Adenosis of both mammary glands. Diffuse form of adenosis of the breast. Why is adenosis dangerous?

Adenosis in the mammary glands is a disease of women mainly for the age group 30-40 years old, however, there are cases of the development of the pathological process at an earlier age - often adenosis worries girls during puberty, as well as at the beginning of bearing a child. There is adenosis in postmenopausal women.

Adenosis - what is it? Adenosis of the mammary glands is a hyperplasia of their lobules - pathological growth and development, accompanied by compaction of the glandular tissue and the formation of diffuse nodes. Disease in the mammary gland is a common form of fibrous mastopathy.

Causes

The main cause of a benign neoplasm is hormonal disorders that have occurred in the female body. Wrong work endocrine system, diseases thyroid gland cause a failure in the production of hormones, which leads to the transformation of breast tissue.

Pathologies affecting the pelvic organs can play a significant role in the progression of adenosis in the mammary gland. Influence is exerted by hyperplastic processes in the uterus, ovarian dysfunction.

First signs and symptoms

The symptoms of the disease in most cases do not differ from the symptoms of classical mastopathy. The first signs of adenosis of the mammary gland are based on a slight swelling, especially noticeable before the onset of menstruation, an increase in breast sensitivity.

Other symptoms:

Itching in the nipples.
Pain in the affected chest.
Perceptible seals.
Detection of nodular formations on palpation of the breast (adenosis may be small-nodular in nature).
Breast enlargement.
A constant feeling of heaviness and tension.

Around the diseased breast, the color of the skin may change, in the advanced stages of the disease, discharge from the nipples may appear, and the lymph nodes may enlarge.

Types of adenosis

Depending on the histological nature, several types of adenosis affecting the mammary glands are distinguished.

1. Diffuse or moderate adenosis of the breast:

Fuzzy seals and no boundaries.
Uneven growth, resulting in seals all over the breast.
Uniform changes over the entire area of the breast provokes the formation of papillomas.

2. Sclerosing adenosis of the breast - features:

The sclerosed type affects the lobules.
The tissue grows in the thoracic ducts.
Rapid growth of fibrous tissue.
The nodules are small, but very dense and mobile.
An increase in lymph nodes is not always observed.

Please note that sclerosing adenosis of the breast has a similar appearance to a malignant tumor, therefore this form of the disease is subject to the most thorough diagnosis.

3. Focal adenosis of the mammary gland, characteristics of the species:

One of the glands is enlarged more than the other.
Pronounced seals.
The tumor spreads to several ducts of the gland.
The seal is flexible and has clear boundaries.

4. How does localized adenosis manifest?:

The formation of seals, divided into areas - large lobules.
Myoepithelial cells are located between the lobules.
The grouping of seals is noticeable only in one area of the tissue; adenosis of the mammary gland in the breast does not spread over its entire area.
Each lobule is surrounded by a fibrous capsule.
Lymph nodes located above the collarbones and in the armpits may be enlarged.

Diagnostics

If symptoms and signs of illness are found, a visit to a doctor should be immediate. The doctor will prescribe diagnostic measures:

Ultrasound of the mammary glands and axillary lymph nodes.
Mammography is an X-ray examination.
CT and MRI of the mammary glands.
Clinical and biochemical blood tests.
Blood tests for hormones TT, LH, FSH.
Puncture and biopsy. (The most common technique is sclerosing adenosis of the mammary gland).

Treatment

Treatment of adenosis of the mammary glands is complex, it is based on vitamin therapy, taking diuretics and adaptogens, sedatives, as well as drugs that regulate the production and level of hormones. For each patient, treatment is selected individually, based on the stage of the disease, age, characteristics of the body, the presence of other diseases.

Surgery is an extremely rare way to treat adenosis. Surgical intervention is advisable only at advanced stages, when the use of drug therapy will not provide the desired result.

For a successful recovery, doctors advise not to forget about preventive rules. Rational nutrition, good rest and healthy sleep, physical activity - running, swimming, walking help not only to recover, but also not to "open the doors" of the disease.

