The initial stage of mastopathy. Signs and symptoms of breast mastopathy. In addition to hormonal disorders, the possible causes provoking the development of mastopathy include

Good day, dear readers!

In today's article we will consider with you such a disease as breast mastopathy, and everything that is associated with it - symptoms, causes, types, diagnosis, treatment, medicines, alternative treatment, prevention, photos and other useful information. So…

What is Breast Mastopathy?

Mastopathy - fibrocystic breast disease, characterized by pathological proliferation of its tissues.

The development of the disease is based on the formation of benign fine-grained seals in the chest, often pathogenic, sometimes with the release of a pathological secret.

The danger of mastopathy is the degeneration of a neoplasm from benign to malignant - into breast cancer. In this regard, many doctors regard this disease as a precancerous condition.

It is believed that breast mastopathy does not go away on its own and requires compulsory treatment.

It should also be noted that the term "mastopathy" refers to a group of breast pathologies, the common denominator of which is an imbalance in the ratio between connective and epithelial tissues.

Development of mastopathy

Doctors have found that the development of breast mastopathy directly depends on neurohumoral regulation.

Neurohumoral regulation is the physiological regulation of the body by the hypothalamus through the transmission of nerve impulses through the blood and lymph. One of the main roles of neurohumoral regulation is maintaining the normal balance of hormones, metabolites and other neurotransmitters in the body, as well as adapting to changing environmental conditions.

For example, the release of adrenaline into the bloodstream during a stressful situation, due to which the body mobilizes strength and muscles in the necessary state to overcome a particular situation.

For the formation, development and growth of the mammary gland, hormones are mainly responsible, especially important in this process are progesterone, prolactin, estrogens and growth hormone. When their balance is regulated at the proper level, everything is normal with breast health, but as soon as hormonal imbalance occurs for one reason or another, there is a risk of developing mastopathy. However, it should be noted right away that the development of the disease does not occur with lightning speed, even with pathological factors - for its development, violations must be systematic over several years.

The most important and frequent hormonal disorders underlying the development of breast mastopathy are considered to be progesterone deficiency against a background of increased estrogen levels and the development of hyperestrogenism, increased prostaglandin levels and hyperprolactinemia. This condition usually leads to an overgrowth of connective tissue, alveolar epithelium and ducts.

For example, estrogen is responsible for the proliferation of the epithelium, which occurs due to its division in the alveoli of the glands and the milk ducts, so a large amount of this female sex hormone enhances the natural development of the breast.

Another pathological factor can be increased production of prolactin, which is directly responsible for the regulation of normal growth, development and functioning of the mammary glands. Its excess increases the susceptibility of breast tissue to estrogen.

Breast mastopathy is divided into 2 main types - diffuse and nodular, which can be called the stages of this disease.

So, diffuse mastopathy is the onset of the disease, characterized by the onset of proliferation of connective tissue with the formation of small nodules and strands.

Nodular mastopathy is a continuation, or the second stage of the disease, characterized by compaction of nodules and their increase to 7-70 mm.

Nodules can be fibrous, cystic or mixed (fibrocystic) in nature, due to which the disease can have such a diagnosis as - fibrous mastopathy, cystic breast disease or fibrocystic breast disease.

Breast cancer can become the final stage in the development of the disease, therefore it is very important to periodically visit a mammologist for examination, and in which case, timely treatment.

Spread of mastopathy

For more than a century, mastopathy has been considered the most common breast disease.

This disease is diagnosed in 30-45% of all breast diseases, and accompanies in 70-95%, due to which, when visiting a gynecologist and detecting any disease, the patient is usually additionally referred to be examined by a mammologist.

It is also noticed that the number of cases of detection of pathology in the female breast increases after 40 years.

Mastopathy - ICD

ICD-10: N60.1;
ICD-9: 610.1.

Mastopathy - symptoms

Symptoms of mastopathy largely depend on the form of the disease, concomitant diseases and the emotional state of the patient.

The main signs of breast mastopathy:

— Chest pain, which in the initial stages of the disease manifests itself only before the next. The nature of the pain can be sharp, dull, aching or pulling, as well as so strong that it hurts a woman even to touch her chest. The pain can also radiate (give) to the arm or shoulder blade. Pain with mastopathy is caused by stagnation in the blood vessels of the breast of blood and swelling of the surrounding tissues, which leads to an increase in breast volume. In addition, an additional factor contributing to pain can be fibrous growths, which literally press on the nerve fibers located in the chest. At the end of menstruation, the pain usually goes away, but as the disease progresses, it haunts the woman on an ongoing basis, getting worse before the next menstruation. The severity of pain or its absence in the presence of fibrous growths also depends on the patient's pain threshold or the individual characteristics of the branching of the nervous system in the chest.

— Breast engorgement, which develops in the second phase of the menstrual cycle, in which the breasts increase in size, becomes hard and heavy. This condition of the breast is due to the same stagnation of blood in the blood vessels of the breast and swelling of the connective tissue. On palpation, the chest is hypersensitive.

- The appearance in the chest of one or more nodules (lumps).

— Discharge from the nipples after pressing on them, which can be of varying intensity. Discharge can also be very pronounced, and appear without much physical effort. Discharge in mastopathy can have a transparent, white, greenish, brown or bloody shades. It must be remembered that discharge is allowed only during pregnancy or lactation, at another period, the presence of discharge is highly likely to indicate the presence of a pathological process in the chest.

Nodular mastopathy is also accompanied by cystic seals of a round or oval shape, without clear boundaries, while the lobule is not palpable on palpation.

Complications of mastopathy

Complications can be:

Development of a background inflammatory process, to which it can join, after the formation of a purulent focus in the chest;

The main cause of breast mastopathy - hormonal imbalance in a woman's body.

The main factors that can trigger the development of mastopathy:

Types of mastopathy

The classification of mastopathy includes the following types of disease ...

By form:

Diffuse mastopathy - the onset of the disease, characterized by the onset of proliferation of connective tissue with the formation of small millet-like nodules. Diffuse seals can be of the following nature:

With a predominance of the glandular component (adenosis);
With a predominance of the fibrous component (fibroadenosis);
With a predominance of the cystic component (fibrocystosis);
Mixed form (fibrocystic mastopathy).
Sclerosing adenosis;

Nodular mastopathy - continuation of the development of the disease, characterized by an increase in nodules up to a size of 7-70 mm and their compaction. Seals with a nodal shape can be of the following nature:

Fibroadenoma;
Leafy fibroadenoma (phyllodic fibroadenoma);
Angioma;
Hamartoma;
Cysts;
Intraductal papilloma;
Lipoma;
Lipogranuloma.

