Sclerosing adenosis of the mammary gland on mammography. Adenosis of the mammary glands: a description of the pathology, what it is from the standpoint of modern medicine. Diagnostics of the sclerosing adenosis of the breast

Adenosis of the mammary gland is a disease that belongs to one of the varieties of mastopathy and is characterized by fibrous and cystic transformation of breast tissue. The pathogenesis of the disease is associated with the development of an abnormal location of cellular structures due to their compression by growths of connective tissue and cystic cavities. In this article we will talk about adenosis of the mammary glands: what it is, how it develops, how life-threatening it is, and what are the methods of treatment.

What it is

Causes and risk factors

The main etiological factor in the development of diseases is a violation of the hormonal background in the female body. Pathological changes in the functional ability of the endocrine system leads to tumor degeneration of breast tissue. Changes in hormonal levels can contribute to a strong and prolonged emotional disorder, excessive physical activity, as well as diseases that reduce immunity.

Provoking factors for the development of adenosis of the mammary gland:

previous abortions and surgical interventions in the form of a cesarean section, traumatizing childbirth;
the first pregnancy in women after 40 years;
complete infertility of a woman;
a woman's refusal to feed her baby naturally.

Risk factors for the development of the disease:

obesity or uniform excess body weight;
inflammatory processes of the reproductive organs of a woman;
chronic pathologies of the pancreas;
hypertension;
immunodeficiency;
long-term use of hormonal contraceptives;
promiscuous sex;
surgical operations on the pelvic organs; mental disorders.

Kinds

By structure

Classification of adenosis of the mammary glands depending on the structure of the pathological process:

Apocrine form- This is a tumor that changes the structural appearance of the cells that make up the lobules of the breast.
Tubular form- this is a tumor that forms inclusions in the form of tubules in the tissues of the gland, as is correct, there are many of them, they are easily palpable and visible during ultrasound examination.
Microglandular adenosis- This is a type of pathology in which a lot of glandular cells of a round shape appear in the fibrous tissue.
Focal adenosis breast or sclerosing adenosis of the breast are types of tumors that are characterized by the presence of their own excretory ducts.

By localization

Localization classification:

Local adenosis the mammary gland is a form of oncological pathology that is benign in nature. The tumor is represented by a neoplasm with clear boundaries; its structure resembles lobules, has a fibrous capsule. The tumor is located in a certain area of the mammary gland and has a clearly defined limited appearance.
Diffuse adenosis the mammary gland is a tumor that is characterized by the absence of clear boundaries of germination. Diffuse adenosis is a very severe pathology that leads to complete destruction of tissues and, as a result, complete amputation of the mammary gland.

Features of sclerosing adenosis

Sclerosing adenosis of the mammary gland differs from other forms of the disease in that the proliferation of tumor cells is so compact that even with standard instrumental research methods, the development of oncological disease can be skipped.

In the sclerosing form of the disease, tumor cells are located in the area of fibrous tissue, the progression of the proliferation of these cells leads to compression of the excretory ducts of the mammary glands. Due to the uniform distribution of fibrous tissue and tumors, the duct is compressed evenly from all sides.

Symptoms

Breast adenosis is a disease that develops gradually against a background of hormonal imbalance.

General symptoms are manifested in the form:

soreness in the chest area, which increases before the onset of menstrual bleeding;
an increase and increase in the density of the glands during menstruation;
discharge of a serous and purulent character from the nipples; the presence of a conglomerate when probing the breast;
soreness of the gland on palpation.

With diffuse adenosis, diffuse soreness is noted throughout the gland. Symptomatic manifestations develop in connection with the change of phases in the menstrual cycle. The pain can be cutting, stabbing and pressing in nature, sometimes radiating to the neck, shoulder or back.

On palpation, there is a sharp sensitivity of the nipple and the presence of purulent discharge when pressed. When probing, you can detect the presence of many small formations in the structure of the gland.

Local form

With a local form of the disease, the tumor is located in a certain area, it has clear boundaries, does not have growths. When probing the gland, a rounded, mobile and painful to the touch formation is found, which is not accompanied by the development of a local inflammatory process. Unlike the diffuse form, there is no discharge from the nipples, and an exacerbation of the disease during menstrual bleeding.

Diagnostics

In practice, the following techniques are used to make the final diagnosis:

General examination of patients and palpation of the affected area.
X-ray research methods (mammography) are carried out in order to detect dense tumor-bearing formations.
Ultrasound is used to examine pathological structures and their consistency. Adenosis of the mammary glands on ultrasound is manifested in the form of an increase in the echogenicity of the affected area and cystic degeneration of glandular cells.
Puncture and bacteriological culture from cystic cavities.

When conducting an external examination of the patient, the parameters are assessed:

comparison appearance a healthy and damaged gland;
assessment of the condition of the skin over the mammary glands;
assessment of the condition of the nipples;
detection of the inflammatory process in the regionally located lymph nodes.

