Diffuse mastopathy - dyshormonal dysplasia, characterized by a diffuse change in the structure of the mammary glands, a violation of the normal ratio of epithelial and connective tissue components. The manifestations of diffuse mastopathy include mastalgia in the second half of the menstrual cycle, swelling and hardening of the gland tissue, colostrum-like nipple discharge. Diagnostics of the diffuse form of mastopathy includes examination of the mammary glands by a mammologist, ultrasound of the glands and mammography. Treatment of diffuse mastopathy is conservative, including hormonal and non-hormonal drug therapy, physiotherapy.
Causes of diffuse mastopathy
Diffuse mastopathy is a polyetiological pathology associated with heredity, environmental factors, lifestyle, endogenous causes. Disruption of neurohumoral regulation, hyperestrogenism and progesterone deficiency is the leading pathogenetic link in the development of diffuse mastopathy. Predisposition to the development of diffuse mastopathy may be due to hereditary mechanisms, primarily the presence of diseases of the mammary glands in close relatives on the maternal line. The presence in the life of a woman of frustrating situations (dissatisfaction with intimate life, family or social situation, conflict situations in everyday life and at work, mental stress) can cause various functional disturbances in the functioning of the neuroendocrine system.
Among reproductive factors, the development of diffuse mastopathy can be promoted by the absence of pregnancies and childbirth, abortions, late pregnancy, various female diseases (adnexitis, oophoritis, ovarian dysfunction), treatment of infertility, etc. The postponed mastitis, chest injuries (milk contusion) negatively affect the subsequent state of the mammary glands. glands), refusal of breastfeeding or a short period of lactation. It is known that in women who have undergone an artificial interruption of pregnancy three times or more, the probability of developing diffuse and nodular mastopathy increases 7.2 times. There is a relationship of increased risk of diffuse mastopathy with early onset of menstruation and their late cessation.
Among extragenital factors, hypothyroidism plays the primary role, in which the risk of diffuse mastopathy increases by 3.8 times. Adverse events, diabetes mellitus, arterial hypertension, hepatitis, cholecystitis, cholangitis, diseases of the adrenal glands, etc., also serve as unfavorable moments. Addiction to smoking and alcohol, ionizing radiation, sunbathing on the beach or in a tanning room topless, unsuccessful environment, are associated with an increased risk of developing diffuse mastopathy. . The protective factors that reduce the likelihood of diffuse mastopathy include early labor (20–25), two or more births with a full lactation period, and oral contraceptive use.
Classification of diffuse mastopathy
In accordance with the clinical x-ray-morphological changes in the tissues of the mammary glands, among the forms of diffuse mastopathy are:
- adenosis, or diffuse mastopathy with a predominant glandular component
- fibroadenomatosis, or diffuse mastopathy with a predominant fibrous component
- diffuse mastopathy with a predominant cystic component
- mixed fibrocystic form of diffuse mastopathy
- sclerosing form of adenosis
When determining one or another clinical variant, one proceeds from the ratio of the connective tissue, glandular and fatty components on mammograms.
According to the degree of the changes, there is a slightly pronounced, moderate and pronounced diffuse mastopathy.
Symptoms of diffuse mastopathy
Manifestations of diffuse mastopathy are closely associated with the change of phases of the menstrual cycle. The leading complaint is the pain in the mammary glands (mastalgia), which occurs in the middle or second half of the cycle. The nature of the pain can be whining, piercing, arching, radiating to the neck, shoulder, hypochondrium or back. Swelling and uniform compaction of the mammary gland tissues are noted, and small granular structures are palpable during palpation. When pressed on the nipple from it appear transparent or colostrum-like discharge, the intensity of which also increases in the premenstrual period.
After the onset of menstrual pain gradually subsides, the seals become less painful, and then disappear for a while. In the late stages of diffuse mastopathy, the compaction and soreness in the glands remain independent of the phases of the menstrual cycle. The pain can even be caused by a light touch on the mammary glands. Due to the severity of mastalgia, women often develop cancerophobia, sleep is disturbed, and anxiety and nervousness appear.
The presence of hyperestrogenism and progesterone deficiency in diffuse mastopathy may be accompanied by delayed menstruation, marked premenstrual syndrome, algomenorrhea, oligomenorrhea or menorrhagia (heavy menstruation), anovulation. Often, on the background of diffuse mastopathy, fibroids of the uterus, ovarian cysts, endometriosis, and endometrial hyperplasia are detected. Many women with diffuse mastopathy also note increased dryness of the skin, brittle hair and nails.
Diagnosis of diffuse mastopathy
The diagnosis of diffuse mastopathy is based on the results of an examination of the mammary glands by a mammologist, an ultrasound scan, a mammographic examination, laboratory tests, and, if indicated, an MRI of the mammary glands and a biopsy.
External changes of the mammary glands in diffuse mastopathy are not detected. Palpation is determined by various length and size, without clear boundaries, painful seals with a granular or lobed surface. Seals with diffuse mastopathy often localized in the upper-outer quadrants of the glands.