According to ICD-10, the disease is divided into the following types:

Benign breast dysplasia and fibrocystic breast disease (N60);
Solitary cyst of breast (N60.0);
Diffuse cystic breast disease, excluding epithelial proliferative disease (N60.1);
Fibroadenosis of the mammary gland, with the exception of fibroadenoma of the mammary gland (N60.2);
Fibrosclerosis of the breast and cystic mastopathy with epithelial proliferation (N60.3);
Breast duct ectasia (N60.4);
Other benign breast dysplasias (N60.8);
Benign breast dysplasia, unspecified (N60.9)

Diagnostics of the mastopathy

Diagnosis of the disease includes the following examination methods:

Self-examination of milk jelly with a mirror and palpation of the breast in a standing and lying position;
Anamnesis;
Mammography;

If there are nodules or tumor-like areas in the breast, a breast biopsy is performed, after which the biomaterials taken, together with nipple discharge, are subjected to cytological examination.

Treatment of mastopathy

How to treat mastopathy? The tactics of treating mastopathy largely depends on the timeliness of its detection, form, concomitant diseases and the patient's age.

The main points in therapy are:

1. Drug treatment;
1.1. Hormone therapy;
1.2. Non-hormonal therapy;
2. Surgical treatment.

1. Medical treatment of mastopathy

The conservative method of therapy (drug treatment) is used mainly for the diffuse form of the disease. Nodular mastopathy often additionally requires surgical intervention, which is especially important when detecting the malignancy of the seals.

1.1. Medicines for mastopathy - hormonal therapy

Important! Before using medications, be sure to consult with your doctor!

Antiestrogens - a group of hormonal drugs aimed at lowering the amount of estrogen in the female body. When using these drugs, pain in the chest is relieved, the menstrual cycle is normalized, and the risk of degeneration of the seals into a cancerous tumor is reduced. Among the side effects can be noted - hot flashes, increased sweating, vaginal discharge, depressive conditions, skin rashes, erythema and others, which is associated with a decrease in estrogen levels. The course of treatment usually lasts 3 to 6 months.

Among antiestrogens one can distinguish - "Tamoxifen", "Fareston".

Gestagens - a group of hormonal drugs that have the property of suppressing the production of estrogen by the body, as well as a decrease in the effectiveness of the pituitary gland's gonadotropic function. In addition, the use of progestogens normalizes the balance of hormones. The effectiveness of the use of gestagens in 80% of cases of the disease has been noticed. However, there are also contraindications, for example - pregnancy, presence and others.

Among the progestogens, one can distinguish - "Orgametril", "Norkolut", "Pregnil", "Progestogel".

Oral contraceptives - a group of hormonal contraceptives, the reception of which normalizes the menstrual cycle and reduces soreness during menstruation, lowers the signs of fibrocystic breast disease. The purpose of oral contraceptives is to suppress the production of gonadotropins.

Among the oral contraceptives can be distinguished - "Marvelon", "Mersilon", "Silest", "Femoden".

Inhibitors of prolactin secretion - a group of hormonal drugs that normalize lactation caused by an increased level of prolactin in the body. Prolactins help to reduce breast cysts, reduce pain in mastopathy, normalize the balance between the production of estrogen and progesterone by the female body, and improve reproductive function. A contraindication is the presence.

Among prolactins, one can distinguish - "Bromocriptine", "Parlodel".

Androgens - male hormones that are estrogen antagonists. Androgen-based drugs suppress excessive estrogen activity. However, taking androgens has a large number of side effects - amenorrhea, excessive sweating, excessive nervousness, swelling, weight gain and other endocrine system disorders.

Among the drugs-androgens can be distinguished - "Danazol".

Gonadotropin Releasing Hormone (LHRH) Analogs - a group of hormonal drugs used to treat fibrocystic mastopathy, but only in cases where other groups of drugs have not found their effectiveness.

1.2. Medicines for mastopathy - non-hormonal therapy

The following groups of drugs enhance the effectiveness of hormonal agents, and also help to relieve symptoms associated with mastopathy.

Vitamin complexes - help to strengthen the immune system in the fight against pathology. In addition, supplementation with vitamins minimizes the side effects of hormonal medications.
The most common, the reception of which is recommended for mastopathy are -, and.

Hepatoprotectors - a group of drugs that support the normal functioning of the liver, as well as protect it from various toxins and restore the cells of this organ (hepatocytes). The use of hepatoprotectors is due to the fact that due to hormonal imbalance, which underlies the development of mastopathy, the liver also suffers.

Among the hepatoprotectors can be distinguished - "", "Legalon", "", milk thistle tea.

Enzymes - a group of drugs that help normalize the functioning of the digestive system. Enzymes normalize the microflora in the gastrointestinal tract, eliminate it.

Among the enzymes can be distinguished - "", "Duphalac".

Sedatives (sedatives) drugs - are aimed at suppressing increased nervousness and mental disorder, which often occurs in women against a background of hormonal imbalance and pain syndrome caused by mastopathy or menstruation.

Among the sedatives, one can single out - "Valerian", "Persen", "Tenoten", tincture.

Diuretics - a group of diuretic drugs that help relieve swelling in mastopathy. Doctors recommend taking only mild diuretics.

Among the mild diuretics can be distinguished - tincture, herbal preparations.

In addition, in the treatment of breast mastopathy, medications such as “Dufaston”, “Janine”, “Zoladex”, “Yodomarin”, “Mastiol”, “Utrozhestan” and others are often prescribed.

Important! With mastopathy, the use of alcoholic beverages and smoking is strictly prohibited.

2. Surgical treatment of mastopathy

Surgical treatment of mastopathy is usually carried out in the nodular form of the disease, as well as in the case when conservative treatment has not led to the necessary results.

Sectoral resection of the breast is used as a surgical method of treatment.
Surgical treatment with this method is carried out under general anesthesia under the supervision of an ultrasound examination. At the same time, the chest is preserved. After preliminary marking, the fibroadenoma and part of the glandular tissue are excised. The cosmetic defect is minimal.

Important! Before using folk remedies for mastopathy, be sure to consult with your doctor!