Treatment with folk remedies

Treatment with folk remedies cannot be the main one, but it may well provide assistance with traditional therapy. Always check with your doctor before using home remedies.

Folk recipes for eliminating pain symptoms of a difficult pathology:

The pumpkin is peeled from seeds and peel, the pulp is applied to the sore chest for the whole night, wrapped in a warm cloth, for example, a scarf.
A compress is pressed to the sore spot from cabbage leaf after shaking it to extract juice. The sheet is coated with oil, left on the chest overnight.
Rub the beets, heat the mass in a water bath, then add 2 tablespoons of vinegar. The compress is applied to the chest, wrapped in a towel.

A timely visit to a doctor is a guarantee for a favorable prognosis in the elimination of adenosis developed in a woman's mammary glands. Treatment of the disease is carried out after diagnostic measures. It should be remembered that taking care of your health is the main rule of prevention that helps to avoid illness.

Every woman at any age should take care of her health. This primarily concerns the mammary glands and reproductive organs. It is not for nothing that doctors insist that women undergo a preventive examination by a gynecologist and mammologist every six months, because a disease or tumor is easier to treat if they are found on early stages... In this article, we will explain what adenosis of the breast is.

Etiology

Many women are familiar with the concept of mastopathy. Adenosis is just one of the varieties of fibrous mastopathy and is divided into several types. We'll look at them later.

By itself, the word "adenosis" in the name of the disease indicates an excessive proliferation of glandular tissue.

Most common reason the occurrence of this disease is a violation of hormonal levels in a woman's body. This condition can be due to a number of reasons, which we will consider next.

This should not include physiological hormonal disorders associated with puberty or pregnancy. In these cases, the process is temporary. As a rule, adenosis occurs with persistent and long-term violations of the hormonal background of a woman. It mainly manifests itself after 35-40 years.

Consider the main causes of this disease:

endometriosis;
ovarian dysfunction;
diseases of the thyroid gland;
overweight;
bad habits;
heredity.

Adenosis of the mammary gland is one of the simplest diseases and often, in the early stages, proceeds unnoticed by a woman, without causing any discomfort.

Symptoms

Any neoplasm in the tissues of the body, benign or malignant, in the vast majority of cases cannot be unnoticed. If a woman conducts regular self-examination of the mammary glands, she may feel lumps in the breast, which will be clearly felt, or have a blurry outline.

Depending on the form, adenosis can cause painful sensations in the chest, provoke discharge from the nipples. In the period before the onset of menstruation, a woman may feel a feeling of heaviness in the chest, squeezing and pain in a certain area.

Forms of the disease

To date, there are several forms of adenosis:

local;
diffuse;
sclerosing;
apocrine;
duct;
microglandular;
adenomyoepithelial.

Let's consider each of them in more detail.

Local form

Local or focal adenosis of the mammary gland is one of the most common types of mastopathy. It is characterized by formations in the form of lobules, which may have large sizes, and surrounded by a fibrous capsule. It is worth noting that the seals have a strictly limited localization area, can cause obvious discomfort and visually stand out against the background of the chest. In some cases, there is soreness of the lymph nodes under the mammary glands and in the armpit.

Diffuse

Diffuse adenosis does not have a clear localization, therefore it can grow throughout the entire breast tissue. Actually, such a feature gives it its name. In modern mammology, diffuse adenosis of the mammary gland is considered the very first stage of mastopathy. The process of forming nodules and ties can disrupt the natural structure of the ducts and lobes of the gland. Over time, they can develop into cysts and large nodules.

It is worth noting that diffuse nodules can sometimes grow actively, acquiring a focal shape and becoming the cause of the appearance of cancerous tumors.

Sclerosing

Sclerosing adenosis of the mammary gland manifests itself as follows:

Breast tissue expands.
At the same time, the integrity of the epithelial and myoepithelial layers of the acini (sections of the glandular lobules) is not disturbed.
The acini are compressed due to the proliferation of nearby tissues.