Treatment

The tactics of treatment differs depending on the form and severity of the disease. Adenosis of the mammary glands is successfully eliminated with the help of conservative methods of treatment, but with rapid progression and in a neglected state, patients are recommended to undergo surgery.

Conservative

Conservative methods include using:

Vitamin-containing medications are used for general strengthening of the body.
A group of drugs with a sedative mechanism of action, are used when a woman is in a depressed state for a long time.
Diuretic and diuretic drugs are used for severe swelling of the soft tissues of the lower extremities.
Hormonal treatment is used as etiotropic therapy.

In the case when adenosis of the mammary glands has developed, treatment is carried out not only with the use of drug correction, but it is also recommended to adhere to special diet... Women are advised to limit the consumption of fatty and genetically modified foods, eat more natural, environmentally friendly and vitamin-containing foods.

Folk remedies

Traditional methods of treatment involve the use of herbal preparations or organic products. As folk methods Compresses made from ground pumpkin seeds, ground beets, or fresh cabbage leaves are widely used.

These methods will not help get rid of the disease, but they will significantly alleviate the general condition of the patient, they do not cause side effects and absolutely harmless to use.

Surgical

Surgical intervention is carried out in extremely neglected conditions and with a local form of the disease. In connection with the advancement in modern medicine, operations have become less traumatic with the use of plastic methods.

However, with a massive lesion of the glandular structures of the gland, an operation is indicated with its complete removal.

Prophylaxis

As a prophylaxis of the disease, women are recommended:

closely monitor the regularity of the menstrual cycle;
periodically attend consultations with gynecologists;
adhere to a healthy lifestyle and timely treat infectious diseases of the reproductive system;
to refuse from bad habits;
avoid pregnancy and childbirth over the age of 40.

An attentive attitude to health will allow avoiding many unpleasant diseases in the future.

Danger of disease

The prognosis for recovery depends on the degree of progression of the disease, and on how effectively conservative therapy was carried out. On the early stages the disease does not pose a particular danger, but a neglected condition can threaten a woman with the development of malignant cancer.

Video

In our video, an oncologist will talk about breast diseases.

Today, such a serious and confusing diagnosis as adenosis of the mammary gland is made to literally every second young woman, and moreover, from year to year the total number of women suffering from this ailment is steadily growing.

Whether or not to treat this ailment with hormones, folk remedies and other methods - this is an almost inexhaustible topic of controversy for most modern doctors.

Despite such a high prevalence of the aforementioned ailment, and the fact that most often the problem appears in women of childbearing age (30 to a maximum of 50 years), there is no single scheme or algorithm representing treatment.

In fact, the main contingent of patients with mastopathy (and adenosis of the mammary gland is considered one of the forms of this particular ailment) are those women who suffer from various kinds of gynecological diseases.

The diseases that most often accompany or even provoke adenosis of the breast include:

Painful (overly) premenstrual syndrome.
Frequent dysfunctional uterine bleeding.
The so-called endocrine infertility of women.
Development of uterine fibroids.
A disease such as endometriosis, etc.

Unfortunately, the incidence and development of breast cancer in women with such diseases, and even with adenosis that has developed along the way, is several times (almost 5 times) higher than in relatively healthy women.

It is worth recalling that adenosis of the mammary gland is a condition that can be characterized by dyshormonal hyperplastic processes occurring in a woman's breast.

This condition differs from other forms of mastopathy by the changes occurring and affecting the glandular tissues, or rather the lobular structures of the breast.

Why do doctors argue about treatment options for adenosis?

Most likely, the controversy over what should be the treatment of breast adenosis is associated with the incredible variety of causes that cause similar hormonal problems in women.

As you know, any form of mastopathy, and in particular adenosis of the mammary gland, can occur as a result of a violation of the physiologically correct balance in female sex hormones.

But this hormonal imbalance can lead to:

As a result of such violations, certain hormonal disruptions leading to the fact that directly in the woman's mammary gland, the correct ratio of epithelial, glandular and, accordingly, connective tissues can change.

However, one must understand that just "out of the blue" the strongest hormonal breakdown cannot occur; this requires some rather weighty reasons, called the neurohumoral factor.

In this case, the prefix "neuro" can mean that a specific triggering mechanism for the development of mastopathy may be various disorders in the work of a woman's nervous system - and these are, first of all, psychoses, neuroses, etc.

In addition, liver disease and other internal organs... The so-called "humoral factor" can indicate the entire internal environment of the female body, where a lot can depend on the work of various biologically active substances - or the same hormones.

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Since any treatment, at the discretion of traditional medicine, should be aimed at eliminating the root causes of the problem, it becomes clear why there is so much controversy regarding this disease:

Firstly, it is always extremely difficult to clearly define the factors that, in a particular case, could provoke the disease.
And secondly, the complexity also lies in the fact that a combination of several factors can lead to the development of the disease.

How is mastopathy (adenosis) treated by traditional doctors?

Today, representatives of traditional medicine, with an established diagnosis of adenosis of the mammary gland, do not consider it necessary to prescribe a powerful (full-fledged) treatment using hormones and other serious drugs.