A typical echographic picture of diffuse mastopathy, determined by ultrasound of the mammary glands, is characterized by thickening of the glandular tissue, fibrous changes of the duct walls and interlobular septa, a change in the echo density of the glandular tissue, multiple cysts, ductectasia, and mismatch of the type of gland structure with age.
Survey radiography (mammography) with diffuse mastopathy reveals heterogeneity of the tissue of the glands with small foci of compaction or cystic formations, dense tightness. Conducting mammography eliminates the presence of tumors in the gland and determine the form of mastopathy.
The presence of discharge from the nipples with diffuse mastopathy may dictate the need for ductography, usually revealing the deformity of the milky ducts and various cyst sizes. The study of a nipple smear allows differentiation of diffuse mastopathy from specific lesions - mammary actinomycosis, tuberculosis, and breast syphilis.
In cases of concomitant extragenital and genital background, a study of thyroid hormones and sex hormones, liver enzymes, a gynecologist-endocrinologist, pelvic ultrasound, is prescribed.
With doubtful data from previous diagnostics, MRI, breast biopsy under ultrasound control with cytological examination of the biopsy specimen, and CA 15 - 3 in blood are used.
Treatment of diffuse mastopathy
With diffuse mastopathy, conservative tactics and dynamic observation are indicated. It is recommended to change the diet with the inclusion of a large amount of plant fiber and dairy products, limiting animal fats. If the patient has intestinal dysbiosis, which interferes with the absorption of vitamins and trace elements, treatment by a gastroenterologist is necessary. The purpose of vitamin-mineral complexes, potassium iodide, dietary supplements, homeopathy, herbal remedies, adaptogens is shown. Diuretic, sedative, enzymatic drugs are prescribed from non-hormonal therapy.
With diffuse mastopathy, it is advisable to increase physical activity, exercise therapy, psychotherapy. Among physiotherapeutic procedures, it is possible to use laser therapy, magnetic therapy, galvanization, electrophoresis, balneotherapy (climatotherapy, mud therapy, clay therapy, mineral and sea therapeutic baths, etc.). It is important that with diffuse mastopathy, any procedures and applications should be performed in a cold or slightly warm form.
Regulatory hormone therapy for diffuse mastopathy is aimed at eliminating hormonal disorders and may include the appointment of gestagens (progesterone, didrogesterone, etc.), thyroid hormones, and rational selection of contraception. To reduce pain and stress in the mammary glands, topically applied gel with progesterone is used.
Prevention and recommendations for diffuse mastopathy
Passing periodic examinations by a mammologist with a set of instrumental studies is the key to successful prevention and early detection of diffuse mastopathy. Timely treatment of gynecological pathology and associated extragenital diseases is necessary.
It is important to regularly conduct self-examination of the mammary glands, in which special attention should be paid to the change in the shape of the breast, the appearance of pain and induration, discharge from the nipples, spots on the skin of the breast. It is recommended that the correct selection of a bra that does not compress the breast, the protection of the mammary glands from injuries, pressure, and impacts. During lactation, nipple cracks, lactostasis and mastitis should be avoided. For the prevention of diffuse mastopathy, it is necessary to apply modern methods of contraception and prevent abortions.
The presence of diffuse mastopathy is a contraindication to conduct an increase mammoplasty, visiting saunas, baths, the use of hot compresses on the chest and local wraps, sunburn both in the solarium and in the sun.
Signs of diffuse fibrocystic mastopathy
This pathological condition is the proliferation of epithelial and connective tissue. This process is characterized by seals in the mammary glands (for more information on what diffuse fibrocystic mastopathy is, you can find out here).
During the period of active development of this form of mastitis, the woman has the following symptoms:
- discomfort in the mammary glands. The pain usually worsens during the critical days period. Discomfort can give to the neck, shoulder, shoulder, hypochondrium. After menstruation, the pain goes away until the next cycle. As for the advanced stage of the disease, the woman feels discomfort constantly, regardless of the menstrual cycle.
- Seals in the mammary glands. When probing the chest, small granular seals are felt.
- Discharge of fluid from the nipples. This symptom is observed when pressing on the nipple. From it flows a clear liquid. Before menstruation, it stands out without affecting the nipple.
If the liquid changes its color, becomes yellowish or greenish, this indicates the development of the inflammatory process. This symptom requires an immediate appeal to a specialist for help.
More details about the symptoms of fibrocystic mastopathy with a predominance of the cystic component can be found in our article.
The mammary glands and organs of the urogenital system in women are interrelated. Therefore, with the development of fibrocystic mastopathy, a cyst can appear in the ovaries.
Also, the results of tests of women with such a diagnosis indicate a hormonal hormone disorder: the level of estrogen rises, an insufficient amount of progesterone is observed. This entails a violation of the menstrual cycle.
Fibrous cystic mastopathy: symptoms
Causes of the disease
There are many reasons that contribute to the development of this pathological condition. These are:
- genetic predisposition to the disease. If a woman in the family had cases of the appearance of this pathology, then there is a risk of its development in the future.
- Gynecological diseases. Diseases of the ovaries and other female organs negatively affect the state of the mammary glands.