Sometimes, with a prolonged course of the disease, the integrity of the milk ducts may be disrupted, in which growths are formed - papillomas. These formations grow over the surface of the tissue lining the milk ducts.

Sclerosing adenosis of the breast is accompanied by pain and a feeling of heaviness in the chest. In this case, there may be an increase in lymph nodes that are located nearby.

Apocrine form

It is characterized by the appearance of nodules that repeat the configuration of the lobes of the breast. In this case, the replacement of differentiated epithelial cells by other cells with a similar structure is observed. In some cases, this phenomenon is identified with infiltrating cancer, although it is not of a malignant nature.

Duct

It is a group of malformed duct lobes. In this case, the layer lining the ducts is overgrown with epithelial cells. In fact, this is the same sclerosing adenosis, only a group of ducts is presented without lobes. The disease is more pronounced and painful.

Microglandular

A rare form of adenosis, which is accompanied by diffuse proliferation of the smallest ducts. At the same time, their compression and growth are not observed, which is characterized, for example, by sclerosing adenosis.

Adenomyoepithelial

This is one of the varieties of the focal form of adenosis and is characterized by the formation of adenomyoepithelioma. It is extremely rare and easily diagnosed.

Diagnosis of the disease

As mentioned earlier, any woman in the course of palpation of the breast can detect any neoplasm in her, if any. It is best to do this in the middle of the cycle, before the next menstruation. It is also advisable to undergo a preventive examination by a gynecologist or mammologist every six months or a year (depending on the woman's age and her predisposition to certain diseases).

In the event that the doctor suspects a woman has a disease of the mammary glands, he prescribes mandatory tests to determine the level of hormones in the blood, ultrasound, CT or mammography. It is not difficult to detect adenosis of the mammary glands on ultrasound, so this is often enough. The examination will help determine the localization of the pathology, its nature and form.

In the event that the above examination methods revealed an advanced form of adenosis, the woman is prescribed additional studies:

cytological;
immunological;
hormonal;
histological.

Preventive measures

Let's consider the main ways to prevent adenosis.

These include:

rejection of bad habits;
lack of abortion;
playing sports;
long-term breastfeeding;
reduction of stress;
regular examination by a gynecologist.

Of course, due to various circumstances, not every woman will be able to follow all these recommendations. However, if you adhere to at least some, the risk of the disease will decrease significantly.

Treatment methods

Of course, any disease should not be ignored. You can not start adenosis of the mammary glands, the treatment of which will help to avoid major problems in the future.

Medicines

As a rule, in this case, conservative treatment is prescribed, which is based on a preliminary examination and consists in the following:

Appointment of multivitamin complexes to activate the body's forces.
Taking sedatives to increase stress resistance.
Diuretic drugs for edema.
Hormonal agents to normalize hormone levels. The drugs "Mabyusten" and "Lindinet" are popular.

It is necessary to pay attention to the fact that taking hormonal drugs cannot last less than 3 months.

Surgical intervention

In case if drug treatment it is not enough, the attending physician prescribes an operation for the woman to remove the formation. As a rule, this applies to advanced forms of adenosis or in the case of active proliferation of fibrous tissue.

The operation is performed with minimal risks to the patient's health, with an optimal cosmetic effect. An incision is made around the nipple along the areola, the mass is cut out and the tissue is sutured. After the operation, a barely visible scar remains.

Folk ways

Many women are not supporters of the reception hormonal drugs or are afraid of surgery. Therefore, they are looking for recipes in traditional medicine using different ways... It is worth noting that not a single herb will become a panacea and it should be used only in combination with the main method of treating the disease, prescribed by the attending physician.

There are the following types of medicinal plants:

Gonadotropic... These plants act on certain female sex hormones, stimulating or suppressing their production. These include: lavender, upland uterus, lemon balm, oregano, meadow lumbago, etc.
Antineoplastic... Among them: red brush, calendula, plantain, elecampane, St. John's wort, calamus root, etc.
Immunostimulating... These are aloe, echinacea, calamus root, hawthorn, ginseng, etc.

