What does breast necrosis look like on ultrasound. Lipogranuloma of the mammary gland. What happens in breast tissue during fat necrosis

• Biopsy of the breast.

For many women, the phrase "fat necrosis of the breast" sounds ominous. In fact, this condition is not so scary and does not even always require treatment. The terrible word "necrosis" in this case means only the death of adipose tissue cells. Over time, dead cells are replaced by a scar or form a cyst.

Why does fat necrosis occur in the breast?

The most common reason is breast surgery. After all, any surgical intervention, especially an extensive one, is a tissue injury, it leads to impaired blood supply. Moreover, fat necrosis does not always develop immediately after surgery, it can take years.

There are other possible reasons:

• Chest injury. Fat necrosis can occur after a car accident due to a chest injury from a seat belt.
• Biopsy of the breast.
• Radiation therapy in oncological diseases. Radiation can damage not only tumor, but also healthy tissue, resulting in a complication - fatty necrosis.
• Among the patients, ladies with curvaceous forms predominate, who have more adipose tissue in their breasts. In the high-risk group, middle-aged women with saggy, out of shape breasts.

What are the symptoms of pathology?

Fat necrosis of the mammary gland may be asymptomatic, in which case it is detected only during the examination, after a mammogram.

A painful swelling may appear in the chest, the skin over it becomes red or bluish in color, but the body temperature remains normal. Some women develop discharge from the nipples. The skin over the lesion is retracted, in some cases the nipple is retracted.

Similar manifestations occur with malignant tumors of the breast. Do not delay a visit to the doctor. Timely examination helps to exclude cancer.

- focal aseptic necrosis of breast fat with its subsequent replacement with scar tissue. Fat necrosis is characterized by the appearance of a dense painful formation that deforms the mammary gland; retraction of the skin and a change in its color, which in the first place makes you think about tumor processes. Diagnosis includes palpation of the breast, ultrasound, mammography, fine needle biopsy. Treatment of fat necrosis requires sectoral resection of the mammary gland.

ICD-10

N64.1

General information

Fatty necrosis of the mammary gland (oleogranuloma, lipogranuloma, steatogranuloma) refers to non-enzymatic necrosis, most often caused by various breast injuries. According to clinical observations carried out by modern mammology, fat necrosis accounts for 0.6% of all nodular formations of the mammary glands. Breast fat necrosis is more common in patients with macromastia than in women with small breasts.

Traumatic factors can be accidental bruises and blows in everyday life or transport, medical manipulations, sports training. Rarely, fat necrosis of the breast is caused by rapid weight loss or radiation therapy. In some cases, the formation of fat necrosis is noted in patients who underwent reconstructive mammoplasty with their own tissues after mastectomy.

Damage to the capillaries can lead to loss of blood supply to a local area of ​​fatty tissue. Further changes are characterized by the development of reactive inflammation in the damaged area with the formation of a demarcation zone that delimits dead tissue. After the inflammation subsides, the process of fibrosis begins - the replacement of necrotic masses with connective tissue cells. In these cases, scar tissue forms at the site of necrosis. In the future, calcium salts can be deposited at the site of fatty necrosis of the mammary gland, causing calcification (petrification) of the focus of necrosis; in some cases, ossification processes are noted.

Symptoms of fatty necrosis of the breast

The development of fat necrosis in most cases is preceded by a traumatic effect on the mammary gland. At the site of the injury, a painful swelling appears, soldered to the skin, having a rounded shape and a dense texture. In the future, the area of ​​fatty necrosis of the mammary gland may lose sensitivity.

The skin over the breast tumor may be cyanotic or red in color. With the formation of fatty necrosis of the mammary gland in the areola, nipple retraction is possible. Unlike mastitis, with fatty necrosis of the mammary gland, body temperature usually remains normal.

Dense infiltrate, deformation of the mammary gland, the appearance of "dimples" on the skin, an increase in lymph nodes gives fatty necrosis an external similarity with the clinical picture of breast cancer. In unfavorable cases, the development of fatty necrosis of the mammary gland can proceed with septic fusion of the focus and sequestration.

Diagnosis of fatty necrosis of the breast

When diagnosing fatty necrosis of the breast, it is important to indicate the patient to a recent chest injury. In the process of palpation of the mammary gland, a mammologist easily determines a painful induration with fuzzy contours, sometimes fluctuation. Ultrasound of the breast does not reveal the characteristic hallmarks of fat necrosis.