It is believed that the initial stages of mastopathy, in particular a condition such as breast adenosis, require only systematic observation and control over the condition, under the supervision of specialists, but nothing more.

Nevertheless, some traditional doctors are convinced that, in addition to this, the adenosis condition can be treated with folk remedies, but strictly under the supervision and supervision of a doctor, so that in case of progression of the disease, additional hormonal therapy and other traditional treatment can be prescribed in a timely manner.

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But, in any case, the principles of treatment of any form of mastopathy should be determined in strict accordance with an integrated (systemic) approach to treatment. Physicians must cover all the variety of external factors that led to the problem.

In this case, the doctor must take into account all the features of the woman's health status, her hormonal status, metabolic processes in the body and, of course, the personal characteristics of a particular patient.

Application of phytotherapy techniques for the treatment of adenosis

Today, the treatment of certain forms of mastopathy (adenosis in particular) with the help medicinal herbs provides for a strictly integrated approach:

The first stage of such treatment involves the normalization of previously disturbed neurohumoral regulation.
The second stage should be the maintenance of this regulation exclusively at a physiologically normal level.

A full-fledged herbal medicine should include solving the problems of all concomitant diseases, since without this there will not be a complete disappearance of the existing pathological processes.

It should be noted that isolated options for the treatment of the mammary glands are a significant strategic mistake, since they do not provide for the correction of all concomitant pathologies and the specific hormonal status of the patient.

In such cases, therapy is only symptomatic, and does not at all eliminate the underlying causes of the pathology. Correct phytotherapy of adenosis (and other forms of mastopathy) should include the following:

Normalization of endocrine relationships.
Direct full effect on the existing tumor.
Complete immunomodulation of the whole organism.
Treatment of concomitant diseases of the endocrine system.
Complete regulation and stabilization of all metabolic processes.

With proper phytotherapy, plants of several individual groups... The first group includes gonadotropic plants, which have a selective effect on the female sex glands.

The second group of plants used in the treatment of adenosis includes plants with antitumor effects. The third group of plants includes plants immunomodulators (increasing immunity).

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60% of women suffer from mastopathy. The worst thing is that most women are sure that mastopathy is the norm and are in no hurry to see a doctor ... but the risk of BREAST CANCER in its place is very high ... If you notice yourself:

aching or pulling pains in the chest area before menstruation ...
sensations of swelling and swelling of the mammary glands. As if the breasts were enlarged ...
tension, seals and nodules. Lymph nodes are felt under the arm ...
nipple discharge ...
change in the shape of the breast, the skin on the nipples retracted and cracks appeared ...
change in body weight ...

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Reading time: 6 minutes

Not everyone knows what adenosis of the breast is. Pathology is a process of hyperplasia in the lobules of the mammary gland, when their accelerated pathological development and proliferation of epithelial cells occurs, while the glandular tissue becomes denser and nodes appear in it.

The disease is one of the forms fibrocystic breast disease... In other words, breast adenosis is one of the particular manifestations of fibrocystic mastopathy (FCM).

The diagnosis has many other definitions: lobular sclerosis, fibrosing adenosis, hyperplasia, myoepithelium, sclerosing adenosis, etc.

The essence of the problem

So - what is it? Today, according to the WHO, 25% of women have breast pathologies (MF), and mastopathy prevails among them.

It has 50 varieties, and adenosis is one of them. It begins to register by the age of 35 and older, even in postmenopausal women.

The disease is considered conditionally harmless due to its benign quality, but requires constant monitoring. Adenosis is similar, but somewhat different from breast adenoma.

Although adenomatosis of the mammary gland is also characterized by the growth of glandular tissue, more connective tissue is involved, and the approach to treatment is different.

Another name for pathology is adenofibrosis. But all these violations are varieties of FCM, and the choice of treatment tactics is determined by a specialist.

It is also necessary to distinguish steatonecrosis - this is a rare form of breast pathology that develops in obese elderly women after injuries (a small hard nodule is located behind the nipple or under the skin).

In scientific medicine, any pathological growths of glandular tissue in organs of a hyperplastic type are called adenosis.

In this case, pathological changes occur in the myoepithelium - epithelial cells that are part of the secretory sections of the sweat, mammary and salivary glands.

If you look at it, you can see that its parenchyma consists of lobules, which are separated by connective tissue septa.

Inside each lobule there is a milk duct with branches to the alveoli. Fatty tissue is always present in the mammary gland; it surrounds the septa of the connective tissue. With age, it begins to replace the glandular tissue.

But most often adenosis is glandular, or rather, its lobules. In this case, a seal forms in the chest, and the functioning of the gland is impaired, although the symptoms are mild at first.

A growing tumor can compress nerves and blood vessels, so most often the affected area must be removed.

Causes and risk factors

The main reason for the pathologies of the mammary glands in 90% of cases lies in hormonal imbalances, namely in a decrease in the production of sex hormones.

