but are able to detect its presence.

To clarify the shape and size of the tumor, a set of procedures is necessarily carried out: MRI, computer infrared diagnostics, biopsy. In some situations, special markers are used that can detect the presence of cancer cells.

Breast disease in men is much less common, but undergoes a completely identical diagnosis. Any breast diseases in men and their symptoms are explained by the presence of hormonal imbalance.

Treatment and prevention

After carrying out all the necessary diagnostic procedures, the most complete picture of the disease is compiled. The vast majority of breast diseases can be cured only with the use of surgery. The seal is removed, then supportive therapy is prescribed. With benign neoplasms, drug treatment without surgery is allowed, but only on condition that the disease is at an early stage of development.

The best prevention of any breast disease in a woman is pregnancy and lactation. The female breast must fulfill its main function - breastfeeding. Otherwise, there is a possibility that a hormonal failure will occur, which can lead to the development of various pathological processes.

It is worth abandoning the daily wearing of beautiful underwear. It is better to give preference to bras made of natural fabric without stones. The size of underwear must strictly correspond to the size of the chest. Tight bras lead to circulatory disorders, which negatively affects the condition of the mammary glands.

Care must also be taken to ensure that the mammary glands are not supercooled. Inflammation and other pathological processes can provoke precisely low temperatures. Even in the summer, you need to make sure that the chest is in comfortable conditions.

A healthy lifestyle, proper nutrition, lack of stress and bad habits are factors that help maintain breast health for many years. Any complaints about the mammary glands should not be ignored. Breast diseases have numerous symptoms that cannot be understood without consulting a specialist. Do not self-medicate - there is a chance to worsen the condition. Breast diseases cannot be prevented, but they are much easier to cure with timely diagnosis.

Mammalogy

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Mammalogy- an independent branch of medicine that studies the structure of the mammary glands of a woman, the physiological processes occurring in them, as well as the prevention and treatment of emerging diseases of the mammary gland. Mammology is interconnected with other medical disciplines that study the woman's body: gynecology, endocrinology, as well as surgery and oncology. Diseases of the mammary glands can occur in women at different ages. The most dangerous in relation to oncological pathology of the mammary glands is considered to be older than 40 years. During this period, women need to regularly exercise breast self-examination, undergo X-ray examination and ultrasound.

The mammary glands of a woman are paired glands of external secretion. Their main function in the female body is lactation, that is, the production of milk, which ensures the feeding of an infant. Therefore, the mammary glands are also called mammary glands.

Like no other organ, the mammary glands are influenced by all the processes that occur in the female body: the menstrual cycle, pregnancy, lactation, menopause - the breast reacts to all this with its anatomical and physiological changes.

Despite the fact that most of a woman's life, the mammary glands are "at rest", but as a hormone-dependent organ, they undergo complex changes due to the physiology of the female body. And the occurrence of most breast diseases is associated precisely with hormonal imbalances.

So, with endocrine disorders in the mammary gland, benign formations can occur - mastopathy, cyst and fibroma of the mammary gland. Their development is often associated with abortions, as well as inflammatory diseases of the female reproductive organs that disrupt the hormonal function of the ovaries and other endocrine glands.

Gynecologist and mammologist.

Every woman should monthly carefully examine the mammary glands on the 6th-12th day of the menstrual cycle. If the first alarming symptoms are detected, it is urgent to resort to the consultation of a mammologist.

A particular mammological disease may be indicated by the appearance of at least one of the complaints in a woman: induration, soreness in the chest, the appearance of discharge from the nipples, changes in the skin on the chest and in the nipple area, a change in the shape of the gland, an increase in lymph nodes in the axillary zones.

After 35 years, women need to undergo an ultrasound of the mammary glands once a year, and after 40 - a mammogram once every 2 years. You should visit a mammologist if you are planning a pregnancy or taking oral contraceptives.

Today, the majority of timely diagnosed breast diseases are successfully treated conservatively. Surgical treatment of mammological pathology is aimed at the most careful preservation of the organ and its function.