Plain mammography, CT or MRI of the mammary glands reveals a nodular formation with a heterogeneous structure, heavy uneven contours. The radiological, tomographic and echographic picture in fatty necrosis often resembles that in breast cancer. Later, when calcification occurs, the focus of fatty necrosis of the mammary gland appears on mammograms as a spherical calcification of the “eggshell” type, which makes it possible to exclude the malignancy of the process.

For differential diagnosis, a biopsy of the mammary gland (puncture fine-needle or trepanobiopsy) is indicated, followed by cytological and histological examination of the obtained samples. Breast biopsy is recommended under ultrasound or X-ray guidance.

Treatment and prevention of fatty necrosis of the breast

Given the irreversible focal changes in adipose tissue, as well as the difficulties of differential diagnosis in fatty necrosis, an organ-preserving sectoral resection is indicated - removal of a part (sector) of the mammary gland.

Only a postoperative histological examination of the macropreparation makes it possible to exclude an oncological process. Microscopically, fatty necrosis of the mammary gland is represented by nodular growths of granulation tissue from epithelioid cells, multinucleated giant lipophages and xanthoma cells around fat inclusions. One of the components of lipogranulomas are fatty cysts - thin-walled cavities filled with oily and serous fluid.

To prevent fat necrosis, it is necessary to avoid injuries to the mammary glands, and also contact a mammologist in a timely manner if damage does occur. In case of trauma to the mammary gland, it is necessary to give it an elevated position with a bandage.

Fatty necrosis of the mammary gland is the necrosis of its fatty tissue, followed by replacement with scar tissue. Such necrosis develops in the form of foci.

For this pathology, a dense painful formation, retraction of the skin and a change in its color are characteristic - such signs make one suspect the presence of a tumor process.

When fatty necrosis occurs, there is a need for a sectoral resection (removal of a section) of the mammary gland.

common data

Fatty necrosis of the mammary gland belongs to a number of so-called non-enzymatic necrosis. In mammology, of all nodular formations of the mammary gland, 0.6% of all diagnosed clinical cases fall on it.

When this pathology is mentioned, the disease in women is meant. With the defeat of the male representatives, the diagnosis sounds like “Fatty necrosis of the breast” (mammary glands are only in women). In men, this disease occurs very rarely - due to the scarcity of fatty tissue of the mammary glands. An exception may be gynecomastia - the development in male patients of the mammary glands according to the female type.

Mostly women of the childbearing period get sick - the age category from 25 to 35 years is mainly affected.

Pathology has other names - it is oleogranuloma, lipogranuloma and steatogranuloma.

The reasons

The occurrence of fatty necrosis of the mammary gland can provoke fundamentally different reasons - for convenience, they are divided into groups:

• traumatic lesions;
• rapid weight loss;
• radiation exposure to breast tissue.

A traumatic lesion that can lead to the development of this pathology can be observed:

• when performing medical manipulations (in this case it is also called iatrogenic);
• outside of the healing process.

Medical procedures, during which the integrity of breast tissue may be violated, with a subsequent risk of developing fat necrosis, can be:

• diagnostic;
• actually curative.

Such diagnostic manipulations include the sampling of breast tissue for examination under a microscope. She happens:

• puncture - the skin and underlying tissues of the mammary gland are pierced, suspicious contents are sucked out with a syringe;
• sectional - cut off a section of suspicious tissues. Most often, such a biopsy is performed during surgery on the mammary gland for cancer.

Cases have been described when a biopsy was performed in case of suspected development of breast fat necrosis, which did not confirm the diagnosis - however, fatty necrosis developed later as a result of the biopsy.

Medical manipulations that can provoke the development of the described pathology include any invasive therapeutic actions. It can be:

• suction of purulent contents from (recently practiced very rarely as a controversial and ineffective method of treatment);
• opening and emptying the purulent focus of this organ;
• removal of a fragment of the mammary gland due to a particular disease - necrosis, benign or malignant tumor, tuberculous focus, and so on;
• plastic surgery. Fat necrosis of the mammary gland can occur in women who, after a mastectomy (radical removal of the affected breast), underwent reconstructive mammoplasty (breast restoration) with their own tissues.