Homeopathy

Homeopathic remedies are also popular among women with breast diseases. And many specialists prescribe them in combination with the main therapy. One of these drugs is Mastodinon. In fact, this is an alcoholic infusion of medicinal herbs, which reduces the production of prolactin and improves metabolic processes in the tissues of the mammary glands, preventing the development of pathological processes.

Conclusion

In conclusion, I would like to draw your attention to the fact that in no case should adenosis be triggered. This process at favorable conditions can grow rapidly and in the future turn into malignant formations.

You should not self-medicate and independently "prescribe" medications to yourself, since they all have contraindications and side effects.

Video

For helpful information on the nature and treatment of benign tumors, see the following video.

Adenosis of the mammary gland is one of the varieties (changes in the gland that occur against the background of hormonal imbalance), in which the glandular tissue grows.

Pathology can provoke carcinophobia - the patient's suspicion and fear that she has a malignant neoplasm, since adenosis of the mammary gland, among other signs, is manifested by the formation of dense seals in it and the appearance of suspicious discharge from the nipple. Adenosis of the mammary gland belongs to the category of those diseases that are treated using both a conservative method (namely, the appointment of hormones) and surgery.

Pathology has other names - fibrosing adenosis, myoepithelial hyperplasia and lobular sclerosis.

Table of contents:

common data

Adenosis of the mammary gland is its benign formation, which has a hormone-dependent character, which is confirmed by the manifestation of clinical symptoms in the second phase of the menstrual cycle.

Pathology occurs in women of reproductive (childbearing) age. Most often, it is detected in patients aged 30-40 years - up to 70% of all patients with this diagnosis fall into this age category.

If a woman suffers from any disease of the gynecological sphere, then the incidence of breast adenosis is, according to various sources, from 90 to 100%. In other words, all patients with diseases of the genital area should be examined for the presence of adenosis of the mammary gland.

This condition develops not only as pathological, but also physiological. Adenosis of the mammary gland is normally observed in:

girls during the establishment of menstruation;
women in the first trimester of pregnancy.

In both of these cases, the manifestations of adenosis regress and disappear on their own after the hormonal background levels off. Nevertheless, in this condition, control by a gynecologist is necessary, since pathological adenosis of the mammary glands can develop against a physiological background.

Causes

The immediate cause of the described condition is an imbalance on the part of female sex hormones - while the following are observed:

a lack of .

The etiological factors that cause hormonal imbalance, and therefore, are indirect causes of the occurrence of adenosis of the mammary gland, have been highlighted. This:

metabolic disorders;
burdened gynecological and obstetric history;
taking certain medications;
gynecological pathology;
some somatic diseases - those that are not associated with the female genital area;
unfavorable ecological situation;
bad habits.

Of all types of metabolic disorders in the development of hormonal imbalance, it is of the greatest importance. The connection is that adipose tissue is capable of producing estrogens. At every overweight with obesity, estrogen synthesis is almost proportionally increased. In this case, a relative (not always pronounced) hyperestrogenism develops - but it is enough to provoke the development of adenosis of the mammary gland. At the same time, the amount of progesterone in the blood remains at a normal level.

The factors of a burdened gynecological and obstetric history, against which a hormonal imbalance develops, leading to the development of adenosis of the mammary gland, are:

abortion;
late pregnancy;
refusal to breastfeed.

Both spontaneous abortions () and artificial (performed in a clinic for medical reasons) lead to hormonal imbalance. A particularly pronounced provoking factor is the termination of pregnancy in its late lines (15-22 weeks). It leads to a very drastic hormonal change in the body, while compensatory mechanisms are not triggered, the body is not able to instantly correct the resulting failure. The level of sex hormones returns to normal gradually, during this time endocrine problems have time to develop - in this case, with such a consequence as adenosis of the mammary glands.