Fortunately, not all breast pain deserves much concern. It can be a consequence of natural hormonal processes in a woman's body. So, in the first 14 days of the menstrual cycle, estrogens are actively produced in the female body, which stimulate the growth of glandular and connective tissue cells. After ovulation, the production of progesterone increases, which eliminates the effect of estrogens and prepares the female body for a possible pregnancy. In this case, the thickening of the endometrium occurs due to the activation of its blood supply. A similar process occurs in the mammary glands, while the breast may swell slightly, which is accompanied by painful sensations that increase with the approach of menstruation. Breast tenderness associated with the menstrual cycle is called cyclical. Another name for such pain is mastodynia.

Cyclic breast pain

Periodic pains of the mammary glands are distinguished by the following features:

occur in the second half of the menstrual cycle, less often a week before menstruation or during menstruation;
affect both mammary glands;
localized more often in the upper part of the mammary glands, but may be total or give to the armpits;
are usually dull, aching;
may be accompanied by the appearance of small nodules that disappear after menstruation;
often accompanied by PMS symptoms such as irritability, pain in the lower abdomen, headaches, emotional instability, etc.

Up to 80% of women of childbearing age are subject to periodic pains in the mammary glands, they do not pose a health hazard, except for physical discomfort.

Non-cyclic pain

If the soreness of the mammary glands is not associated with the menstrual cycle, this can be a cause for serious concern. They are distinguished from cyclic pains by a certain localization, usually affecting only one gland; burning, pressing or bursting nature of sensations. Often, such pain is accompanied by other symptoms of the disease, which can be expressed in:

deformation of the gland itself or the nipple;
discharge from the nipple of a different nature;
changes in the skin of the chest - redness or "orange peel";
feeling of heaviness in the mammary gland;
changes in regional lymph nodes.

In addition, with non-cyclic pain in the mammary gland, signs of general malaise can be observed: weakness, lethargy, fever, loss of appetite, etc. More often, such symptoms appear in women after 30 years and during menopause. They can be a sign of a serious illness, including:

benign neoplasms - cysts, fibroadenomas, lipomas;
malignant neoplasms - cancer, lymphosarcoma;
acute mastitis and other inflammatory processes;
sclerotic changes in the mammary glands.

However, severe pain in the mammary glands can occur as a specific reaction to the implant, or may be the result of a chest injury, including after surgical interventions. Also, pain syndrome can occur due to malformations of the lactiferous lobules or ducts, as a result of wearing tight underwear and simply with large breast sizes.

breast cyst

A cyst is a liquid neoplasm that most often forms inside the ducts of the mammary glands, usually without causing discomfort for a long time. Usually these are small capsules, ranging in size from a few millimeters to several centimeters, filled with a non-inflammatory fluid. Small cysts are difficult to detect on palpation and are more often found on mammograms. Such neoplasms may disturb in the premenstrual period, but may be asymptomatic.

With large sizes of the capsule, there may be pulling pains of a local nature, uneven surface of the gland during palpation, a burning sensation, and sometimes discharge from the nipple appears. Giant cysts, to which the inflammatory process joins, make themselves felt constantly with unpleasant sensations, fever, a feeling of fullness in the chest, swelling of the axillary lymph nodes.

Typically, the occurrence of cysts is associated with changes in the hormonal background, characterized by an excess of estrogens with a lack of progesterone. That is why the risk group for this disease includes nulliparous women over the age of 30 years. Psycho-emotional factors, as well as a sharp weight gain or chronic overweight, can lead to the formation of cysts. Often, cysts are provoked by mastopathy, diseases of the ovaries and uterus, disorders in the thyroid gland, abortion, osteochondrosis of the thoracic spine.

If, according to the results of the examination, there is no risk of malignancy of the cyst and it does not cause inconvenience, it is usually not touched.