- Improper functioning of the thyroid gland. Abortion and late pregnancy can lead to such a violation. Also, women who have not given birth are at risk of detecting this disease.
- Early puberty or late onset of menopause.
- Obesity. Excessive body weight contributes to an increase in estrogen in the body.
- Irregular sex life. Prolonged abstinence violates the hormonal balance, which is the impetus for the development of this form of mastitis.
- Emotional shocks. Regular stressful situations lead to an unstable psycho-emotional state. This is the most common cause of this disease.
- Inflammatory processes in the organs of the urogenital system.
Also a prerequisite for the development of fibrocystic mastopathy can be various injuries of the mammary glands.
How dangerous is this breast pathology?
Despite the fact that diffuse fibrocystic mastopathy is benign in nature, its active development without proper treatment may entail such dangerous consequences:
- breast deformation, there is visual asymmetry of the mammary glands,
- inflammatory processes with the subsequent decay of pathological seals,
- conversion of benign neoplasms to malignant,
- violation of the integrity of tumors, their gap.
For information on whether bilateral fibrocystic mastopathy is dangerous for women, read this article.
The choice of treatment method should be made by the woman together with the attending physician who will take into account the severity of the disease and the patient's condition.
Mechanism of disease development
Adequate functioning of the mammary glands depends on the correct ratio of estrogen and progesterone in the tissues. The increase in estrogen levels is due to insufficient synthesis of progesterone in the second phase of the menstrual cycle. A certain role in the development of diffuse mastopathy is played by an increased level of prolactin (in the absence of pregnancy, lactation). This hormone stimulates the proliferation of mammary cells and an increase in the number of estrogen receptors.
Diffuse form of mastopathy is the initial stage of the disease, it precedes the nodular form. The woman has proliferation of connective tissue in the lobules of the mammary glands, as well as an increase in the amount of epithelial tissue in the ducts. There is a blockage of the ducts, but at the same time alveolar secretion is preserved, as a result of which cysts appear. With the progression of the disease, knots are formed, the size of which can be walnut.
Patients with a diffuse form of the disease are observed by general practitioners, gynecologists, surgeons, oncologists, they are prescribed a comprehensive drug therapy, patients with a nodular form are observed by oncologists, the main treatment method is surgical (followed by drug therapy).
One of the main questions that women with mastopathy are asking is - can their disease develop into cancer? Directly - it cannot, but these pathologies have similar hormonal and metabolic disorders, the same risk factors. Often these diseases are combined. In 46% of cases, breast cancer occurs on the background of benign tumors. The risk of developing oncology against mastopathy varies from 1 to 31% depending on the degree of proliferation (growth) of the glandular epithelium.
Forms of the disease
To better understand what diffuse mastopathy is, the classification of its forms helps. In terms of morphological changes in the tissues, this pathology is divided into:
- Adenosis is the proliferation of glandular breast tissue, occurs in women 30-40 years old.
- Fibroadenomatosis, a change in fibrous tissue around the lobules, is diagnosed before menopause.
- Sclerosing adenosis - enhanced formation of fibrous tissue and glandular cells in the breast lobules while maintaining their configuration, is found in 5% of women 20-40 years old.
- Fibrocystic is the appearance of multiple cystic formations with elastic capsules, in 60% of cases this form is detected in women after the onset of menopause.
- Mixed fibrocystic mastopathy - the presence of different components of connective tissue, the most complex form of the disease.
To assess the specific form of mastopathy allows the assessment of the ratio of connective tissue, glandular and fatty elements on mammograms. По степени выраженности изменений в тканях патология подразделяется умеренную, выраженную, резко выраженную формы.
Causes of pathology
Diffuse breast mastopathy is a polietiologic disease, that is, its occurrence is due to a combination of factors. The leading role in the development of the disease belongs to impaired neurohumoral regulation, elevated estrogen levels, and progesterone deficiency. The risk of developing pathology increases:
- hereditary factors: the presence of breast diseases in close relatives in the mother line),
- stresses, nervous shocks,
- reproductive factors: lack of pregnancy or late childbirth, multiple abortions (more than 3), refusal to breastfeed or short lactation, diseases of the female genital organs, treatment of infertility,
- diseases (mastitis), chest injuries,
- earlier onset of menstruation (up to 11 years) or late menopause (after 55 years), pronounced premenstrual syndrome,
- diseases of the endocrine system, gastrointestinal tract: hypothyroidism, diabetes mellitus, obesity, hepatitis, cholecystitis, adrenal pathologies,
- high blood pressure
- bad habits: smoking, alcoholism,
- exposure to environmental factors: radiation, direct sunlight, poor ecology.
Early births (up to 25 years), oral contraceptives, 2 or more births with a full lactation period contribute to a reduction in the risk of mastopathy.
Symptoms of the disease
Signs of diffuse mastopathy are most pronounced in the second phase of the menstrual cycle, during this period a woman has pain in the mammary glands. It can be aching, bursting or piercing, sometimes the pain spreads to the shoulder, neck and back areas. In some cases, lymph nodes are involved in the pathological process.