The described pathology develops in late pregnancy, since in women over 35 years of age, ovarian functions begin to fade away, and the likelihood of developing hormonal imbalance increases. When pregnancy occurs, the work of the ovaries is activated - this leads to a postpartum failure in the production of estrogens and progesterone, as a result, hormonal disruption develops.

note

If you refuse to breastfeed, the concentration increases, because of this, milk stagnation occurs in the milk ducts. Due to this stagnation, the ducts become clogged and expand, and this, in turn, leads to the formation of cysts and further - a violation of the internal structure of the mammary glands with the formation of adenosis.

It is often indicated that the cause of adenosis may be postpartum agalactia - a complete lack of milk production. In fact, adenosis of the mammary glands can simply occur against the background of agalactia - but it is not its immediate cause, but only a "beacon" about the possibility of its development. Adenosis and agalactia are two consequences of hormonal disruption... Agalactia develops due to a lack of progesterone, which regulates the development and "specialization" of cells in the parenchyma of the mammary glands, as well as due to excess estrogen. In her case, with hyperestrogenism, the stroma (connective tissue base) of the glands grows, and the lack of progesterone provokes an uncontrolled growth of the glandular epithelium.

Uncontrolled use of combined oral contraceptives (COCs), drugs that prevent the development of unwanted pregnancies, can lead to the development of adenosis of the mammary gland. The reason is that when taking COCs, the individual characteristics of the woman's body and non-compliance with the regimen may not be taken into account. This leads to hormonal imbalance and the development of dysplastic processes in the mammary glands.

Of all gynecological diseases most often, the background for the occurrence of adenosis of the mammary glands is:

- overgrowth of the inner layer of the uterus;
- both good and malignant;
- a benign tumor that develops in the muscle layer of the uterus;
- the appearance of endometrial cells in atypical places throughout the body.

Somatic diseases can act as triggers of adenosis of the mammary gland (literally - triggers) - these are pathologies that in themselves are not the cause of the described disease, but are capable of starting a pathological process. Most often, such starting pathologies are:

- pronounced persistent increase in blood pressure;
pancreatic disease;
liver pathology;
chronic;
disorders of the sexual sphere.

Most often, of all the factors of an unfavorable environmental situation, the development of adenosis of the mammary gland provokes an increase in the amount of harmful substances in the atmosphere and water.

Bad habits that can provoke the development of the described disease are not only smoking, alcohol abuse and the use of drugs, but also persistent chronic sleep disturbance (constant lack of sleep due to domestic and work circumstances, lack of satisfaction with sleep), as well as regular violation of the diet (in particular, eating unhealthy food).

Disease development

Cyclic changes that occur in the mammary glands are regulated by such active biological substances as:

hypothalamus-releasing factors;
follicle-stimulating hormone (FSH);
luteotropic hormone (LH);
prolactin;
chorionic gonadotropin;
glucocorticoids;
progesterone;
thyroid hormones;
pancreatic hormones.

The main ones in the development of the disease are:

hyperestrogenemia - excess estrogen;
deficiency of progesterone.

In this case, hyperestrogenism can be:

absolute;
relative.

Exposure to estrogens leads to the fact that the milky tract grows, as the multiplication of their cells increases. The consequences of a lack of progesterone are as follows: it normally inhibits the activity of estrogen, which means that due to a deficiency of progesterone, the excessive effect of estrogen on the mammary glands is further enhanced. In fact, cells multiply uncontrollably and uncontrollably. From the point of view of the structure of breast tissue, it looks like this:

the connective tissue inside the lobules of the breast grows and swells;
glandular cells in the lactiferous ducts develop rapidly - because of this, their blockage and expansion described above arise, and then - the proliferation of glandular tissue.

There are several types of breast adenosis - they are distinguished by:

the area of damage to the tissues of the gland;
histological (tissue) structure.

According to the prevalence of pathological education, there are 2 forms of the described pathology, such as:

focal (or local). At the same time, a mobile large formation in the form of a ball or disk is formed in the mammary gland. The node itself consists of separate lobules and is covered with a fibrous capsule;
diffuse. It is characterized by the fact that several areas of seals are formed in the mammary gland at once, while their shape and boundaries are indistinct, blurred. Such seals grow in different places the mammary gland, in the tissues are unevenly located.