Fibroadenoma

Fibroadenoma, or nodular mastopathy, is a seal that usually occurs in the upper part of one of the glands. It is not attached to the skin, and therefore to the touch it is a smooth, elastic and mobile tumor. Most often, such benign neoplasms do not exceed 8 mm in diameter, without causing concern to the patient, but can grow up to 15 cm and occupy the entire surface of the gland. Most often, such neoplasms are single, rarely they can resolve on their own, but they can also grow rapidly. Adolescents and young women are susceptible to this disease, while it is not accompanied by pain, fever and other characteristic symptoms. If the tumor is localized in the nipple area, then with pressure, pain and light discharge may occur. Fibroadenoma can become malignant (malignant) into a sarcoma.

An unambiguous cause of breast adenoma has not been identified, but many different factors can become its provocateurs. Among them are various hormonal and endocrine disorders, diseases of the liver, ovaries, adrenal glands, thyroid gland, disorders of the pituitary gland, obesity, and diabetes mellitus. In addition, adenomas can occur due to improper use of hormonal contraceptives, frequent stress, abuse of solar procedures, frequent hot baths, etc.

Mastitis

Mastitis is an inflammation of the mammary glands that most often occurs in nulliparous women. First of all, the disease is characterized by swelling and engorgement of the gland, pain when trying to feed and pumping, fever. In the absence of timely therapy, the symptoms increase, general weakness appears, a dense inflammatory node is felt in the chest, and the skin above it changes color. Lack of treatment at this stage threatens the development of a purulent abscess followed by sepsis.

The cause of mastitis can be any inflammation in a woman's body, including caries, and milk stagnation contributes to it - lactostasis, which leads to incomplete pumping. In this case, there are sensations of bursting of the chest. Cracks in the nipples often contribute to the penetration of infection into the body, and underwear with traces of milk serves as an excellent substrate for their development.

Malignant neoplasms

In the first stage of breast cancer, no external symptoms are observed, and self-examination can reveal a small, dense, painless, inactive nodule with an uneven surface. With the growth of a tumor on the skin above it, retractions, folds, and swelling may appear, and in the future, discharge from the nipple of a different nature may appear. In the second stage of the disease, changes appear in the nearest lymph nodes, especially the axillary ones, which swell and become painful on palpation. At the same time, pains in the mammary gland itself are not yet observed at this stage, they appear in the later stages, when a complete cure is no longer possible.

The most significant risk factor for breast cancer is genetic predisposition. If the closest relatives in the female line had malignant neoplasms, you are at an increased risk. In addition, inflammatory diseases of the breast often lead to the development of malignant tumors. Other factors of this disease include:

hormonal changes during puberty, pregnancy, menopause;
long-term continuous use of contraceptives;
exposure to radiation, including solar radiation;
the presence of bad habits;
sedentary lifestyle.

Diagnostics of breast diseases

Every woman, regardless of age and any other factors, taking care of her own health, should do self-diagnosis once a month. It includes visual inspection and palpation of the mammary glands and nearby lymph nodes. It is carried out on the 5th-7th day of the menstrual cycle, standing in front of a mirror in good light, bare to the waist. Inspection is carried out with raised hands and with lowered. On examination, pay attention to any changes:

breast size and symmetry;
skin conditions;
pigmentation
appearance of axillary, sub- and supraclavicular lymph nodes.

After a visual inspection, palpation is carried out for various seals. The armpits and areas along the collarbones are palpated without fail. Any changes in tissue density, nodules, swelling, soreness should alert. At the end of the self-examination, lightly squeeze the nipple to detect discharge. If there is at least one change, you need to contact a mammologist without fail.

Depending on the presumptive diagnosis, the specialist may prescribe the necessary examinations. To assess the general condition of the body, women usually take a general and biochemical blood test, a general urine test. To make a differential diagnosis, they may prescribe mammography, ultrasound of the mammary glands, breast MRI, blood tests for tumor markers, tissue biopsy, etc. In many cases, to make an accurate diagnosis, you need to consult several specialists: a surgeon, a neurologist, a gynecologist, an endocrinologist, etc.