Breast tissue swells and evenly compacted, with a palpation, the doctor finds a granular formation. When pressed on the nipple may appear transparent or colostrum-like discharge (their intensity increases before menstruation).
In the first half of the cycle with diffuse mastopathy, the symptoms become less pronounced, the seals may disappear for a while, and at the late stage of the pathology, the soreness and seals remain regardless of the phase of the menstrual cycle. The pain occurs even with a light touch, which often becomes the cause of nervousness and carcinophobia.
With increased levels of estrogen and progesterone deficiency, severe PMS, delayed menstruation, heavy menstruation, and lack of ovulation may occur. On the background of mastopathy, fibroids, endometriosis, ovarian cysts develop, brittle hair, nails, and dry skin are noted.
Examination by a mammologist begins with a visual assessment of the state of the breast. When diffuse breast mastopathy external changes are not detected. In the process of palpation, painful lobed or granular consolidations are found without clear boundaries. They can be of different shapes and sizes, their localization is mainly in the upper outer parts of the breast.
The main instrumental method of investigation is ultrasound. When echographic examination revealed thickening of glandular tissue, cysts, structural changes in the walls of the ducts and partitions between the lobules, dilatation of the ducts, inconsistencies in the structure of tissues with the patient's age.
The second most popular method of research is mammography (X-ray). The pictures show cysts and pockets of compaction in the tissues, cords. Mammography allows you to accurately determine the form of mastopathy and identify tumors in the affected organ.
In the presence of discharge from the nipples woman held:
- Ductography - X-ray examination of the ducts of the mammary glands using a contrast agent. In patients with mastopathy, ductal deformities and cysts are detected in the pictures.
- The study smear from the nipple. The analysis allows to exclude tuberculosis, syphilis, actinomycosis in the patient.
If the patient has endocrine or gynecological diseases, as well as gastrointestinal tract pathologies, then liver enzymes, thyroid hormones, and sex hormones are examined. It is recommended to visit the gynecologist-endocrinologist and make an ultrasound of the pelvic organs.
If the studies performed are not sufficient for diagnosis and prescription of therapy, then blood CA15-3 is determined, MRI and breast biopsy are performed, followed by cytological examination of the obtained tissues.
The main methods of treatment
The treatment regimen is selected for each patient individually. At the initial stage of the disease, it is enough to adjust the lifestyle and use of local means; in more advanced cases, complex therapy is carried out. After completion of treatment, dynamic observation of the patient's condition is shown.
A set of measures related to lifestyle adjustment includes:
- Dieting. A woman needs to reduce the amount of consumed fats, tea, coffee, cocoa, enrich the diet with dairy products, fruits, vegetables, fiber and foods rich in iodine. If the patient has diseases that prevent the normal absorption of vitamins and minerals (for example, dysbiosis), then she needs to undergo a course of treatment by a gastroenterologist.
- Wearing a comfortable bra. Lingerie must match the size of the breast.
- Refusal of bad habits: smoking, alcohol.
- Avoiding nervous shocks, stresses.
- Increased physical activity, physical therapy, physical therapy (electrophoresis, magnetic therapy, laser therapy), balneotherapy (mud and clay therapy, sea baths).
Drug therapy is carried out using local remedies that reduce symptoms of the disease (Prozhestogel, Mastofit), as well as oral medications. Comprehensive treatment includes:
- Hormone therapy. This is the basis of treatment, since the main reason for the development of mastopathy is hormonal imbalance. The patient is prescribed progesterone drugs (Utrozhestan, Duphaston), oral contraceptives, thyroid hormones.
- Anti-inflammatory therapy (if mastopathy is complicated by tissue inflammation). It involves the use of nonsteroidal drugs - Ketorol, Diclofenac.
- Acceptance of enzymes, sedatives and diuretics, use of drugs to improve immunity, as well as potassium iodide, vitamin-mineral complexes.
For the treatment of mastopathy, widely used dietary supplements, herbal remedies (Mastodion, Fitolon), traditional medicine.
Herbal teas (burdock, mint, red brush, valerian), lotions and compresses are especially popular, but they can only be used as an aid in complex treatment; the use of folk remedies instead of conservative therapy is unacceptable.
Causes of diffuse mastopathy
This disease is polyetiological, that is, it develops under the influence of a complex of factors. Among them are some diseases, genetic predisposition, lifestyle, reproductive characteristics of the body, unfavorable environmental conditions.
But the physiological cause of diffuse mastopathy always lies in a hormonal imbalance - an excess of estrogen and prolactin and progesterone deficiency.
Reproductive risk factors include:
- lack of pregnancy and childbirth, infertility,
- late first childbirth (after 30-35 years),
- rejection of breastfeeding or short duration,
- early onset of menstruation (up to 12 years),
- genital pathology (ovarian dysfunction, adnexitis, oophoritis, and others).
The development of diffuse fibrocystic mastopathy of the mammary glands is affected by hypothyroidism - insufficient production of thyroid hormones by the thyroid gland. Adverse factors are obesity, adrenal gland diseases, hepatitis, diabetes, cholecystitis.