Elder. Black elderberries also have medicinal properties. The fruits of this plant slow down the growth of tumors and help the body fight cancer cells. For the treatment of mastopathy, you need 2 times a day, on an empty stomach, take 1 tbsp. a spoonful of elderberry juice. The course of treatment is carried out daily for several months.

Linseed oil. Flax contains phytoestrogens, which have a hormonal balance-normalizing effect. To use flax as a medicine, you need to eat 1-2 tbsp. tablespoons of flax seeds and wash them down with plenty of water. The beneficial effect occurs 10-14 days after the start of the intake. Flax seeds are also useful for adding to various dishes.

Apricot. The kernels of apricot kernels contain (cyanide, vitamin B17) - a toxic substance that in small doses stops the development of tumors. Among traditional healers, apricot pits have long been used to treat cancer. For medicinal use, take 5 to 10 apricot kernels daily. If there is no apricot, then you can replace them with kernels of plum, cherry, grape seeds.

Celandine. To prepare the product, it is better to use a self-dried one, which is cut off in the morning, at the root, and dried in a complete state for preparation. To prepare a remedy for mastopathy, you need to grind 1 sprig of dry celandine and pour vodka in a 500 ml jar, then set aside the remedy in a dark place, for 15 days, for infusion. Next, strain the tincture through a dense cloth, and take it according to the following scheme - for the first three days, 1 drop diluted in half a glass of water, after three days, 2 drops each, and so go up to 15 drops a day. Then take a 2-month break and repeat the course. You need to store the product in a dark container, in the refrigerator. To measure drops, you can use a vial of any medicine.

Rhodiola cold (red brush). Salidroside, which is part of the red brush, has anti-inflammatory, immunomodulatory, and anticarcinogenic (antitumor) properties. Thanks to salidroside, as well as many other useful substances (cobalt, manganese, silver, chromium, nickel), which are contained in this plant, the use of the remedy on cold rhodiola helps to normalize estrogen metabolism, the production of progesterone, prolactin and maintain the balance of other hormones. You need to use a red brush in the form of decoctions or tinctures. To prepare the product, you need to pour 1 teaspoon of the dried plant with a glass of boiling water, let it brew for 45 minutes, strain and take 2 times during the day.

Sage. You can take this remedy only from 6 to 15 days before ovulation. To prepare the product, you need to put 1 teaspoon of dry crushed into a thermos and pour it with a glass of boiling water, let the product brew for 30 minutes, strain and drink 3 times, during the day, 15 minutes before meals.

Prevention of mastopathy includes:

Elimination of the use of alcoholic beverages;
Avoiding stress, especially systematic;
To give up smoking;
Leading an active lifestyle - you need to move more, play sports;
Swimming is useful;
Observe the work / rest / sleep mode, sleep at least 8 hours a day;
Eating mainly foods fortified with vitamins in the diet;
Visit a mammologist regularly for examination, especially for women over 45;
To be examined by a mammologist for gynecological diseases.

Mastopathy - doctor

Mammologist;

Mastopathy - video

- one of the most common diseases in women in the reproductive and. The disease is characterized by pathological proliferation of glandular tissues and the formation of seals, and is most often manifested by pain and discharge from the nipples.

Cancer processes in the mammary gland can have similar manifestations, therefore, patients are interested in how to distinguish these diseases and whether mastopathy can develop into cancer.

Types of mastopathy

Specialists-mammologists distinguish two general groups of mastopathy: nodular and diffuse. With a diffuse form of the disease, soreness manifests itself due to the proliferation of connective tissue and an increase in many small nodules at once under the influence of hormonal imbalance. Nodular mastopathy arises as a consequence of an untreated diffuse form of the disease.

It can manifest itself as a fibroadenoma or cyst and, under the influence of risk factors, become malignant over time (leading to the appearance of a malignant tumor). As a rule, the likelihood of developing breast cancer in patients with mastopathy is 3-5 times higher than in healthy women of the same age group.

Diffuse mastopathy occurs more often than nodular. The disease develops due to hormonal imbalance (excess of estrogens, prolactin with an insufficient amount of progesterone - this ratio is often observed in ovarian disease or menopause, as well as in some other conditions). With the proliferation of connective tissue, the patient begins to feel discomfort and tension of the glands, small nodules are palpated on palpation. Most often, the sensitivity of the breast increases, pathological discharge from the nipples is observed.

Depending on the nature of hormonal disorders, mastopathy may be accompanied by constant fatigue, dry skin, menstrual irregularities and amenorrhea, irritability or apathy.

Diffuse mastopathy can be of three types:

(manifested by the growth of connective tissue);
cystic (characterized by the appearance of fluid-filled cysts, in the later stages it can be accompanied by inflammation of the gland caused by congestion);
fibrocystic (mixed).

If untreated, dense nodes with a diameter of up to 8-10 centimeters are formed. They can have the character of a cyst or fibroadenoma. Despite the fact that any of the listed pathologies increases the risk of developing breast cancer, leaf-shaped fibroadenoma is most likely to pass. Medical practice shows that no special conditions are required for malignancy. The most likely risk factor is a hormonal surge (for example, during or after menopause).

Pain with nodular and diffuse mastopathy

Pain in mastopathy depends not only on the stage, but also on the type of disease. The cause of painful sensations is multiple formations and proliferation of connective tissue. They compress the nearby nerves, which causes discomfort for the patient.

Chest pain with diffuse mastopathy has a number of differences:

increases in the premenstrual period, and after the end of the cycle disappears or decreases significantly;
accompanied by breast swelling and increased sensitivity;
is aching or oppressive;
manifests itself as increased sensitivity or even soreness of the nipples, in the later stages - discharge from them.

It is also possible to determine nodular mastopathy by a number of characteristic pain symptoms:

the pain does not go away during the entire cycle, with the aggravation of the disease it becomes more acute;
discomfort is given to the shoulder, armpits, back, forearm zone;
the pain usually has an aching character, but in an acute form it can become stabbing;
hypersensitivity turns into painful discomfort (aching pain appears even with a light touch or pressure of linen on the chest);
the nipple area becomes very painful.

Benign lesions are usually mobile relative to the surrounding tissues.

It is very important to carry out differential diagnostics in order to distinguish it from breast cancer and to increase the chances of successful treatment in the presence of a malignant disease.