According to the tissue structure (the type of cells that have grown), such types of adenosis are distinguished as:

Symptoms of adenosis of the breast

The clinical picture of adenosis of the mammary gland is manifested by similar symptoms as in other types of mastopathy. Symptoms can vary depending on the form of the disease.

The general signs of the described pathology are:

mastodynia - soreness and engorgement of the glands, as well as increased sensitivity of their skin;
discharge from the nipple.

Pain characteristics:

by localization - in the development of a pathological focus;
by distribution - the entire mammary gland can hurt;
in intensity - moderate, intensified on the eve of menstruation;
on occurrence - may develop with a delay.

If a local form of adenosis of the mammary gland is formed, a formation is found in it. Its characteristics are as follows:

in shape - round or irregular;
in size - from 1 cm in diameter and more;
by consistency - dense;
in structure - lobular structure;
for mobility - mobile;
in relation to the surrounding tissues - not welded to them.

note

With a local form of adenosis, there are no signs such as the secretion of mucus or milk from the nipple, deformation of the skin and an increase axillary lymph nodes... Also, there is no pain on palpation.

In the case of the development of a diffuse form, the following symptoms appear:

pain;
swelling of the mammary gland before menstruation;
discharge from the nipple;
formations in the gland in the form of nodules.

Pain characteristics:

by localization - spilled throughout the mammary gland;
by distribution - they can be given to the tissues of the chest wall adjacent to the mammary gland;
by nature - aching, crushing;
in intensity - moderate;
by occurrence - mainly develop with a delay.

Discharge characteristics:

by color - yellow or colorless;
by consistency - liquid;
by quantity - not abundant.

Characteristics of formations:

Diagnostics

The diagnosis of adenosis of the mammary gland is made on the basis of the patient's complaints, anamnesis (history of the disease) and the results of additional examination methods - physical, instrumental and laboratory.

Physical examination determines:

on examination - the size and shape of the mammary gland, the condition of the skin, nipple and areola, the presence or absence of discharge from the nipple;
on palpation - consistency, the presence of formations, soreness.

Instrumental diagnostic methods, which are prescribed when there is a suspicion of the occurrence of adenosis of the mammary gland, are:

- a comprehensive study of the mammary gland;
- sampling of breast tissue with their subsequent study under a microscope.

During mammography, such diagnostic methods are involved as:

X-ray mammography - X-ray examination of the mammary gland (pictures are taken in two or three projections);
ultrasound mammography - with the help of ultrasound in the tissues of the mammary gland, the foci of compaction are revealed, they are evaluated;
tomosynthesis - the method is based on creating a two-dimensional image of the breast, by which it is evaluated internal structure;
(MRI-) mammography - a method of tomographic examination of the breast;
optical mammography - the condition of the breast tissue is studied using optical equipment.

Also important in the diagnostic process are the following laboratory research methods:

If there are any somatic diseases, in order to identify them, such examination methods are prescribed as:

Complications

The most common complications of breast adenosis are:

inflammatory diseases of the breast;
its deformation;
the formation of cysts;
the formation of papillomas in the milk ducts - short outgrowths of a benign nature;
mammary cancer - the probability of its occurrence in the presence of the described pathology increases 5 times. The frequency of malignant transformation depends on the intensity of cell proliferation. So, non-proliferative forms (with them, the cells practically do not grow) are malignant in 0.86%, if moderate proliferation is observed - breast cancer occurs in 2.5%, with a severe degree of proliferation, a cancer tumor develops in 32% of cases.

Breast adenosis treatment

The choice of adenosis treatment method (conservative or surgical) depends on the form and nature of the course of the disease described.

With the development of a diffuse form, conservative treatment is attracted. It is based on the following appointments:

If a mild form of the disease has developed, monophasic combined oral contraceptives are prescribed, the course of treatment in this case is 6 months. If a more pronounced form of the disease has developed, the course of treatment is at least 3 months.

With the development of a focal form of adenosis of the mammary gland, a surgical method of treatment is attracted. In this case, a sectoral resection of the gland is performed - excision of the formation within the limits of healthy tissues.