The risk increases with the abuse of smoking and alcohol, tanning topless in the solarium and in the sun, as well as chronic stress, poor nutrition, lack of regular sex life.
Signs of diffuse mastopathy
The main symptom is breast tenderness (mastalgia) that occurs in the second half of the cycle. The pain is aching, arching, sometimes piercing, and can extend to the armpits, shoulder, back, neck, and hypochondrium.
Her chest swells, her tissues are compacted evenly, and small grains are felt during palpation. These signs of diffuse cystic mastopathy decrease after the onset of menstruation and disappear in the first half of the cycle only in the early stages of the development of the disease.
In the later stages of mastalgia is always present.
Hormonal imbalances (high estrogen and prolactin levels and progesterone deficiency) also lead to the following symptoms:
- delay of menstruation,
- painful and heavy menstruation or lack thereof
- pronounced symptoms of PMS (drowsiness, irritability, tearfulness),
- brittle and dull hair, dry skin.
Less commonly, with diffuse mastopathy, a whitish, greyish-green liquid or mixed with blood is secreted from the nipples.
Classification of diffuse type mastopathy
Depending on the nature of changes in breast tissue, such types of dyshormonal hyperplasia are distinguished:
- diffuse glandular mastopathy,
- sclerosing is the most oncological form with the deposition of calcium salts (calcinates) in tissues.
Diffuse fibrous breast mastopathy is more commonly detected in young patients and during puberty. Cystic form is common among women of menopausal age.
According to the degree of tissue change, dysplasia of the mammary gland is mild, moderate and pronounced.
Diagnostic methods for the determination of diffuse mastopathy:
- Examination of the mammary glands and their palpation, revealing painful to the touch seals without clear boundaries.
- Mammography - determines the form of the disease and the presence or absence of malignant elements.
- Ultrasound examination shows an increase in the glandular tissue echo-density, fibrous changes in the structure of the lobular septa and duct walls.
- Ductography - is carried out with discharge from the nipples, reveals the deformation of the milky ducts.
- The analysis of a nipple smear is needed to exclude pathologies similar in signs to dysplasia of the mammary glands (actinomycosis, syphilis or breast tuberculosis).
Additional diagnostics of diffuse mastopathy includes the analysis of sex and thyroid hormones, biopsy and MRI of the mammary glands, taking a liver test, blood test for tumor markers, ultrasound of the pelvic organs.
General description of the disease
What is diffuse mastopathy and how dangerous is it? This disease is considered as the initial stage of negative changes in the mammary gland. It is characterized by an uneven growth of connective fibers, which have the form of not fully formed nodules and cords. These negative processes violate the structure of the lobules and ducts of the mammary glands, accompanied by the formation of small cysts. With certain factors, this glandular mastopathy can turn into a nodular form, which is manifested by the presence of foci of seals. This process is considered to be one that promotes the development of breast cancer.
Cystic formations characteristic of diffuse mastopathy have the ability to change in some way during the menstrual cycle. This is due to the hormonal background of the woman, which is characterized by instability. Cysts can be single or multiple, with a dense shell or filled with fluid. Education data is benign, but there is always a risk of their rebirth. Therefore, doctors closely monitor the condition of women with diffuse breast mastopathy.
Depending on the type of pathological changes in the breast tissue, diffuse fibrocystic mastopathy is divided into the following types:
- adenosis. This type is called fibrocystic mastopathy with a predominance of the glandular component,
- fibroadenomatosis. This is the so-called diffuse mastopathy with a predominance of the fibrous component,
- diffuse cystic mastopathy, where cystic tissue prevails,
- diffuse fibrous mastopathy of the mixed mammary glands,
- sclerosing form.
Determination of a specific form of mastopathy is carried out on the basis of a diagnostic study. On a mammogram, the doctor determines the amount and ratio of glandular, cystic, adipose and other tissues. Also, the results of the study allow to determine the degree of FCM - slightly pronounced, moderate, pronounced.
Causes of disease
The causes of fibrocystic mastopathy are the following negative factors:
- a history of gynecological diseases such as adnexitis, tumors of the reproductive organs, polycystic ovaries,
- artificial interruption of pregnancy. Increases the risk of developing this disease by 7 times,
- dissatisfaction in sexual life,
- late first childbirth (after 30-35 years),
- long-term use of drugs that affect the hormones of a woman,
- pathological conditions that disrupt the normal functioning of the thyroid gland or adrenal glands,
- long stay in a stressful condition, a physical and emotional overstrain,
- breast injury (including improper laundry),
- bad habits (alcohol use, smoking),
- hereditary factors (the disease is often transmitted through the maternal line),
- complete rejection of breastfeeding or a very short lactation period,
- earlier or later puberty,
- the risk of developing this form of mastopathy is significantly increased in the presence of other associated diseases - diabetes, hypertension, hepatitis, cholecystitis, cholangitis and others,
- Excessive exposure to infrared radiation when topless is set on the beach or in a solarium,
- negative environmental effects - ionizing radiation, unfavorable environmental conditions.