In women, during their life, total hormonal changes occur at different age periods: menopause, postmenopause, pregnancy, lactation, less often - early puberty.

Hormonal disruptions begin with ovarian dysfunction, hyperplasia in the uterus, are observed with hypo- and hyperthyroidism, and can affect the pituitary gland.

At any interval of such bursts, it is the glandular tissue of the mammary gland that turns out to be the most vulnerable.

If, at the same time, a woman is constantly experiencing stress, smokes and violates the rules of nutrition, then the situation is aggravated.

In addition, it plays a role:

heredity and bad ecology;
abortion (especially during long periods of pregnancy);
early labor or overstimulation of labor;
refusal of hepatitis B after childbirth and suppression of lactation;
gynecological problems and other pathologies of the small pelvis;
long-term reception OK;
pregnancy after 35 years;
hypertension, diabetes, obesity.

With obesity, for example, there is a passion for sweet and fatty, and the liver in such conditions cannot cope with such an increased load.

Sugar is transformed into fat, which itself begins to produce low-quality estrogen, all this together leads to adenosis in the mammary gland.

Therefore, in such women (whose dietary regimes did not correspond to healthy norms), as a rule, hepatosis becomes a concomitant pathology.

Classification of pathology

All damage to the epithelium during benign processes are divided into 3 types:

Overgrowth without active proliferation.
Proliferation without atypia.
Atypical hyperplasia.

With adenosis, there is no active cell proliferation, therefore it is the least dangerous in terms of malignancy. There are 2 main forms - diffuse and local adenosis MF.

Diffuse, or focal, adenosis of the mammary gland is associated with the degeneration of the myoepithelium.

Glandular tissues develop as cystic fibrous changes. Diffuse adenosis of the mammary gland is usually mild, while the lumps have indistinct shapes and boundaries, but they are common throughout the breast.

As it develops, the affected area increases. During such processes, not only the glandular tissue is damaged, but also the lactiferous ducts. As a result, papillomas develop inside them in the form of outgrowths of the epithelium.

With a local form (), limited seals can occur in any lobule of the gland, therefore their structure is lobular.

The formations are relatively large, each lobule is surrounded by a layer of fibrosis (capsule). Myoepithelial cells are located between the lobules.

The compaction affects only a single area, therefore it is noted. Depending on the affected part, this form has several subspecies:

Sclerosing adenosis of the breast - Affects the lobules. There is a rapid proliferation of fibrous tissue.

The nodules in this form are very dense, small and mobile. Active tissue growth is noted in the thoracic ducts, as a result of which intraductal papillomas appear, and the ducts themselves are overgrown with epithelial cells.

The lymph nodes are usually not affected. Soreness appears in the chest in the first half of the MC.

The tumor spreads to several ducts of the gland. The seal is flexible and has clear boundaries.

Apocrine adenosis - Nodules contain a lobule of the mammary gland; they are easily palpable, located along each lobule. Intraductal papilloma is covered with epithelium and muscle epithelial cells (ductal hyperplasia of the mammary glands). Often, an altered glandular epithelium is found in it, which has acquired a resemblance to the epithelium of the apocrine glands (apocrine epithelium).

Adenomyoepithelial form - It does not have a specific localization, it is rare. Seals of epithelial cells with it are formed randomly.

Microglandular form - It occurs even less often, while epithelial seals are formed in the smallest ducts in size. The fibrous tissue becomes permeated with small round nodules, which are often located and there are many of them.

Tumor-like type - The lump is small, resembles a disc, no symptom makes itself felt. X-ray helps to identify pathology. By morphology, there are altered epithelial cells.

Tubular form - It differs from others with microcalcifications and 2 layers of epithelium. A mass of identical retracted tubules is formed in the gland.

Danger of adenosis

The danger lies in the fact that pathology often proceeds without pronounced symptoms, respectively, and is diagnosed late.

It can lead to the development of mastitis and mastodynia, tumors and changes in the shape of the breast.

Symptomatic manifestations

The standard of the clinic is that at first there are no symptoms.

on palpation;
in the first days of the cycle, engorgement and swelling of the breast occurs;
there is a transparent discharge from the nipples.

There are signs of adenosis of the mammary gland, which have its individual forms, but they are nonspecific and are lost in the general mass.

Pain, swelling and engorgement of the breasts can also cause adenomyosis, so an examination is necessary here.

Women themselves are able to grope for movable elastic balls with a granular surface (they will occupy only some part of the breast). Most often, adenosis is observed in young girls at the end of puberty and in pregnant women in the 1st trimester.

Diagnostic measures

Diagnostics is carried out primarily in order to identify the malignancy of the formation, and then to determine the form of adenosis.

The main determining method is still mammography. With this method, the entire characteristic of the existing education is determined: its location, size and shape.

Any shadows always correspond to the area of lobular hyperplasia. It is with her help that a complete diagnosis is established, therefore such an examination is very informative.