The development of iatrogenic fat necrosis is associated with:

• forced intraoperative traumatization of gland tissues - for example, when removing large sections of it, stopping bleeding with the help of diathermocoagulation (“cauterization” of the destroyed walls of blood vessels with electric current);
• gross inaccurate diagnostic or therapeutic manipulations, which is fraught with damage to the glandular tissue of the mammary gland, as well as its blood vessels and nerve endings.

Traumatic injury, not associated with medical procedures, is one of the most common causes of breast fat necrosis. According to the mechanism of development, such injuries are:

• torn;
• bruised;
• bitten;
• chipped;
• chopped;
• firearms.

By origin, such injuries that can lead to the development of fatty necrosis of the mammary gland are:

• household;
• production;
• sports.

Domestic injuries that can lead to the occurrence of the described disease can be facts of traumatization:

• unintentional;
• deliberate.

The most common form of injury to the mammary gland, which can lead to fatty necrosis of the mammary gland, is:

Prolonged compression of the gland is considered to be a special type of trauma to the tissues of the mammary gland, against which its fatty necrosis may develop. Most often it occurs during disasters:

• natural - these are soil collapses in the mountains, snow avalanches, suction in bogs, staying under fragments of buildings during earthquakes;
• man-made - mainly collapses due to powerful industrial explosions.

Also, prolonged compression of the mammary glands can be observed in traffic accidents, when people are trapped in a vehicle before the arrival of rescuers and doctors. Basically, this type of trauma is observed during:

• car or bus accident;
• train wreck.

Occupational injuries of the mammary gland, contributing to the development of its fatty necrosis, are less common than domestic ones. They are mainly associated with violation of labor protection rules (falling on slippery steps that lead to the office space) or ignoring safety regulations (improper care of large farm animals that can hit the mammary gland with a hoof or horn).

Sports injuries are most often observed in women who have chosen strength sports or those that are associated with the risk of falls. It:

• women's boxing;
• all kinds of wrestling;
• women's football;
• volleyball;
• basketball;
• tennis;
• running with obstacles

and others.

Rapid weight loss, against the background of which fat necrosis of the mammary gland can develop, can be observed with:

• severe diseases and pathological conditions;
• deliberate adherence to a strict diet aimed at quickly losing weight before any important event - a wedding, a beauty contest, sports competitions (especially of a high rank, where a certain weight is an important condition for participation).

Severe diseases and pathological conditions, against which rapid weight loss can occur, contributing to the development of fatty necrosis of the mammary gland, are:

• rapidly progressing oncological diseases (in particular, the defeat of their especially aggressive forms);
• - an infectious lesion caused by Mycobacterium tuberculosis (Koch's wand);
• - a violation of the metabolism of carbohydrates, provoked by a lack of insulin in the body;
• - intoxication (poisoning) of the body with hormones produced by its own thyroid gland;
• gross violation of the psycho-emotional sphere;
• insufficiency of the adrenal cortex (other names - Addison's syndrome, hypocorticism);
• - senile dementia;
• (Hodgkin's disease) - a malignant lesion of the lymphoid tissue;
• any chronic intoxication in which and are regularly observed.

Radiation exposure to breast tissue, which can lead to the development of fatty necrosis, is observed in such cases as:

• radiation therapy - in particular, the effect on malignant neoplasms of the mammary gland;
• frequent passage of diagnostic procedures fraught with radiation exposure (, fluoroscopy and others);
• contact with radioactive substances due to professional activity. It is fraught with pronounced radiation effects on the body in case of violation of labor protection rules or ignoring safety precautions (individual protective equipment);
• unauthorized access to radioactive substances.

A group of factors that are not direct provocateurs of the development of fatty necrosis of the mammary gland, but can contribute to the necrosis of its tissues, has also been identified. It does not mean that under the influence of such factors, the described pathology develops without fail - nevertheless, the risks should be taken into account. These are diseases and conditions such as:

• vascular pathology - because of it, microcirculation and nutrition of mammary gland tissues are disturbed;
• blood diseases - the consequences are the same as with vascular pathology;
• regular wearing of tight clothing.

Development of pathology

At the heart of the maximum majority of disorders that lead to the necrosis of breast tissue and the formation of areas of fatty necrosis is a violation of blood supply and, as a result, a sharp deterioration in the nutrition of these tissues.