Signs of disease
Signs of diffuse fibrocystic forms of mastopathy:
- the occurrence in the middle of the cycle and immediately before menstruation chest pain. At the same time, there is a feeling of heaviness, distention, which is explained by the stagnation of lymph in the tissues. Also, many women report symptoms such as stitching in the breast, discomfort that occurs in the neck, back, or hypochondrium,
- swelling of the breast tissue. It can be uniform or, on the contrary, on palpation, characteristic foci with seals will be detected,
- the presence of clear or colostrum-like nipple discharge. They are mainly detected before menstruation. On other days of the menstrual cycle, the intensity of the discharge is much lower.
Depending on the associated diseases, bilateral diffuse mastopathy or other forms of it may be accompanied by menstrual irregularities. Such women often have amenorrhea, too abundant or, on the contrary, scanty monthly discharge. Patients may complain of the presence of premenstrual syndrome.
With careful diagnosis of women with diffuse cystic mastopathy, uterine fibroids, endometriosis, ovarian cysts and other diseases of the reproductive system are often detected. Also, complaints about dryness and brittleness of hair, nails, and unsatisfactory condition of the skin are frequent.
Diagnosis of the disease
In cystic mastopathy, doctors prescribe a comprehensive study that allows you to determine the nature of the problem with great accuracy. It includes:
- visual inspection. Externally, the affected breast may be no different from completely healthy. On palpation, certain formations are clearly defined. They can have a different size, character (granular, lobed surface), without clear boundaries. Most often, any neoplasm is located in the upper-outer part of the breast,
- Ultrasound of the mammary glands. Depending on the form of the disease, this study allows to identify foci of glandular tissue thickening, any fibrous changes, the presence of cysts. Also, as a result of ultrasound diagnostics, it is rather easy to identify any negative processes that occur in the mammary gland,
- mammography or general radiography. This is the main study that is assigned to women to determine the state of the mammary glands. Allows to reveal the small centers of consolidation, cystic educations. Using this diagnostic technique, it is easy to make a conclusion about the form of mastopathy that a woman has, to exclude cancer and to determine the presence of any tumors,
- ductography. Shown in the presence of any discharge from the mammary glands, which do not belong to the period of lactation. This x-ray contrast study of the ducts. Using this technique, it is easy to identify the location and size of tumors or cysts,
- examination of the contents of the nipple discharge. Allows differentiation of mastopathy from other diseases with similar symptoms (tuberculosis or syphilis of the mammary glands, actinomycosis, and others).
If you suspect the presence of comorbidities, a comprehensive examination of the thyroid gland, adrenal glands, and pelvic organs is prescribed. Consultation of other specialists - a gynecologist, a gastroenterologist, an endocrinologist is also shown.Sometimes in the presence of doubtful results, studies resort to additional diagnostic methods - MRI, biopsy with cytological analysis.
Treatment of the disease
How best to treat diffuse mastopathy to get a positive result? It all depends on the degree of development of the pathology, the presence of concomitant diseases, the age of the woman. It is possible to cure diffuse cystic mastopathy in a conservative way with the help of drugs of both hormonal and non-hormonal type.
Doctors most often prescribe:
- vitamin therapy. Diffuse mastopathy is treated with vitamins such as A, E, C, group B. These drugs are prescribed for a long time,
- homeopathic remedies
- painkillers. Appointed when pain is strongly pronounced and cause significant discomfort for the woman (especially if there are serious changes in the mammary glands),
- iodine-containing remedies - to eliminate iodine deficiency, improve the thyroid gland,
- Herbal preparations, which have a positive effect on the female reproductive system, with a sedative effect, help to treat diffuse mastopathy,
- sometimes anti-edematous, anti-inflammatory drugs,
- hormone therapy. In cystic mastopathy, treatment with this group of drugs is indicated only after a thorough study. It should show the presence of an imbalance of hormones in the female body. The most commonly prescribed progestogens (both inside and out), prolactin inhibitors, combined oral contraceptives (COCs).
How to treat diffuse fibrocystic mastopathy with minimal negative impact on the female body? Many doctors prescribe special physiotherapy procedures that positively affect the condition of the mammary glands in the presence of this pathological condition:
- laser therapy. Special light radiation is applied, which has a vasodilating, immunostimulating, lymphatic, anesthetic, anti-inflammatory effect,
- magnetic therapy. Implies a magnetic field (constant or pulsed) on problem areas. As a result, a vasodilating effect is observed, the metabolism in the tissues increases, swelling is eliminated, pain is reduced,
- galvanization. During the procedure, the problem areas are exposed to direct current with low voltage. Galvanization has a positive effect on the human body, allows you to get rid of many problems
- medicinal electrophoresis. The procedure involves the introduction of the necessary drugs in certain parts of the body when exposed to an electric current,
- balneotherapy Used mud therapy, climatotherapy, clay therapy, the use of various therapeutic baths.
With cystic mastopathy, the risk of developing malignant tumors in the breast is low. Many doctors are inclined to believe that women who have this disease are no more prone to cancer than those who were completely healthy.