In the case of adenosis of the mammary gland, on the roentgenogram, multiple shadows of an irregular shape and with fuzzy boundaries are always noted, which correspond to areas of hyperplastic lobules.

In second place is ultrasound, although it is not so informative (the size and shape, of course, are determined). But on the ultrasound, you can distinguish the malignancy of the process.

For this, a biopsy is also used, followed by microscopy of the taken piece of tissue.

A blood test for the hormones TSH, LH, FSH is mandatory - this allows you to determine the etiology.

In addition, they take blood for biochemistry and a detailed blood test. If the diagnosis is unclear, MRI and CT are performed.

Treatment principles

There are conservative and surgical methods of treatment for adenosis. Sometimes they are combined.

Diffuse forms are successfully treated and cured conservatively; focal forms - surgically.

Conservative treatment is represented by hormonal therapy, which includes diuretics, vitamins, adaptogens, hepatoprotectors.

It should normalize the level of female hormones, therefore, various OCs and gestagens are used. On average, the course of admission lasts up to six months under constant supervision.

With the ineffectiveness of conservative treatment, in advanced cases and with rapid tumor growth, an operation is performed. More often this is observed in the sclerosing form and apocrine.

List of possible assignments:

"Lindinet 30" - reduces the growth of glandular tissue. Already after 2 months, the symptoms of adenosis disappear, and the MC normalizes.
Gestagens are prescribed for more pronounced signs of adenosis. Among them are "Norkolut", "Pregnin", "Duphaston", "Progesterone" in oil solution. The dose and regimen are selected only by a doctor.
From OK - "Silhouette", "Janine", "Zhenegest" and others.

With adenosis of the mammary glands, treatment will give the first results with hormonal therapy after 2 months:

pain and discharge from the nipples disappear;
seals go away;
the menstrual cycle is normalized.

Sometimes in young girls and in milder forms of the disease, homeopathic treatment is used. By itself, it is weak, but when combined with hormones, the effect is more pronounced and lasting. The most commonly used drugs are "" and "Mammoleptin".

Surgery- This is a sectoral resection of the affected area of the breast or its exfoliation (enucleation).

The excised tissues are sent for urgent histology right during the operation. When the tumor degenerates, atypical cells are found. Then the tactics of further treatment is adjusted.

What are the predictions

The prognosis is good if treatment is started on time. When affecting the ducts, special dynamic control is required.

Relapses are possible only with subsequent hormonal disruptions.

For prevention purposes, considerable attention should be paid to the correct choice of products:

less animal fats and heat treatment;
more fiber, cereals, greens.

Adequate drinking regime, weight normalization is required. Moderate exercise will help:

morning exercises;
walks;
swimming;
meditation;
from exercise, push-ups are useful.

A positive mood and a healthy lifestyle will protect not only from adenosis, but also from a number of other diseases.

Be sure to visit a doctor every six months, as well as a monthly self-examination of the mammary glands after menstruation.

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The correct selection of contraceptives is necessary, preferably planning a pregnancy before 35 years of age.

Mastopathy is one of the most common benign tumor diseases in women. The manifestations of mastopathy and its danger largely depend on the form of the process. Diffuse fibrocystosis of the mammary gland is the most common. And one of the forms of such mastopathy - - refers to potentially oncological.

A diagnosed sclerosing adenosis increases the risk of breast cancer by almost 7 times in comparison with other types of mastopathy.

Features of breast fibrosclerosis

Sclerosing adenosis occurs in 5% of women aged 20 to 40 years with mastopathy. The disease develops by the proliferation of connective cells in the epithelial tissue of the mammary gland, which then undergo fibrous degeneration. The processes of tissue replacement in fibrosclerosis are accompanied by the formation of calcifications.

The limited form of sclerosing adenosis is characterized by nodular localization, and diffuse - by the development of multiple small foci of tumors.

The presence of fibrosclerosis often leads to the fact that on images of mammography this disease can be confused with the initial stage of invasive breast cancer.

Treatment of sclerosing adenosis of the breast

Since breast fibrosclerosis is a background for the development of cancer, the patient must be under strict medical supervision. Most often, fibrosclerotic tissue is not removed, but a wait-and-see approach is taken.

D24 Benign neoplasm of breast

Causes of adenosis of the breast

Each disease has its own prerequisites. The same applies to adenosis of the mammary gland, the causes of which are as follows:

Hormonal disorders that the female body has undergone. After such a failure, the breast tissue begins to experience transformations that threaten the woman's health.
This is the first and main reason why tissue changes occur in the female breast.

Hormonal problems do not arise by themselves, but as a consequence of various problems:

Various diseases of the female body, problems with the endocrine system, and so on.
In many cases, both hormonal problems and breast adenosis are caused by severe stress and negative situations, in which the woman experienced many negative emotions.
In addition, hormonal problems cause a decrease in the body's immune defenses, which can happen for a very wide range of reasons.
The production of a large amount of hormones by the female body in the first weeks and months of pregnancy, which leads to its strongest hormonal changes. At the same time, the amount of estrogen in the blood increases, as well as prolactin, but the level of progesterone decreases.