The mechanism of development of pathology is as follows. Damage to the capillaries (traumatic or against the background of a particular disease) leads to a sharp violation of the blood supply to a separate area of ​​fatty tissue (therefore, fatty necrosis develops in the form of foci). The body reacts to such a process with reactive inflammation - at the initial stage it is aseptic (non-infectious). The mentioned inflammation develops in the damaged area with the formation of the so-called demarcation line around it - it separates the affected tissues from healthy ones.

After some time, dead tissues disintegrate, the decay products are removed from the mammary gland with the bloodstream. If there are many or large necrotic foci in the mammary gland, an abundance of decay products can provoke the onset of an intoxication syndrome.

Since defense mechanisms are activated, inflammation stops after a while. In the location where it arose, the process of fibrosis starts - connective tissue cells begin to develop, which finally displace dead foci and form a connective tissue scar.

note

Sometimes necrotic areas do not have time to disintegrate, and calcium salts are deposited in them - foci of petrification appear (. In some cases, this process is so intense that ossification (ossification) processes are triggered - a focus is formed in the mammary gland, in its structure and physical characteristics (density) resembling a piece of bone tissue.

In adverse cases, the progression of the described pathology of the mammary gland can take place with:

• with septic fusion of the focus;
• sequestration - the formation of cavities in place of dead tissue.

Symptoms of fatty necrosis of the breast

Since the formation of fat necrosis is preceded by a traumatic effect, the clinical picture begins to develop even before the formation of full-fledged necrotic foci.

Symptoms of fatty necrosis of the breast are:

• tumor formation;
• retraction of the nipple;
• pain syndrome;
• signs of a violation of the general condition of the body.

A tumor-like formation appears at the site of exposure of the pathogenic factor to the breast tissue. Its characteristics:

• in shape - round or ovoid (egg-shaped);
• by consistency - dense, at the same time elastic;
• by mobility - soldered to the skin, so its mobility is limited;
• by sensitivity - painful. In the future, with the formation of fat necrosis, pain may fade, and loss of sensitivity of soft tissues may also increase. Both processes are connected with the fact that in the process of necrosis the nerve endings also become dead;
• according to the characteristics of the integument - the skin over the tumor becomes cyanotic (bluish) or red, sometimes a combination of these two shades is possible.

Retraction of the nipple is observed if the focus of fatty necrosis is formed in the thickness of the mammary gland in the area of ​​the areola.

Characteristics of the pain syndrome:

Signs of deterioration in the general condition are associated with the ingress of necrotic elements into the bloodstream. These are the symptoms of the classic intoxication syndrome, namely:

• deterioration in general condition, feeling unwell;
• general weakness and lethargy;
• worsening sleep up to;
• deterioration of appetite, with the progression of pathology - its complete absence.

With fatty necrosis of the mammary gland, the temperature is usually normal and rises only in the presence of large foci of necrosis.

Diagnostics

The diagnosis of fatty necrosis of the mammary gland is made on the basis of complaints, anamnesis and the results of additional examination methods.

The physical examination determines the following:

• on examination - the affected mammary gland is enlarged, the tissues are swollen, the skin over the lesion is bluish or red;
• on palpation (palpation) - the swelling is confirmed, the soreness of the mammary gland is also determined. In the tissues, one or more foci of compaction are determined.

note

In some cases, there may be changes similar to signs - its deformation, the formation of "dimples" on the skin, a dense infiltrate, as well as an increase in peripheral lymph nodes.

In the diagnosis of fatty necrosis of the mammary gland, such research methods are used as:

• - a set of methods that are used specifically to study the state of the mammary gland;
• mammary gland - make tissue sampling with subsequent study under a microscope.

During a mammogram, the following are used:

• x-ray mammography;
• ultrasound mammography - helps to identify areas of necrosis, assess their size, quantity, as well as the condition of surrounding tissues;
• tomosynthesis is the creation of a two-dimensional image of the mammary gland with all the changes in its tissues;
• MRI mammography is a high-tech method for obtaining a tomographic image of the breast;
• optical mammography - when it is carried out, optical equipment is used.

Informative in the diagnosis of fatty necrosis of the mammary gland are the following laboratory research methods:

Probably everyone knows that the tissue on the female breast is very delicate and in no case should it be injured (blows, bruises). Every woman must know that her mammary glands must be protected from tight underwear, protected in large crowds of people and try to avoid any damage. And all because the ladies' breasts are very sensitive and soft tissues, which, with a slight physiological impact, can change their structure. The female breast is prone to similar painful processes like mastitis, fibroadenoma, mastopathy and papillomas. And it may appear fatty necrosis of the mammary gland.