There are several forms of breast adenosis, which are usually localized in the glandular components of the mammary gland. With sclerosing adenosis, the growth of lobules is observed, while the layers of the inner and outer tissue are preserved.

The first stage of dyshormonal diseases of the mammary gland develops mainly at the age of 30 - 40 years, but pathology is possible at a younger age and after 50 years.

Adenosis is one of the simplest forms of dyshormonal pathologies. In the sclerosing form, the change in glandular tissues practically does not occur, the basement membranes are preserved, the structures are limited.

Sclerosing adenosis consists of small lumps, which are associated with an increase in lobules. Usually the seals are very sensitive, in some cases they are painful. Due to distorted forms on mammography, adenosis can be mistaken for a cancerous tumor, but it is worth noting that the pathology belongs to benign conditions.

The disease can be detected against the background of pathological proliferation of breast tissue, which leads to a change in shape, carcinoma (ductal or lobular).

ICD-10 code

In ICD-10, sclerosing adenosis of the mammary gland belongs to the class of breast diseases (N60-64).

ICD-10 code

N60.3 Fibrosclerosis of breast

Causes of sclerosing adenosis of the breast

The main cause of the pathology is hormonal disorders that occur in a woman's body (a frequent cause of this is constant stress, a weak immune system).

An imbalance of sex hormones in a woman may be associated with puberty, pregnancy, in this case, the level of estrogen and prolactin in the blood increases, progesterone decreases. Such hormonal changes cause the development of various forms of mastopathy, but prolonged hormonal disorders usually lead to sclerosing adenosis.

To determine the cause of the disease, a blood test for the hormonal ratio is often prescribed.

In some cases, sclerosing adenosis of the mammary gland is associated with hyperplastic processes in the small pelvis (excessive proliferation of the endometrium, ovarian dysfunction, ovarian cystic disease, thyroid pathology, excess weight associated with thyroid pathologies or the consumption of foods high in fat and easily digestible carbohydrates).

Pathogenesis

Adenosis increases the risk of developing breast cancer several times, in comparison with other types of mastopathy. Sclerosing adenosis of the mammary gland is diagnosed in women between 20 and 40 years of age (approx. 5% of all cases of mastopathy).

The disease is characterized by the proliferation of connective cells in the epithelial tissue and their fibrous degeneration. The process of tissue replacement produces calcifications, which are often confused with invasive breast cancer on mammography.

Sclerosing adenosis is of two forms - limited (single nodules) and diffuse (multiple foci).

Symptoms

A common symptom of pathology is frequent pulling pains that worsen before menstruation. A palpable seal of the correct shape appears in the breast (in the entire gland or in a separate area), which can pass to the surrounding tissues.

Sclerosing adenosis of the mammary gland can also affect the ducts of the mammary gland, which causes the formation of papillomas (a benign tumor in the form of a papillary growth).

Diffuse sclerosing adenosis of the breast

Diffuse form sclerosing adenosis is caused by a violation of neurohumoral regulation, which leads to an increased production of estrogen or a lack of progesterone in the body. Also, the disease can be provoked by bad habits (alcohol, smoking), ecology (especially in large cities), hazardous production (ionizing radiation), sunburn (tanning salons, beaches, etc.). Childbirth (from 20 to 25 years old), breastfeeding, oral contraception (within reasonable limits) will help to reduce the risk of pathology, all these factors represent a kind of protection against diseases caused by dyshormonal pathologies.

Diffuse sclerosing adenosis of the mammary gland is associated with the phase of the menstrual cycle and provokes severe pain in the second half or middle of the cycle.

Proliferation without atypia

Benign lesions of the mammary gland are divided into three categories according to the type of cells: without proliferation (tissue proliferation is not observed), with proliferation without atypia, and atypical proliferation of the glandular component of the mammary gland.

Pathologies without proliferation, usually do not degenerate into cancerous tumors.