Mastopathy develops precisely for this reason - an imbalance of hormones, but with adenosis of the mammary glands, this hormonal disruption is very long-term.

Quite often, pathological processes in the small pelvis of a woman and in endocrine system, which are of a hyperplastic nature, namely:

hyperplastic processes in the endometrium of the uterus, when there is also an increase in estrogen levels and a decrease in progesterone,
dysfunctions in the ovaries, which lead to the appearance of cysts, which are of a functional nature,
pathological processes that characterize the thyroid gland, for example, hypothyroidism and hyperthyroidism,
dystrophic manifestations of the liver of a fatty nature, which arise as a consequence of an overweight woman, as well as a large amount of fatty foods or easily digestible carbohydrates, which she often eats.

Symptoms of adenosis of the breast

There are five types of disease: sclerotizing, apocrine, ductal, microglandular, adenomyoepithelial. There is also focal adenosis of breast tissue. The symptoms of the disease vary depending on the type of problem. Each of the varieties will be described below in the appropriate section.

Symptoms of breast adenosis differ depending on its two main forms - local and diffuse. This division depends on the location of the tumor.

Common to all types of adenosis is pathological transformations that affect the tissues of the myoepithelium. In each specific type of disease, its own, only this type of inherent changes in the tissues of the mammary gland occur.

Also, periodic pain in the chest, which occurs quite often, is characteristic. Pain can be either bursting or pulling. The level and frequency of pain begins to increase before the onset of menstrual bleeding. Such pain sensations do not depend on the degree of the disease, as well as its form. In addition to the above pains, there are signs of breast engorgement, which are observed in the luteal phase of the menstrual cycle.

There are no visual signs at first. There is no discharge from the breast, and the nipple in its size and shape does not acquire any transformations. The gland increases with periodic engorgement either over the entire area of the breast, when tissue changes are diffuse, or it increases and engulfs only a part of the breast. It depends on the form of the disease.

With a tumor type of disease, the formation of a movable node is found in the tissues of the breast. It can be different in structure: include several lobules or have a disc-like appearance. At the same time, the woman does not experience discomfort, which does not imply early referral to specialists for diagnosis and treatment.

In some cases, breast adenosis is formed in parallel with another form of mastopathy, but this picture of the disease does not affect the symptoms and development of the underlying problem in any way.

When examined by a specialist, you can identify some signs of a violation of the structure of breast tissue. In this case, you will need to resort to palpation to find seals affecting some parts of the breast. It happens that these tissue transformations affect the entire breast completely. In this case, there is no change in the skin, as well as the shape of the breast. Lymph nodes during the disease are also not enlarged and visually function normally, except in the local form of the disease.

Consider the specific manifestations of some subspecies of the pathological process:

With apocrine adenosis, the outlines characteristic of the lobules of the breast are affected.
In the case of a tubular form in the mammary gland, the formation of retracted tubes, which are of the same size, is ascertained. These tubes are multiple, so they are easy to identify during examination.
In the microglandular form, the fibrous tissue of the gland begins to penetrate with small rounded glands, and their number is large enough and they are often located.
In the adenomyoepithelial form, the symptoms are similar to the previous form, with glandular manifestations, but this form of the disease is very rare.

Forms

Lesions of the mammary glands, which affect the epithelium and are benign, can be divided into several categories, taking into account their histological type:

processes of tissue damage that do not differ in active proliferation, that is, the proliferation of pathological cells,
processes of tissue damage that have active proliferation, but do not have cell atypia,
processes of tissue damage with active proliferation and atypia in the structure of cells, also called atypical hyperplasia.

The glandular adenosis of the mammary glands, which is discussed in this article, belongs to the first group of tissue damage. Therefore, it is considered the safest manifestation of various forms of mastopathy. In this case, the disease refers only to the glandular tissue of the breast and does not cause invasive breast cancer. Although, with a disease, fibrous tissue is formed in a hypertrophied degree, that is, excessively, while mixing and including healthy glandular cells. Such a process leads to damage to the lobules of the mammary glands, which is not a positive phenomenon for a woman's health.

This problem in most cases is found in women who have reached the thirty-forty-year mark. But in some cases, teenage girls who have already come to the end of puberty may also be susceptible to the disease. All women who have not gone beyond childbearing age are no exception: both young and older. Sometimes after conception in expectant mothers for the first few weeks, signs of adenosis of the mammary glands may be observed. In some cases, the symptoms of the disease bother a pregnant woman for the entire first trimester of waiting for the baby, and then go away by themselves by the beginning of the second trimester.

Sclerosing adenosis of the breast

The reasons for the occurrence of this particular form of the disease include an imbalanced balance of estrogen and progesterone in the body, as well as problems with functioning. thyroid gland, namely hypothyroidism.