Despite this, in the presence of positive progress during treatment, it is necessary to undergo every regular examination in a timely manner and be observed at the doctor all the time. Also, to prevent the development of serious fibrosis, it is recommended to regularly monitor the state of the mammary glands in the first half of the menstrual cycle on a regular basis. For this it is necessary to investigate them, to determine the presence or absence of any seals, discharge from the nipple.
To prevent the development of cystic mastopathy, you need to use reliable methods of contraception, exclude abortions. Pregnancy and childbirth with subsequent feeding (at least for several months) has a positive effect on the condition of the breast. For women of any age for the prevention of this disease is shown food with a large amount of fiber, dairy products. At the same time, it is necessary to limit the consumption of animal fats as much as possible.
Also, to prevent mastopathy, it is necessary to exclude any negative factors - injury to the breast, stress, excessive exercise, alcohol and others. If this disease is detected, any temperature effect on the chest (hot baths, sauna, warm compresses) is prohibited.
What is mastopathy?
Benign lesions cause pain and serve as a trigger factor for the development of cancer. What is breast mastopathy? Disease of the mammary glands (mastopatia) dishormonal nature, characterized by the proliferation of connective tissue of the breast and glandular fat cells, which is accompanied by the appearance of cystic formations and fine-grained seals. There are 2 main forms of the analyzed disease, but according to the characteristics of their manifestation they are divided as follows:
- diffuse mastopathy,
Diffuse form of mastopathy affects the entire area of the mammary gland and is divided into these two forms: cystic and fibrous. The appearance of a fibrous node indicates a painful condition. This disease looks like an increase in connective tissue of the mammary glands. The fibrous form of the disease affects young girls and women after menopause. The reason may be an imbalance of hormones, resulting from stress or under the influence of negative factors.
Thanks to the name, the characteristic of fibrocystic mastopathy, which is associated with the appearance of specific nodes with fluid contained within, becomes clear. Cystic formations have a soft structure and clear contours. With the appearance of cysts, the onset of critical days is accompanied by tenderness of the mammary glands. The risk of cystic forms of exposure to women aged 50 years. During this period, the predominance of estrogen in the body.
Excessive growth of connective tissue is observed with diffuse fibrocystic mastopathy (DFKM). The mixed form is accompanied by the appearance of small cystic tumors. Education can be scattered in a chaotic manner. Fibrocystic breast mastopathy is manifested simultaneously on two breasts, and therefore has a second name: bilateral diffuse mastopathy. Inside the tumors there is a transparent color liquid, however, it is not possible to take a puncture for content analysis due to the small size of the formation.
What is dangerous mastopathy
Having diagnosed mastopathy, one should not let the treatment take its course. This disease can not go away on its own. The doctor-mammologist will issue an opinion, make a diagnosis, prescribe treatment. The most important danger of mastopathy is the ability to develop into an oncological disease of the breast. Knowing the peculiarity of the pathology, physicians are wary of mastopathy, immediately defining it as a precancerous condition, although initially the education is benign.
Causes of mastopathy
In most cases, women at the age of 40 fall into the risk group, but the risk of developing the disease in young girls is not excluded. Most of the other mastopathic patients are affected by many gynecological diseases. Further development of the disease is directly related to neurohumoral regulation (disruption of the vital processes of the body).
Numerous hormones are responsible for the growth and development of the breast, the most significant of which are: progesterone, estrogen, somatotropic hormone and prolactin. The state of the mammary glands depends on the ratio of hormones in the body. Hormonal imbalance entails a chance of development of the disease. Other causes of mastitis include:
- menopause later than normal
- termination of pregnancy or lack of it throughout life,
- earlier onset of menarche (menstruation),
- refusal to breastfeed a child,
- age of women over 35,
- genetic predisposition.
Symptoms of mastopathy
A benign disease has the characteristic signs of a pathological process, with the appearance of which women should consult a doctor before the disease has acquired a form of cancer. The degree of development of mastopathy depends on the symptoms, the most common of which are: pain, engorgement of the mammary gland in the 2nd phase of menstruation, the appearance of nodules and discharge from the nipples. The echo signs of the disease are determined by ultrasound. The characteristic features of the disease depend on the form of the disease:
- Diffuse fibroadenomatosis affects young women. There is a syndrome of "stone chest", you can feel the grain. There is pain, which can remove only analgesics.
- If you do not cure the previous type of disease, then nodular mastopathy will begin to develop. On palpation, cysts, seals, nodules are found. All formations have no clear boundaries and can reach 7 cm.
The initial symptoms of the disease go unnoticed. The discomfort in the area of the mammary glands that may appear can be suspicious: it occurs depending on the menstrual cycle, especially the obvious symptom manifests itself in the period of PMS. Often women do not notice the changes, and at this time the disease develops further. The following symptoms may be:
- minor pain
- swelling of the mammary glands,
- hypersensitivity of the mammary glands,
- clear liquid from the nipple,
- increase in axillary lymph nodes.