Differences in symptoms of breast cancer and mastopathy

Some signs of breast cancer are similar to the symptoms of mastopathy, but the rest (in combination with hardware techniques) still allow for a differentiated diagnosis.

Symptom	Mastopathy	Mammary cancer
Hardening of the skin gland	Absent (breast augmentation with mastopathy often has the character of painful swelling, but palpation is not difficult)	Observed
Discharge from the nipples	Transparent, yellowish, white or purulent (with an inflammatory process (discharge	The discharge is clear or bloody
Skin erosion	Absent	Observed
Breast tenderness	Present, with a diffuse form of mastopathy, it decreases after menstruation, with a nodular form, it persists throughout the cycle	Observed in diffuse (mastitis-like and erysipelas) form of cancer of the gland
Breast symmetry disorder	Can be seen with large lesions (cysts, fibroadenomas)	The tumor can enlarge part of the gland
Palpation of the node	Maybe with the nodular form of the disease, the formation is mobile	The knot is palpable, but immobile due to tight adhesion with the surrounding tissues
Soreness of the node	Feeling the knot causes pain	The node is painless
Retraction of the nipple and skin of the breast surface	Is absent	Observed
Changes in the surface relief of the skin (collection in wrinkles, folds, etc.)	Is absent	It is fixed, when the tumor grows into the surface of the skin, it takes the form of a cauliflower inflorescence, in case of armored cancer, the affected gland becomes covered with a crust
Skin discoloration	Not visible	It is fixed when the neoplasm grows into the skin
Puffiness	It is observed throughout the affected gland with stagnation caused by tissue compression	There is a "lemon peel" effect (swelling of the area above the tumor)
Lymph node changes	Swollen lymph nodes	The appearance of a seal in the armpit or near the clavicle with damage to regional lymph nodes
Pain syndrome outside the breast	Not visible	It is fixed when the cancer grows into the surrounding tissues (chest)
Hyperthermia (fever)	May be present in congestion and inflammation	Observed in diffuse forms of breast cancer

The success of early diagnosis of cancer may depend on how the chest hurts with mastopathy and what symptoms accompany this condition.

How to distinguish mastopathy from cancer using diagnostic methods

If, with mastopathy, the chest hurts and all the symptoms indicate the absence of oncology, the doctor still recommends that the patient undergo a series of additional studies. Differential diagnostic methods allow you to determine the localization, size and shape of the formations in the breast.

In rare cases, mastopathy turns into breast cancer (the frequency of malignancy is every tenth case with a diagnosed leaf-shaped fibroadenoma), therefore, the specialist must determine what is more justified: removal of the neoplasm, setting the patient on an oncological account or prescribing conservative therapy.

If a lump is found in the mammary gland (either alone or at a yearly check-up), a mammogram (x-ray of the breast) is required. As a rule, mammography is prescribed for women over 35 years old, because in young patients, the mammary gland is sensitive to the effects of gamma rays. They are advised to replace the radiography of the gland with ultrasound diagnostics. Benign nodes on ultrasound have smooth outlines, and a malignant tumor has an uneven relief.

If malignancy is suspected, the patient undergoes a biopsy of tumor tissues (taking a sample to study the degree of cell differentiation). In order to diagnose cancer, an analysis is also performed for the main tumor marker of the mammary gland (Ca 15.3) and a contrast study of the glandular ducts.

When confirming the oncological diagnosis, an ultrasound of the regional and abdominal regions and a chest x-ray are prescribed, which allow to investigate the extent of the spread and the stage of the disease. The neoplasm is examined for sensitivity to progesterone and estrogen, if necessary, prescribing hormone-lowering therapy.

In the case of diagnosed mastopathy, the opposite is true: after examining the patient's hormonal background, she is prescribed replacement therapy with synthetic analogues of deficient hormones (most often progesterone).

Regardless of whether the breast hurts with mastopathy, if a seal is found, you should immediately contact a mammologist. Based on the results of analyzes and studies, he will be able to accurately establish the degree of malignancy of the process and prescribe adequate treatment.

Mastopathy - benign breast disease, or rather, fibrocystic disease or fibroadenomatosis. Other synonyms (rarely used) are Schimmelbusch disease, chronic induration, chronic cystic mastitis, serous cystic tumor, cystic adenoma, etc.

Mastopathy is defined in the pathological growth of breast tissue, while the growth of connective and glandular tissue occurs in the gland with the formation of seals and cysts, occurs in sixty to eighty percent of women of reproductive age.

The main reason is hormonal imbalance (primarily sex hormones) in a woman's body... Therefore, with mastopathy, infertility is often observed. Often, mastopathy appears against the background of stress, thyroid diseases, adnexitis, liver diseases (the liver is responsible for the inhibition of sex hormones). The main factor in the threat of the disease is the hereditary factor (the presence of the disease in maternal relatives).

Causes of mastopathy

First, as a result of a change in hormonal levels - a violation of the balance of sex and other hormones.

Mastopathy is formed against the background:
thyroid diseases
ovarian diseases (most often chronic adnexitis)
liver diseases (after hepatitis, the utilization of sex hormones may change)

All this often leads to an unlimited or relative (in relation to other hormones) dominance of estrogens. Often the cause of mastopathy cannot be found.

Types of mastopathy

From a diagnostic point of view, mastopathy is divided into two groups - nodular and diffuse. With nodular mastopathy, a node develops in the mammary gland, with diffuse - many small nodular formations without a predominance of any.

This division allows you to determine the tactics of treatment. Nodular mastopathy often simulates breast cancer and therefore requires diagnostic tests to exclude it. With diffuse, they are limited to local examination and further therapeutic treatment.

Diagnostics of the mastopathy

Diagnostics is based on the data of diagnostic research, mammography, ultrasound, cytological examination.

Mastopathy is not a precancerous disease. Only some of its forms, accompanied by pronounced proliferation (cell division), can be the background for the formation of breast cancer. Nodular forms of mastopathy can represent a malignant neoplasm of the breast (while breast cancer can simulate nodular mastopathy). Therefore, if there is a fear of cancer expressed during examination, mammography, ultrasound examination or biopsy, a sectoral resection is usually prescribed in order to prove or refute the diagnosis of breast cancer.

Symptoms of mastopathy

All of the symptoms listed below can be detected both in combination and separately.