Breast diseases occur in women of any age, but the most frequent patients of a mammologist - this is the name of a doctor who deals with breast diseases - are still ladies over forty. At this age, it is necessary to visit a doctor for a preventive examination at least once a year. Here are the most common problems women face.

Discharge from the nipple

The discharge of fluid from the nipple is not always a disease, even after menopause. A malignant tumor is detected in less than 10% of women with nipple discharge. However, if any discharge from the nipple occurs, you should consult a doctor.

Bloody issues, as a rule, are caused by a small benign formation in the milk duct (intraductal papilloma). Some of them can be felt, others are detected by X-ray examination (mammography). If a woman is concerned about the presence of discharge, then the mass is usually removed on an outpatient basis using local anesthetics.

Milk secretion(galactorrhea) in women outside the lactation period often indicates hormonal disorders.

Benign formations

Benign diseases include cysts, cystic fibrous mastopathy, fibroadenomas.

breast cyst

Cysts are fluid-filled cavity formations that may appear as a result of blockage (obliteration) of the milk ducts; they are relatively easy to detect when examining the glands. The cause of the formation of breast cysts is unknown, although sometimes they are the result of trauma. Cysts can cause pain in the breast.

To study the contents of the cyst, it is drained: liquid is sucked off with a thin needle, which also gives an analgesic effect. This liquid is examined in the laboratory under a microscope. The doctor determines the color and amount of fluid and pays attention to whether the cyst disappears after removing the fluid. If the fluid contains blood (brown or cloudy fluid) or if the cyst reappears within 12 weeks of drainage, then the cyst is surgically removed because it is possible for cancer to develop in the cyst wall, although this is rare.

Mastopathy

Mastopathy is a diffuse or nodular change in breast tissue. In the latter case, cysts and (or) fibrous nodes are formed in the gland. The disease is based on the increased production of female sex hormones - estrogens. Multiple abortions, gynecological diseases, pathology of the endocrine system (primarily the thyroid gland) are of particular importance. The average age of patients is 20–50 years.

Most often, there is a bilateral lesion of the mammary glands, accompanied by the following symptoms of mastopathy:

Engorgement and pain in the mammary glands, worse before menstruation;

the appearance of dense formations (nodes), usually located in the upper outer quadrant;

Enlarged axillary lymph nodes;

sometimes bloody or serous discharge from the nipple.

If any seals of the breast tissue appear, cancer should be excluded. For this, mammography is performed, as well as a puncture biopsy with a thick needle, followed by a cytological examination of the material obtained.

With diffuse forms of mastopathy, it is necessary to treat the main cause - gynecological diseases, thyroid diseases (thyrotoxicosis). In the presence of large painful cysts, they are drained (removal of fluid with a needle).

To reduce pain in the mammary gland, danazol is prescribed (a synthetic drug with a weak andronogen-like effect, close to testosterone), as well as tamoxifen (a drug that blocks the action of estrogens).

Surgery is indicated in the following cases:

If seals in the gland are localized;

In the presence of fibrous nodes;

If the fluid in the cysts (if present) contains blood or if the cyst reappears within 12 weeks of drainage.

Fibroadenomas

Fibroadenomas are small benign dense formations consisting of connective and glandular tissue. These tumors usually appear in young women, often in teenage girls. The nodes are easily displaced, have clear boundaries, they can be detected during self-examination as formations of small size and stony density. They have a rubbery consistency because they contain collagen (a tough, fibrous protein found in cartilage, bones, tendons, and skin).

Nodules are usually removed surgically under local anesthesia (local anesthesia), but they often recur. After several nodes have been removed and found to be benign, the woman and her doctor may decide not to remove the remaining nodes, especially since they may reappear.

Mammary cancer

Malignant diseases include several types of breast cancer and Paget's disease. Leaf-shaped cystosarcoma can be either malignant or benign.

A malignant tumor can develop from the cells lining the milk ducts, as well as from adipose and connective tissues. Some tumors grow very slowly and spread to other organs (metastasize) only after they reach a significant size. Other types of tumors are more aggressive and grow and spread quickly.