Unpleasant pain can be both strongly and mildly expressed: their intensity and the nature of the manifestation depend on the stage of mastopathy. The initial stage of the disease is characterized by pain before the onset of menstruation, therefore, is perceived by patients as part of PMS. Mastopathy is characterized by stagnation of venous blood, which leads to severe pain (in which it is impossible to touch the mammary glands) and swelling. Types of pain with mastopathy are:
The next sign of mastopathy makes it appear when he appears to run to the doctor. Discharges can be detected both with pressure on the nipple and without exerting effort. The color of the liquid may be bloody, white, brown (purulent), green. In the absence of discharge, the doctor speaks about their transparent color. Bloody hue with blood impurities indicates specific processes in the mammary gland of a malignant nature. In the body of a healthy woman should not be observed any discharge, except during lactation or during pregnancy.
How to treat mastopathy
It is necessary to determine the disease as soon as possible. At revealing of pathology it is necessary to undergo a mammogram. The specialist makes a diagnosis, chooses the tactics of treatment and the scheme depending on the factors: the patient's age, comorbidities, the degree of the disease, the nature of the violation of the menstruation cycle. In case of fibrocystic mastopathy, not only therapy, but also surgical intervention may be required.
When mastopathy develops into a malignant tumor, it is immediately removed. The operation for mastopathy is called sectoral resection of the mammary gland: the breast remains intact, and only part of the tissue and fibroadenoma are excised. During surgery, general anesthesia is used as anesthesia, and marking of the intended incisions is made in advance. The control with the help of ultrasound helps to preserve cosmetic aesthetics.
The principle of the formation of pathological changes
Mastopathy, or fibrocystic disease (in accordance with the definition of the World Health Organization) is a complex of hyperplastic (proliferation) processes in the mammary glands caused by an imbalance of hormones in the body.
In clinical practice, mastopathy is divided into forms:
The need for such a division is mainly due to the question of how to treat diffuse mastopathy, that is, with the choice of one or another treatment strategy. Diffuse mastopathy is observed by surgeons, gynecologists, general practitioners, oncologists and is treated by the use of complex therapeutic agents, nodular - is treated mainly by surgical methods in oncological centers followed by drug therapy and is observed only by oncologists.
Previously, various forms were found in 30-70% of women, mostly at the age of 30-50 years, and among women with gynecological diseases, this figure was 75-98%, in recent years, mastopathy often occurs even in adolescent girls and in women in involutionary period.
Etiological risk factors
The development and functioning of the mammary glands as part of the reproductive system of a woman’s body is controlled by the hypothalamic-pituitary-ovarian system. Changes in them in adolescence and the processes of a cyclical nature in the childbearing period of life. Changes in pregnancy and lactation occur under the influence of the hormones of the hypothalamus (releasing factors) and the pituitary (somatotropic, gonadotropic, thyrotropic, luteinizing hormone, prolactin), thyroid gland, adrenal glands (corticosteroids, progesterone), pancreas (insulin), insulin. progesterone), etc.
Therefore, any factors causing violations of various parts of the neuroendocrine system lead to an imbalance of hormones and the development of diffuse and other forms of mastitis. The main factors are:
- hereditary predisposition - diseases of the mammary glands in the immediate family (through the mother) both benign and malignant (you can read about benign mammary glands here),
- frequent and chronic stressful situations and depressive states as a result of domestic and labor conflicts, dissatisfaction with family relationships, psycho-emotional overstrain,
- factors associated with the reproductive system - lack of regular sexual life, repeated artificial termination of pregnancy, inflammatory processes in the uterus and appendages and other gynecological diseases, the number of births and the duration of breastfeeding, early onset of menstruation and late menopause, etc.,
- diseases and functional disorders of the neuroendocrine system (thyroid dysfunction, metabolic syndrome, polycystic ovary syndrome, diabetes mellitus, ectopic hormone-producing tumors, hypothalamic tumors, pituitary and circulatory disorders in the brain vessels, etc.),
- functional disorders or pathological processes in the liver, biliary tract, intestine, which can lead to a delay in excretion of excess estrogen,
- chronic nicotine and alcohol intoxication, as well as the constant intake of foods and drinks containing significant amounts of methylxanthines - chocolate, cola, cocoa, strong brewed tea or coffee.
Degree of danger of disease
Can diffuse mastopathy develop into cancer?
Directly - no. Mastopathy per se is not considered a precancerous condition. However, their main characteristic feature is common causal risk factors and the presence of similar hormonal and metabolic disorders. Marked similarities and morphological changes, with nodular forms of mastopathy and malignant tumors.
These diseases are often combined. In accordance with the data of histological studies, cancer tumors on the background of benign tumors are found in 46%, that is, on average, 5 times more often. The risk of transformation into a malignant tumor with non-proliferative forms of mastitis is 0.86%, moderately proliferative - 2.34%, with mastitis with significant proliferation of the glandular epithelium - 31, 4%.
Can diffuse mastopathy develop into a nodular?
While maintaining the risk factors that cause the disease, it is possible. The nodal form is essentially the next stage in the development of mastopathy. It is characterized by the formation in both or one of the mammary glands of one or multiple permanent limited seals (nodes), changes in which are no longer dependent on the menstrual cycles.
Given these factors, women with identified mastopathy in any form are subject to appropriate treatment and must be under constant dynamic observation.