1. Pain in the mammary gland. Dull, aching, pain, a feeling of heaviness, which intensifies in the premenstrual period, a feeling of discomfort. The pain may be local or radiate to the arm or shoulder blade. Pain can be constant or intermittent and is usually associated with the menstrual cycle. Although pain is the main symptom of mastopathy, 10-15% of women do not feel any feelings, despite the fact that upon examination and feeling, they reveal the same changes as in women experiencing pain. This is due to different individual pain thresholds. The appearance of pain is motivated by compression of the nerve endings by edematous connective tissue, cystic formations and their involvement in sclerosed tissues.

2. Areas of seals in the breast tissue are revealed during self-examination as seals with implicit contours, the boundaries of which are quite difficult to determine.

3. An increase in lymph nodes in the armpit and their sensitivity to feeling is observed in ten percent of women who suffer from mastopathy.

4. Increase in the volume of the breast. It is a repeated engorgement of the gland, which is caused by venous congestion and swelling of the connective tissue, while the mammary gland can increase in volume by more than 15%. The swelling is accompanied by mastodynia (breast tenderness, tenderness), or mastalgia (breast pain). Mastodynia is often accompanied with migraine-like headaches, edema, negative sensations in the abdomen (flatulence, constipation, feeling of fullness), increased nervous irritability, anxiety, fear. The complex of these body disorders is also called premenstrual syndrome. As a rule, with the onset of menstruation, the symptoms of premenstrual syndrome disappear.

5. Discharge from the nipples. They can be abundant (then they manifest themselves on their own) or appear only with pressure on the nipple. By color, the discharge can be: whitish, transparent, greenish, brown, bloody. You need to pay the most attention to bloody discharge - this is often a threatening symptom. Any discharge from the nipples is a sufficient reason to visit a mammologist.

6. A node in the gland. This symptom can occur with nodular mastopathy. In this case, a node in the gland is defined as a clearly defined formation, the size of which can vary greatly. It is sometimes very difficult to distinguish between nodular mastopathy and breast cancer. Diagnostic surgery is rarely necessary. This can only be carried out by a specialist using additional diagnostic tools. Therefore, upon detection of any volumetric formation in the breast, it is necessary to appear at the mammologist's appointment.

Treatment of mastopathy

Treatment consists in eliminating the cause when it is identified. To improve the functioning of the immune system, vitamins A, group B, C are used. Treatment of chronic adnexitis is carried out.

Medicines that must be prescribed for the treatment of mastopathy:

Hormonal drugs (progesterone, danazol, bromocriptine, small doses of estrogen.)
oral contraceptives to regulate the menstrual cycle
antiestrogens

For painful sensations, you can use analgesics, mild diuretics (reduce swelling of the mammary gland that occurs shortly before menstruation), homeopathic remedies.

Still, the treatment of fibrocystic disease is determined depending on its form. For all nodal types, especially proliferative ones (fibroadenoma, etc.), a sectoral resection of the mammary gland is performed with the obligatory immediate histological examination of the material obtained, treatment is carried out in an oncological hospital. If a histological examination finds cancer cells in the tumor, the patient's mammary gland is removed, followed by chemotherapy. If the histological examination shows the benign nature of the node, only a sectoral resection is prescribed. After surgery, since the cause of the disease, namely dyshormonal disorders of fibrocystic mastopathy, have not been eliminated, patients need to be treated conservatively.

The main task of the treatment of mastopathy is to reduce pain, reduce cysts and fibrous tissue in the mammary gland, reduce proliferative growth in the mammary gland (prevention of recurrence of tumors and oncopathology), as well as adjust the hormonal background (after determining hormonal disorders and consulting a gynecologist-endocrinologist). If the patient has concomitant inflammatory diseases of the female genital area, endocrine diseases (hypothyroidism, nodular goiter, diabetes mellitus.), Treatment is carried out in conjunction with a gynecologist, endocrinologist.

Traditional treatment (mastodinone, vitamin therapy, mammoleptin, hepatoprotectors, sedatives - motherwort tincture, valerian root, herbal decoctions, klamin, seaweed, food supplements, iodine preparations) have been prescribed for years and often do not give a clear effect, do not reduce pain and do not reduce proliferative process in the mammary gland. Prolonged use of hormones, contraceptives often adversely affect the breast tissue, cause complications - stimulate the proliferative process, promote the formation of cysts, increase fibrosis, and increase pain. Based on the foregoing, we can conclude that in no case should one self-medicate, and at the slightest suspicion of a disease, an urgent need to contact a specialist.

Mastodinon

According to doctors, every woman spends 5 to 7 years in a condition known as premenstrual syndrome or PMS. Every month, 90% of women suffer from sudden mood swings, mastalgia, swelling, headaches and many other unpleasant symptoms that precede the onset of menstruation. For many of them, PMS has become a completely normal phenomenon, because it is almost useless to deal with its manifestations. And some women even consider premenstrual syndrome an integral companion of menstruation and perceive it as a sign that everything is in order with their health. Scientists, on the other hand, tend to consider PMS as an unnatural condition of the female body that needs treatment.

To date, more than 150 signs of premenstrual syndrome have been described. Of course, they cannot appear at the same time: each woman, as a rule, has her own individual set of monthly torments. This can be chest pain, back pain, headache, muscle spasms, edema, mastalgia, etc. Unfortunately, not all of these signs are as harmless as they might seem at first glance.

One of these unpleasant manifestations of premenstrual syndrome is mastodynia. Mastodynia, or mastalgia, can be a symptom of PMS, but it can also occur on its own in young women and girls in adolescence. The main signs of mastodynia are pain in the mammary gland, breast swelling, and sensitivity to touch. And if many women are accustomed to enduring these symptoms, then most doctors agree that mastodynia must be treated.

It should be noted that pain in the mammary gland can also signal another serious breast disease - mastopathy. It is quite often confused with mastodynia, since the symptoms of these two disorders are almost the same. Doubts when making a diagnosis will help resolve an ultrasound of the breast on different days of the month. With mastodynia, a woman experiences pain in the mammary glands about two weeks before the onset of menstruation, and lumps in the breast can also be felt. If the critical days have passed, and the seals and soreness remain, you should definitely contact a mammologist.

In 90% of cases, a woman can independently diagnose mastopathy. However, this disease is quite serious and does not go away on its own, therefore, if you suspect mastopathy, you should not self-medicate: it is better to seek advice from a specialist mammologist. To determine the nature of the breast disease, the doctor prescribes a full examination - mammography, ultrasound, and in some cases a puncture - taking tissue with a thin needle. Like other diseases, it is better to treat mastopathy in the early stages.