The reasons

Fatty necrosis of the mammary gland in which the death of living cells occurs and subsequently their replacement with scar tissue. Also, fat necrosis is also called oleogranuloma (which is usually caused by a chest injury), lipogranuloma and steatogranuloma. These lumps are usually painless and are most common in overweight middle-aged women who have large breasts.
Sports training and unintentional impacts can cause fat necrosis of the breast. Very rarely, necrosis may occur after breast plastic surgery or mastectomy.

Symptoms

The first sign is considered an unhealthy swelling caused by damage to the breast, which can be soldered to the skin. By consistency, it can be solid and have a spherical shape. Over time, damaged breast tissue loses sensation. The breast can change its color, from bluish to red, sometimes even the nipple can be pulled inward. Very often, such symptoms resemble mastitis, but as a rule, with mastitis, there is a strong increase in temperature, and with fatty necrosis of the breast it is not.

Diagnostics

On ultrasound of the mammary glands, computed tomography or magnetic resonance imaging, formations of an inhomogeneous and nodular nature are detected, which have no clear contours. At the first examination, these formations can be taken as the first signs of breast cancer. But once the focus of necrosis begins to calcify (eggshell-like roundness appears), the risk of cancer symptoms is reduced to nothing.

It is very important to tell your doctor about recent chest injuries. A mammologist by palpation can determine a seal that does not have distinct contours.

Treatment and prevention

Fat necrosis cannot be cured, it can only be dealt with in an operable way. During the operation, a necrotic area is removed and, without fail, this fragment is subjected to a histological examination to determine whether breast cancer has developed.
For the purposes of prevention, a woman should avoid any injuries to the mammary gland, and if they do happen, then you should immediately contact a mammologist.

Fatty necrosis of the breast necrosis of an area of ​​adipose tissue of the mammary gland with its subsequent replacement with scar tissue occurs due to impaired blood circulation in this area.

The mammary gland consists of glandular tissue and adipose tissue, there are also layers of dense connective tissue that divide the gland into lobes. Each mammary gland consists of 15 - 20 lobes, which in turn are divided into smaller lobules. The space between the lobules is filled with adipose tissue. In addition, adipose tissue is present at the base of the gland, which forms a kind of cushion. The shape and volume of the mammary glands depend on the amount of adipose tissue. The defeat of adipose tissue leads not only to a cosmetic defect, but is also accompanied by a violation of the functions of the mammary glands.

The most common cause of the development of fatty necrosis of the mammary gland is an injury that occurs as a result of a blow, compression, fall, excessive massaging. Breast injuries are more common in women involved in sports, where the risk of injury is significantly increased compared to everyday life, as well as in women with macromastia (large breast size). In addition, the development of the disease is possible due to the transferred infectious process, surgical intervention, for example, reconstructive mammoplasty, subcutaneous administration of drugs, sudden weight loss, hormonal disorders.

It is important to notice signs of fatty necrosis at an early stage in time and immediately contact a mammologist for a detailed diagnosis. Relapses of the disease do not develop in the case of high-quality removal of dead tissue. A reoccurrence of fat necrosis can only occur with repeated trauma. Tissue necrosis is an irreversible process, therefore, necrotic tissues will never recover. With a favorable outcome, dead tissue is replaced by connective tissue. With an unfavorable outcome, purulent inflammation develops.

Symptoms

Trauma is a common cause of breast fat necrosis. A painful induration appears at the site of impact. This formation is soldered to the skin, has a dense texture, has no clear boundaries. The skin over the altered area becomes hot to the touch, the color becomes bluish or red. With the spread of the process, the deformation of the mammary gland occurs, retractions appear. In the case of a long course of the disease, the necrotic adipose tissue is replaced by scar tissue (connective tissue). This process is accompanied by a decrease in soreness, as well as a pronounced persistent deformation of the mammary gland. In rare cases, axillary lymph nodes increase due to the development of an inflammatory process in them. The general condition of a woman usually does not suffer, only in severe cases of the disease, when septic melting of the foci occurs, there is an increase in body temperature, chills, and the appearance of general weakness. In the advanced stage, the formation of cracks and ulcers with purulent discharge is possible.