Sclerosing adenosis of the breast is a form of the disease that affects the lobules of the breast. At the same time, it has the following manifestations:

The most localized proliferation (proliferation of pathological tissues), to which the acini of the breast, which are structural units of the mammary gland, have undergone.
At the same time, the epithelial and myoepithelial layers of the acini are preserved, since they are surrounded by a basement membrane.
Fibrosis of pathological tissues can rather strongly constrain the acini of the lobules that it surrounds. Therefore, the outline of the lobules and their location remains intact. Standard examinations with adenosis can state a well-visible configuration of the breast lobules.
Fibrous tissue forms very quickly and in its growth necessarily alternates with the glandular cells of the breast tissue.
In the form of symptoms, this type of disease is characterized by the presence of small nodules, with sufficient mobility and density.
There is an increase in axillary lymph nodes in some cases of the disease.

Diffuse adenosis of the breast

This form of the disease is characterized by the following manifestations:

Lumps in the chest do not have clear forms and any boundaries.
The neoplasm grows unevenly, that is, diffusely, over the entire area of the breast. That is, tissue enlargements are observed throughout the breast, and not in any particular area.
During the progression of the disease, the boundaries of the compaction grow, affecting the tissues of the gland that surround this pathological formation. In this case, the changes occur evenly over the entire area of the breast.
In this case, there is a danger of damage not only to the breast tissue, but also to the ducts of the gland, which leads to the formation of papillomas. Papillomas are benign tumors that appear on the skin or mucous membrane, and begin to protrude under the surface of these integuments, resembling a papilla.

Diffuse adenosis of the mammary gland stands out due to the classification of the disease in relation to the place of its spread.

Focal adenosis of the mammary gland

With this form of the disease, the following changes in the chest are found:

One of the mammary glands is enlarged to a greater extent. The so-called asymmetry of the mammary gland sets in.
In the tissues of the enlarged breast, seals are found on palpation.
Seals can be single or multiple.

Focal adenosis of the mammary gland has the following manifestations of the disease:

The tumor surrounds several ducts of the breast.
The inner surface of each duct is lined with columnar epithelium. And outside, the ducts are surrounded by hyperplasmic myoepithelium.
Therefore, with this type of disease, you can observe in the chest the outlines of a movable seal with a clear shape

Local adenosis of the mammary gland

Local adenosis of the mammary gland is characterized by the following manifestations:

In the affected breast, seals begin to form, which are characterized by a lobular structure.
The resulting lobules are quite large in size.
Each lobule is surrounded by a fibrous capsule.
Myoepithelial cells are located between the lobules, which have yellow... They are very clearly visible in the diagnosis of the disease.
The grouping of seals occurs only on a specific segment of the breast tissue, that is, it affects a specific area and does not extend to the entire breast.
An increase in regional lymph nodes, which are located in the armpits and above the collarbones, is possible.

Diagnostics of the adenosis of the breast

It happens that changes in the glandular tissues of a fibrous nature begin to grow strongly. In this case, it is possible to affect the duct of the breast, which sometimes entails the development of oncological processes in the gland. To exclude such a complication, specialists can prescribe histological, immunological and cytological studies to a sick woman.

Diagnosis of adenosis of the mammary gland is carried out as follows:

With any symptoms that bother a woman, she turns to a gynecologist or mammologist. The examination, first of all, includes examination of the patient's breast and her palpation. If doctors begin to share a woman's concern, then they prescribe the following procedures for her:

ultrasound examination, which the mammary glands must undergo, as well as axillary lymph nodes, if they are enlarged,
mammography, which consists in X-ray exposure in small doses to the mammary gland in order to obtain a picture,
clinical research,
biochemical analysis,
blood tests for TT, LH, FSH and other hormonal ratios.

Mammological and ultrasound examinations allow the doctor to see the localization of the focus of the problem, as well as find out what is its shape and border.

Sclerosing adenosis of the breast is manifested by nodules that look very much like cancer. Palpation of the breast makes it possible to ascertain movable seals, which have a clear shape and increased density. Examination and mammological examination, which will be done by a specialist, can reveal these seals, but not distinguish them from oncology. Therefore, in order to exclude malignant processes in the breast, it is important to conduct a biopsy of the breast tissue.

Breast adenosis treatment

If, with sclerosing adenosis, a single node or nodes are found that do not progress to growth, then surgery is not performed. In this case, an examination by a mammologist and ultrasound diagnostics are prescribed once every six months.

Treatment of sclerosing adenosis of the mammary gland is carried out with the help of surgical intervention, during which sectoral resection is used. General or local anesthesia is chosen. At the same time, its type is determined by the number of nodes and their sizes, as well as the age characteristics of the patient and the history of the disease in which this type of anesthesia is prohibited.

To make the operation cosmetically correct, specialists cut the areola along the edge, without paying attention to the localization of the node. It is important to do this for aesthetic reasons so that the mammary gland has a decent appearance after surgery. The node that was cut out during the resection is most often sent for a histological study in order to clarify the diagnosis and exclude the presence of atypical cells.

After surgery, the patient can be sent home. In this case, oral analgesics are prescribed to relieve pain after surgery.