Experts distinguish two types of mastopathy - nodular and diffuse. They differ in the number of nodules in the breast tissue. Diffuse mastopathy manifests itself in the form of pain in the mammary gland, which intensifies a few days before the start of the next menstruation. In this form of the disease, as a rule, therapeutic treatment is sufficient. More serious nodular mastopathy may require surgical intervention.

Thanks to many years of experience in the study of mastopathy, today specialists have at their disposal several proven methods of treating this breast disease. First of all, with mastopathy, it is necessary to eliminate the causes that caused the hormonal imbalance in the body, and restore the functioning of the nervous system. Competently selected complex therapy helps a woman get rid of the disease within one month. At the same time, in the course of treatment, doctors widely use a variety of auxiliary agents: vitamins in high dosages, homeopathic medicines (for example, Mastodion), agents for normalizing liver function and pain relievers.

Composition and release form of Mastodinon:

Combined homeopathic herbal preparation.
Drops for oral administration, 30, 50 and 100 ml in a bottle.
Tablets 60 and 120 pcs. packaged.
100 grams of drops contain: Agnus castus (Vitex sacred, or Abraham's tree) 20 g, Caulophyllum thalictroides (Basil stalk) 10 g, Cyclamen (Cyclamen European) 10 g, Ignatia (Chilibuha Ignatia) 10 g, Iris (Iris multicolored) 20 g , Lilium tigrinum (Tiger lily) 10 g. Ethanol content: 47.0 - 53.0% (by volume).
1 tablet contains: Agnus castus (Sacred Vitex, or Abraham's tree) 162.0 mg, Caulophyllum thalictroides (Basil stalk) 81.0 mg, Cyclamen (European Cyclamen) 81.0 mg, Ignatia (Chilibuha Ignatia) 81.0 mg, Iris (multicolored iris) 162.0 mg, Lilium tigrinum (tiger lily) 81.0 mg.

Indications for the use of Mastodinon:

fibrocystic breast disease;
premenstrual syndrome (mastodynia, tension of the mammary glands, mental lability, edema, headache / migraine);
menstrual irregularities and / or infertility caused by the insufficiency of the corpus luteum.

Method of administration and dosage:

The drug is taken in 30 drops or 1 tablet 2 times a day (morning and evening). Drops are slightly diluted with water or other liquid. The tablets should be taken with a little liquid.

Mastodinon must be taken for at least 3 months, including during menstruation. Improvement usually occurs in 6 weeks. If, after stopping the reception, the complaints resume, then it is necessary to continue treatment and consult a doctor. Due to its good tolerance, the drug is suitable for long-term therapy.

Side effects of Mastodinon:

Allergic reactions are possible.
In very rare cases, stomach pains, nausea, slight weight gain, itchy exanthema, acne and headaches are possible. While taking preparations containing Agnus castus, temporary psychomotor agitation, confusion and hallucinations may occur. In these cases, it is necessary to cancel the drug and consult a doctor.

Contraindications for Mastodinon:

Hypersensitivity to the components of the drug, during pregnancy and breastfeeding.
Due to the lactose content in the tablets, they should not be used in patients suffering from rare inherited galactose intolerance, genetic lactase deficiency or malabsorption of glucose and galactose.
The drug should not be used in children under 12 years of age.
If pregnancy occurs while taking the drug, then the drug should be discontinued.

Interaction with other medicinal products:
It is possible to weaken the effect of the drug while taking dopamine antagonists.

Special instructions:

Drops and tablets Mastodinon are not used in the treatment of malignant diseases of the mammary glands. For prolonged, unclear and recurring complaints, you should visit a doctor, since we can talk about diseases that require treatment under the supervision of a doctor.

Treatment with homeopathic medicines does not exclude the use of other medicines.
Slight turbidity of the solution or the formation of a slight precipitate during storage is possible. This does not affect the effectiveness of the drug.

It is known that in homeopathic treatment, bad habits such as smoking and drinking alcohol have a negative impact on the effectiveness of the homeopathic medicine.

Mastopathy - symptoms and treatment

What is mastopathy? We will analyze the causes of occurrence, diagnosis and treatment methods in the article by M.E. Provotorov, a mammologist with 10 years of experience.

Definition of disease. Causes of the disease

In the structure of breast diseases, the specific gravity has such a pathology as fibrocystic breast disease(hereinafter FCM or simply mastopathy). In this disease, there is a violation of the ratio of epithelial and connective tissue components of the tissue in the structure of the mammary gland, as well as a wide range of proliferative (associated with the accelerated formation of new cells, leading to tissue proliferation) and regressive changes. As practice shows, this disease is quite common among the fertile (fertile) half of the female population. According to various authors, up to 70% of women may have FCM pathology.

Mastopathy is a consequence of hormonal imbalance: the main role in the development of this disease is played by the hormones estrogen, its metabolites, and also progesterone. Changes in thyroid-stimulating hormone, thyroid hormone levels, prolactin levels, and many other causes can also contribute to the development of the disease.

The main factors leading to hormone imbalance are:

early menarche (early onset of the menstrual cycle) - due to the renewal of the hormonal background, it is difficult for the body to quickly adapt to changes; this, in turn, affects the tissue structure of the mammary glands;
late onset of menopause - the main role is played by the long-term effects of hormones (especially estrogens) on the gland tissue;
no history of pregnancy;
abortion, provoking sudden changes in hormonal levels;
lack of lactation or an extremely short period of breastfeeding;
stress;
disorders associated with metabolic processes - diabetes mellitus, liver dysfunction;
endocrine system disorders - hypo- or hyperthyroidism, thyrotoxicosis;
diseases of the genitourinary system, reproductive disorders (female and);
uncontrolled use of hormonal drugs, including contraceptives.

If you find similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of mastopathy

The main symptoms of mastopathy are:

pain;
thickening of the structure of the mammary gland;
discharge from the nipples (can be clear or resemble colostrum - the fluid that is released before and immediately after childbirth).

On palpation, large and small formations with a granular surface can be found. Pain can be of different nature and intensity. In addition to the soreness of the mammary glands, engorgement, swelling and an increase in breast volume are felt. Pain can be radiating and spread to the armpit, shoulder and shoulder blade, and also disappear in the first days of menstruation. However, some women are constantly worried about the soreness of the mammary glands, regardless of the phase of the menstrual cycle.