The likelihood of developing breast cancer increases with age: about 60% of malignant breast tumors occur in women over 60 years of age. The highest risk of the disease is in women over 75 years of age.

There are the following risk factors for developing breast cancer:

Previously cured breast cancer;

The presence of breast cancer in family members;

Previous benign breast disease;

Early puberty (first menstruation before age 12);

Late (after 55 years) the onset of menopause (last menstruation);

Late first pregnancy (after 30 years);

No pregnancies;

Prolonged use of oral contraceptives;

Long-term estrogen replacement therapy;

Obesity after menopause.

Breast cancer usually doesn't show up at first. As a rule, the first symptom of breast cancer is the onset of pain and the appearance of a node, which often has clear boundaries with the surrounding breast tissue. In more than 80% of breast cancer cases, a woman discovers the node herself. In the early stages, the node can freely move under the skin when it is examined with fingers. In later stages, the nodule is usually fixed to surrounding tissues such as the chest wall or skin. At a late stage of the development of the disease, swollen nodes or festering ulcers appear on the skin.

If breast cancer is suspected, in addition to the usual diagnostic studies of the breast, an x-ray of the chest organs is taken to detect tumor metastases, and the sensitivity of the malignant tumor to progesterone or estrogens is also determined.

Treatment depends on the type of cancer and the severity of the disease. There are several types of surgeries:

Nodule removal, partial mastectomy, or removal of the affected quadrant while preserving healthy breast tissue as much as possible (usually in combination with radiation therapy);

Removal of all breast tissue (simple mastectomy, usually combined with radiation therapy)

Radical mastectomy with removal of the underlying muscles of the chest and other tissues (usually in combination with radiation therapy).

Radiation therapy is aimed at the destruction of malignant cells in the area from which the tumor was removed, and in the surrounding tissues, including the lymph nodes (often in combination with chemotherapy).

Chemotherapy is the use of drugs that cause the death of rapidly multiplying cells or inhibit their reproduction.

Sex hormone antagonists (drugs that suppress the action of hormones that support the growth of malignant cells) are also used to suppress the growth of cancer cells in the body. Another doctor may prescribe tamoxifen, which blocks the action of estrogens.

Standard diagnostic studies of the breast

Mammography is a method of X-ray examination, which uses low doses of radiation and which allows you to detect pathological foci in the mammary gland. Such a study is one of the best ways to diagnose breast cancer in the early stages of its development. It should be borne in mind that mammography is a very sensitive method and often gives a false positive result (that is, it may indicate the presence of a tumor when in reality it is absent), so other specific studies are often required additionally.

In women aged 50 years and older with no symptoms of breast disease, a yearly or two-yearly mammogram reduces breast cancer mortality by 25% to 35%. In asymptomatic women, mammography can detect about 40% of malignant tumors missed during a general examination.

The American Cancer Society recommends having the first mammogram at age 40. Although nodules are rarely found at this age, the resulting mammogram can serve as a basis for comparison with subsequent mammograms. Women under 35 are advised not to have a mammogram, but an ultrasound, which is considered more informative at this age.

Ultrasonic scanning. An ultrasound, or ultrasound scan (a test that uses high-frequency sound), is not part of a routine test to detect breast cancer. Ultrasound is performed mainly in young women (up to 35–40 years old) to distinguish breast cysts from a dense nodule. Establishing this distinction is very important, since the cyst must be observed, and the dense node must be examined with a biopsy.

Thermography. This is an examination in which the temperature difference in certain parts of the body is determined, which may be due to a malignant tumor. This method often gives both false negative and false positive results.

Biopsy of the breast. When a node is found that may turn out to be malignant, a biopsy is performed - suction of the elements of the node using a needle attached to a syringe (aspiration biopsy), removal of a small part of the tissue (incisional biopsy) or the entire node (excisional biopsy). In most cases, no hospitalization is required to perform a biopsy. Local anesthetics (painkillers) are usually used.