Diagnostics

Every woman should be examined by a gynecologist twice a year. At the appointment, the doctor feels the mammary glands for prophylactic purposes. If a suspicious formation is found in the mammary gland, the gynecologist writes a referral to the mammologist for further examination. With fatty necrosis, a formation with fuzzy contours is palpated, bringing pain to the patient. In the future, it is possible to prescribe ultrasound of the mammary glands, however, it should be noted that this research method will not help in verifying the diagnosis, so the rationality of its use remains in question. In addition, the doctor may prescribe the following studies: review mammography, CT, MRI. These studies will also not show specific features that are unique to fat necrosis. Considering that a nodular formation with a heterogeneous structure raises suspicions not only regarding the disease in question, but also such a formidable one as breast cancer, a breast biopsy is indicated. A biopsy is necessary for further cytological and histological examination, which will help in establishing the diagnosis. The study is recommended to be carried out under X-ray or ultrasound control.

Treatment

Unfortunately, it is impossible to get rid of the problem with the help of drugs, since they are not able to save a woman from the most altered area of ​​\u200b\u200bthe breast. Therefore, the treatment uses surgical intervention, which consists in a sectoral resection of the mammary gland, that is, the area of ​​\u200b\u200bthe mammary gland that is affected by fatty necrosis is removed. After removal, this area is sent for histological examination to exclude malignant cells. When the process is sufficiently started, it is necessary to resort to the removal of the entire mammary gland. Currently, this phenomenon is rare, since every year women undergo preventive examinations, during which it is possible to detect the process at an early stage. A running process is observed if a woman ignored trips to a gynecologist, and also did not seek help from a doctor after she discovered symptoms characteristic of this disease.

Given that the disease proceeds with pain, it is possible to use painkillers to eliminate this phenomenon.

In the future, you should be more careful about your health and avoid traumatic factors. If, nevertheless, an injury has occurred, it is recommended to give the mammary gland an elevated position with a bandage. After that, it is necessary to monitor the condition of the injured mammary gland and, in case of symptoms characteristic of the disease, immediately consult a doctor for help.

Medications

In the treatment of fatty necrosis of the mammary gland, drugs are practically not used, since they are not able to eliminate the problem of the disease itself. And they are appointed to relieve pain, which is a frequent companion of the disease. Of the painkillers, you can use analgin, nimesulide, ketorolac. These drugs are prescribed mainly in the form of tablets, with severe pain that does not go away after taking an anesthetic tablet, injections are prescribed. The most effective drug from this group, which has the most pronounced analgesic effect, is ketorolac. It is important to know that these funds are not recommended for long-term use. In most cases, they are used no more than 5 days.

In the clinic of the disease, there may be an increase in temperature. In such cases, drugs with antipyretic effect, such as ibuprofen, are prescribed. It is worth noting that medicines should be used only when the temperature rises above 38 ° C, until this period our body is able to cope with its condition itself.

Folk remedies

To prevent the development of fat necrosis, it is necessary to protect yourself from injuries, since they are considered the most common cause of the development of the disease. In addition, it is extremely important to conduct an independent examination of the mammary glands. Every woman should be able to perform this procedure, but this does not mean that if you follow a regular self-examination, you can neglect going to a gynecologist. The specialist will assess the condition of the mammary glands with the greatest accuracy and, if necessary, appoint studies to confirm his doubts.

The following steps must be followed for the survey:

1. Stand in front of a mirror with your arms extended along your torso. Check if both mammary glands are the same in size, shape, appearance, if there are any differences among them. Any changes, for example, redness of the skin, the presence of retractions or wrinkling, discharge from the nipple should alert and become a reason to go to the doctor;
2. Repeat the same steps, but with your arms raised above your head.
3. Put your hands on your belt, then alternately tighten and relax the muscles of the anterior chest several times. With these actions, continue to monitor the condition of the mammary glands;
4. Alternately, on both mammary glands, pinch the nipples between the thumb and forefinger. During these actions, attention should be paid to the presence of discharge from the nipple, if any, it is necessary to note the nature of the discharge;
5. Lie on your back and relax. With the pads of 2-4 fingers brought together, alternately feel the right and left glands. The right gland is felt with the left hand and vice versa. Feeling is done in a circle. Identification of areas of compaction or vice versa softening, pain when palpated indicates the development of a process that is not characteristic of the normal state of the mammary gland;
6. Repeat the feeling in a standing position.

All these actions do not cause difficulties in performing, so every woman should find the time and opportunity to examine the mammary glands.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.