Pain syndrome can occur both in response to touching the gland, and in the form of constant discomfort that increases during menstruation. With the progression of the disease, the symptoms become brighter, the soreness is more noticeable, and tissue compaction can be determined already regardless of the frequency of the cycle.

Pathogenesis of mastopathy

Dyshormonal disorders play an important role in the development of mastopathy. Of particular importance are:

relative or absolute hyperestrogenism (excess estrogen);
a progesterone-deficient state (lack of progesterone).

Relative hyperestrogenism accompanied by a change in the level of estrogen relative to progesterone, but, in turn, these hormones are still within the normal range. Absolute hyperestrogenism characterized by an increase in the target level of estrogen.

Thus, with an increase in estrogen, proliferation occurs - the proliferation of ductal alveolar epithelium, while progesterone tries to interfere with this process due to its abilities: it reduces the expression of estrogen receptors and reduces the local level of active estrogens. These properties of progesterone limit the stimulation of breast tissue proliferation.

With hormonal imbalance (an excess of estrogen and a deficiency of progesterone), edema and hypertrophy of the intralobular connective tissue occurs in the tissues of the mammary gland, and the proliferation of the ductal epithelium leads to the formation of cysts. When arising progesterone-deficient conditions excessive concentration of estrogens leads to the proliferation of breast tissue and disruption of the receptor apparatus.

It is worth noting that the results of studies on the content of these hormones in blood plasma cannot always confirm this pathogenetic process. Most scientists were able to detect a lack of progesterone in mastopathy, but in other studies, its level was within normal limits.

In the development of FCM, an equally important role is played by increased prolactin levels in the blood, which is accompanied by engorgement, soreness of the mammary glands and edema. These symptoms are more pronounced in the second phase of the menstrual cycle.

Medical research has proven connection between diseases of the mammary glands and genitals... It was found that with inflammatory diseases of the genitals in 90% of cases, pathological changes occur in the mammary glands. And provided that uterine fibroids are combined with, the risk of nodular forms of mastopathy increases.

It should be noted that inflammatory diseases of the genitals do not act as a direct cause of FCM development. However, they can have a direct impact on its development through hormonal disorders.

Women suffering from adenomyosis and endometrial hyperplasia have a particularly high risk of developing breast diseases.

Classification and stages of development of mastopathy

In modern medicine, there are several classifications of FCM.

Currently, the most common of them is the classification of N.I. Rozhkova. In it, those forms of mastopathy are distinguished that can be detected on radiographs and using morphological research. These include:

diffuse mastopathy with a predominance of the fibrous component (characterized by swelling, an increase in interlobular connective tissue septa, their pressure on the surrounding tissue, narrowing or complete overgrowth of the duct lumen);
diffuse mastopathy with a predominance of the cystic component (one or more elastic cavities with liquid contents appear, which are clearly delimited from the surrounding tissues of the gland);
diffuse mastopathy with a predominance of the glandular component (characterized by edema and proliferation of glandular tissue);
mixed mastopathy (with this type, the number of glandular lobules increases and connective tissue interlobar septa grow);
sclerosing adenosis (there are frequent pulling pains, a dense neoplasm is formed);
nodular mastopathy (characterized by the formation of well-defined nodes).

There is a classification of mastopathy, which is based on the degree of proliferation. Grade I includes FCM without proliferation, grade II - mastopathy with epithelial proliferation without atypia, grade III - mastopathy with atypical epithelial proliferation. Grades I and II are precancerous conditions.

Complications of mastopathy

It is important to remember about the relapse of the pathology, which is possible after conservative therapy or in the presence of undetected hormonal disruptions, cyst suppuration and, as a result, mastitis, which does not allow performing the operation with an aesthetic approach. However, rough postoperative scars can also contribute to breast discomfort.

Also, complications of mastopathy can be attributed, but it occurs quite rarely.

Diagnostics of the mastopathy

When visiting a doctor, patients most often complain of chest pain and engorgement of one or both mammary glands, which intensifies a few days before the onset of menstruation. Almost all women experience mild pain before the onset of menstruation. However, if breast tenderness is a consequence of the pathological condition of the mammary glands, then the pain becomes more pronounced and asymmetric. However, 15% of patients do not experience pain in the chest area, and the reason for their visit to a doctor is a seal in the glands.

FKM diagnostics is carried out in stages:

puncture of nodules and morphological examination of punctates and nipple discharge (cytological examination);

hormonal research;
gynecological examination.

When palpating the mammary glands, it is important to pay attention to the consistency, presence or absence of strands, seals, volumetric formations, to evaluate the density of strands, their adhesion to the skin, etc. Palpation of the axillary, subclavian and supraclavicular lymph nodes is mandatory.

Treatment of mastopathy

First of all, the treatment consists in finding and eliminating the causes of mastopathy: nervous disorders, ovarian dysfunction, gynecological diseases, liver diseases, etc.

The main tasks of the treatment of mastopathy: to reduce pain, reduce cysts and fibrous tissues in the mammary gland, to prevent recurrence of tumors and oncopathology, and also to correct hormonal status (after the detection of hormonal disorders and consultation of a gynecologist-endocrinologist).

If the patient's body has concomitant inflammatory diseases of the female genital area, endocrine diseases (hypothyroidism, nodular goiter, diabetes mellitus, etc.), then the treatment must be carried out in conjunction with a gynecologist, endocrinologist and therapist.

Treatment of mastopathy can be roughly divided into two main types - conservative (medication) and surgical (surgical) treatment. Most often, conservative treatment with IFC is carried out. In the event that there are large cysts and significant seals that do not respond to conservative treatment or if therapy is unsuccessful, surgical treatment is performed.

Conservative treatment

The usual tactics for managing women suffering from mastopathy was developed back in the 60s and 70s, so at the moment it is not effective enough. The new drugs introduced into practice have increased the effectiveness of treatment at the initial stage. However, these drugs turned out to be ineffective for women with fibrocystic mastopathy, who had a history of close relatives (mother, grandmother, sister, aunt) suffering from breast cancer.