Therapy for other forms of the disease depends on the type of adenosis and the nature of its course.

The diffuse form requires the use of conservative treatment, in which hormone therapy is used. Combined oral contraceptives and gestagens are prescribed.

With an easy stage of the disease, oral contraception is used for at least six months. Among the drugs, Lindinet 30 is shown, which has a positive effect on the glandular tissue, reducing its growth. At the same time, women observed the disappearance of the symptoms of adenosis, as well as the normalization of the menstrual cycle within a short period of time in two months.

Gestagens are indicated when the disease has progressed to a more serious stage. In this case, there is an increase in the symptoms of the disease, mainly before the onset of menstrual bleeding.

Of the medicines, the positive effect of Norkolut, Pregnin, Dufpstone, Progesterone in an oil solution can be distinguished. Usually they are prescribed for use in the luteal phase of the cycle, namely from the sixteenth to the twenty-fifth day. The dosage is selected by the doctor, and the effectiveness is noticed after two months of using the medicine. Women report the disappearance of signs of breast engorgement and a decrease in pain. Discharge from the nipples also stops or is greatly reduced in quantity. The course of treatment with drugs should be, according to the minimum recommendations, from three months to six months.

Sometimes, with this type of disease, specialists resort to prescribing oral contraceptives like Janine, Silhouette, Zhenegest, which contain dienogest in an amount of two milligrams. The same medications are used to treat endometriosis, which can cause breast adenosis.

In some cases, doctors resort to homeopathic treatment, for example with the help of Mastodion. But we can note the appearance of only a temporary effect of alleviating the symptoms of the disease. If you use the drug in combination with hormonal agents, the effect will be long-lasting. Although nulliparous women, young girls, as well as with a mild form of the disease medicine assigned independently.

Focal forms of adenosis are treated only with surgery. There is evidence that the local type of the disease is not inclined to regress, even if the correct hormonal treatment was carried out. In this case, surgery is a resection, that is, excision of an enlarged breast node. With fibroadenomatosis, an excisional biopsy can be used to rule out the suspicion of a malignant process. In this case, histological examination is carried out urgently.
For any form of adenosis, the intake of vitamins A, B1, B2, B9, C, E and P. is prescribed.
Also important is a diet that includes a large amount of fiber, namely greens, vegetables, fruits, berries, whole grains.

Prophylaxis

First of all, the prevention of adenosis of the mammary gland consists in timely regular visits to specialists. These include gynecologists, and according to indications and mammology. Beginning in adolescence, gynecological examinations must be carried out regularly, at least once a year. With existing endocrine disorders, you should contact gynecologists twice a year, as well as regularly visit an endocrinologist.

Such measures will make it possible to identify the disease at the initial stage and begin treatment on time. This will help to avoid serious complications for the body and restore health to the woman.

It is also important to diagnose gynecological and endocrine diseases in time in order to prevent their development, as well as the appearance of unpleasant complications such as adenosis.

A successful pregnancy is one of the factors in the prevention of the disease. There is a direct link with the good course of pregnancy and the absence of breast adenosis. Breastfeeding a child during the first year of his life is also an excellent prevention of fibrotic changes in the tissues of the mammary gland. Undoubtedly, it is important that there are no abortions as factors leading to hormonal disruptions in a woman's body.

And of course, I would like to say about the absence of severe stress, the normal psychological environment at home and at work for a woman. Since it is known that many hormonal disorders in beautiful ladies arise precisely because of shattered nerves and a negative environment for the psyche.

Well, and finally, let's remind about proper nutrition, without which it is impossible to be healthy under any circumstances. It is better to exclude almost all fatty and smoked foods, and also be careful with salty foods. But foods containing fiber, like fresh plant foods, should be preferred.

Forecast

I would like to remind the ladies that such a problem is not an oncology, so there is no need to panic. The prognosis of adenosis of the mammary gland depends on its type and form, as well as the degree of hormonal disorders in a woman.

Expectant mothers who have been diagnosed with this disease can rejoice that in most of them adenosis will disappear in the second trimester of pregnancy.
At the initial stage of a local or diffuse form, when a woman follows all the doctor's prescriptions regarding a healthy lifestyle, and has also undergone appropriate treatment, the disease can be stopped forever.
With the progression of endocrinological problems, remission of adenosis is possible, even if it was successfully treated some time ago. Therefore, it is important to start therapy for the very hormonal problem that led to the onset of adenosis. The same applies to the gynecological prerequisites of the disease.
With surgical interventions that remove the nodes of the altered glands, it is possible to stop the transformation of the glandular tissue. This progress depends on many factors, including the transition of women to proper nutrition and a healthy lifestyle. Psychological stability and the absence of a stressful environment are also important, as are periodic measures to maintain the hormonal background in optimal condition.

Breast adenosis is the mildest form of mastopathy, in which, nevertheless, it is very important to choose the right treatment for a successful recovery. In order to maintain health for many years and avoid more serious consequences for women of any age.