With drug treatment, the following drugs are used:

Hormone therapy

This method of treatment is prescribed in difficult cases of FCM. Normalization of the hormonal balance is primarily aimed at eliminating pain. Stabilization of the state of the endocrine glands and the gastrointestinal tract helps prevent the appearance of new formations, reduce the size of existing ones, reduce or eliminate pain. However, proliferative forms of fibroadenomatosis and fibrocystic or fibromatous mastopathies do not respond well to this method of treatment.

The use of hormonal drugs is prescribed individually and is carried out under the supervision of the attending physician. Medicines are used in the form of tablets, injections or gels that are applied to the mammary gland. Patients of reproductive age may be prescribed hormonal contraceptives. Systemic hormone therapy should be carried out by a highly qualified specialist who can control the hormonal status.

Hormone therapy involves the use of antiestrogens, oral contraceptives, gestagens, androgens, inhibitors of prolactin secretion, analogs of the releasing hormone gonadotropin (LHRH). Analogue treatment

LHRH is applicable to women with mastodynia (breast pain) in the absence of effective treatment with other hormones. The action of gestagens is based on an antiestrogenic affect at the level of breast tissue and inhibition of the gonadotropic function of the pituitary gland. Their use in the complex therapy of mastopathy increased the therapeutic effect up to 80%.

For the treatment of mastopathy in women under 35, oral monophasic combined estrogen-gestagenic contraceptives are applicable. Their contraceptive reliability is almost 100%. In most women, while using these drugs, there is a significant decrease in pain and engorgement of the mammary glands, as well as restoration of the menstrual cycle.

Currently, in the treatment of mastopathy, a rather effective external drug is used. It contains micronized progesterone of plant origin, identical to the endogenous one. The drug is released in the form of a gel. Its advantage lies precisely in external use - so the bulk of progesterone remains in the tissues of the mammary gland, and no more than 10% of the hormone enters the bloodstream. Due to this effect, there are no side effects that occurred when taking progesterone orally. In most cases, it is recommended to continuously apply the drug, 2.5 g to each mammary gland, or to apply it in the second phase of the menstrual cycle for 3-4 months.

Non-hormonal therapy

Methods of non-hormonal therapy are: diet correction, correct selection of a bra, the use of vitamins, diuretics, non-steroidal anti-inflammatory drugs that improve blood circulation. The latest non-steroidal anti-inflammatory drugs have been used for a long time in the treatment of diffuse mastopathy.

Indomethacin and brufen, used in the second phase of the menstrual cycle in the form of tablets or in suppositories, reduce pain, reduce swelling, promote resorption of seals, and improve the results of ultrasound and X-ray examinations. The use of these drugs is especially indicated for the glandular form of mastopathy. However, for most women, homeopathy or herbal medicine may be sufficient.

Conservative treatment of mastopathy should consist not only in the long-term use of sedatives, but also vitamins A, B, C, E, PP, P, since they have a beneficial effect on the breast tissue:

vitamin A reduces cell proliferation;
vitamin E enhances the effect of progesterone;
vitamin B reduces prolactin levels;
vitamins P and C improve microcirculation and reduce local edema of the breast.

Since mastopathy is regarded as a precancerous disease, long-term use of natural antioxidants is required: vitamins C, E, beta-carotene, phospholipids, selenium, zinc.

In addition to vitamins and sedatives, patients are shown the intake of adaptogens, lasting from four months or more. After a four-month course, the use of the drug is stopped for a period of two months, and then the treatment cycle is resumed for four months. In total, at least four cycles must be carried out. Therefore, the full course of treatment can take approximately two years.

Diet food

When treating mastopathy, it is necessary to establish the work of the digestive system. Therefore, recovery can be accelerated by following a special diet. To do this, it is necessary to reduce the calorie content of food by avoiding carbohydrates. First of all, it is important to completely get rid of the use of easily digestible carbohydrates (sugar, honey, jam and flour products) and increase the proportion of vegetables, unsweetened berries and fruits consumed.

With mastopathy, which has developed as a result of problems with the thyroid gland, it is necessary to limit the use of meat dishes, since protein stimulates the secretion of thyroid hormones, on which the level of the female sex hormone - estrogen depends.

If mastopathy appeared against the background of hypertension, then it is necessary to limit the use of fats, especially butter and lard to reduce hormonal stimulation of the breast.

To provide the body with the necessary amount of calcium, which regulates the functions of hormonal glands and has an anti-inflammatory and anti-edema effect, you should consume kefir, yogurt and cottage cheese. Among other things, it is advisable to include in the diet seafood that contains iodine - fish, squid, shrimp and seaweed. This trace mineral is also present in large quantities in walnuts and mushrooms.

In addition to the general course of treatment, you can also take herbal decoctions that help to improve sleep and pain relief, have a diuretic effect, containing iodine and other beneficial elements.

Surgery

If conservative treatment of mastopathy has not brought results, then the pathology must be eliminated by surgery. Surgical removal of the affected tissue is prescribed in the following cases:

rapid growth of neoplasm;
impossibility of drug treatment due to diabetes mellitus;
malignant transformation of mastopathy, detected by biopsy;
genetic predisposition to.

During the operation, a separate sector of the mammary gland is removed, in which cysts and seals are found (sectoral resection). The operation takes 40 minutes under general anesthesia.

After surgery, antibiotics and vitamins are prescribed. If necessary, anesthesia is carried out, taking sedatives. Hormone therapy can be used to prevent relapses. In this case, patients need to start treating the underlying disease that caused the imbalance of hormones.

With large cysts, it is possible to conduct laser coagulation these formations. This technique is quite young and not widely used due to expensive equipment. For this procedure, a modern laser device BioLitec is used, which allows coagulation of cystic formation without incisions and anesthesia. Also, with this procedure, there is no risk of infection, staying in an inpatient department is not required.

Thermal procedures, including physiotherapy, are not recommended in the treatment of FCM, since they can intensify inflammatory processes.

Forecast. Prevention

A favorable prognosis is reduced to a timely visit to a specialist mammologist, periodic ultrasound of the mammary glands. All this will help protect yourself from the unpleasant consequences of the pathology of the mammary glands. You do not need to be afraid of the symptoms of the disease and its treatment, you should be afraid of the consequences. Mastopathy can disappear without a trace, it only requires attention to one's own health.

It is worth remembering that being overweight is a harbinger of many hormonal disorders. If, after 50 years, a woman's clothing size has changed from 50 to 56, then this should be regarded as a warning about the danger emanating from the human hormonal system. This, in turn, indicates the need for a survey.