Sclerosing adenosis of the mammary gland is characterized by the growth (proliferation) of glandular tissue in the center of the breast lobule, while the cells can retain their structure, i.e. the disease develops without atypia.

With atypical hyperplasia, the risk of transformation into a cancerous tumor increases by 4-5 times.

First signs

Sclerosing adenosis of the mammary gland may not appear for a long time; the main symptom may be pain in the mammary glands before menstruation, which usually does not cause anxiety in many women. The pain in most cases is pulling and intensifies in the phase of the corpus luteum.

The development of adenosis may be indicated by the appearance of a movable seal in the mammary gland, which can be felt.

Consequences

When sclerosing adenosis is detected, specialists, in most cases, are in no hurry to prescribe treatment, especially hormonal drugs.

Hormones can harm women's health, especially in young age, since hormonal surges in this period occur most often and the pathology can pass without much intervention.

If the need arises, a specialist can prescribe minimal hormonal therapy, operations for this form of mastopathy are very rare.

Despite the fact that doctors are in no hurry to treat sclerosing adenosis of the breast, the risk of degeneration into a cancerous tumor is quite high and constant monitoring of the woman's condition is required.

Complications

Sclerosing adenosis of the breast usually requires minimal treatment, which includes dietary changes and treatment for diseases that provoked hormonal imbalances.

Usually, this form of mastopathy does not cause an atypical process, but a woman is recommended to be regularly examined by a mammologist.

Diagnostics of the sclerosing adenosis of the breast

If you suspect dyshormonal diseases of the mammary gland, after a preliminary examination by a specialist, mammography and ultrasound examination are prescribed.

The examination helps to identify the pathological focus, to determine the shape and boundaries of the tumor.

With the growth of adenosis and damage to the milk ducts, the likelihood of a malignant process increases significantly. For the timely detection of pathology, cytological, histological and immunological studies are prescribed.

Analyzes

Sclerosing adenosis of the mammary gland is considered a hormone-dependent disease, and a hormone test is prescribed to identify the causes.

An analysis for the level of progesterone, luteonizing hormone (LH), follicle-stimulating hormone (FSH), estrogen, testosterone, etc. allows you to determine if there are hormonal disturbances in a woman's body.

Estrogen is produced by the ovaries (an insignificant part is the adrenal glands), these hormones are responsible for the development of secondary sexual characteristics, and also participate in the reproductive system.

Estradiol, which is responsible for cyclical changes in the body, helps to reduce the risk of developing heart and vascular diseases, and prevents the development of osteoporosis, is distinguished by a special biological activity.

Progesterone is produced mainly by the ovaries (a small part by the adrenal glands). This hormone is also called the pregnancy hormone, since in an "interesting" position, the level of the hormone increases, it helps prepare the inner layer of the uterus for embryo implantation, prevents embryo rejection, and reduces uterine contraction.

FSH, LH are referred to as gonadotropic hormones, for the production of which the pituitary gland is responsible. They are responsible for the maturation of follicles, the formation of the corpus luteum, and the production of progesterone and estrogen.

In addition to determining the level of hormones, the ratio of hormones in the body is important.

Instrumental diagnostics

Instrumental diagnostic methods are necessary for making an accurate diagnosis.

This type of diagnosis can be invasive (with a violation of the integrity of the skin) and non-invasive. Sclerosing adenosis of the breast

An invasive biopsy is a biopsy that allows you to examine tissue samples under a microscope.

Fine needle aspiration biopsy is used for palpable breast lesions. The procedure is performed without anesthesia, using a syringe and a long thin needle.

The needle is inserted into the mammary gland and the glandular tissue is drawn into the syringe, which is sent for laboratory testing.

A thick needle biopsy allows you to get more breast tissue for examination. The analysis requires a thick needle with a cutting device.

The advantage of the method is that due to the larger tissue area, after histology, the doctor will be able to make a more accurate diagnosis.

Non-invasive, i.e. not violating the integrity of the skin, methods of instrumental diagnostics include mammography, ultrasound, computed tomography.

Mammography is recommended annually for women over 35 years of age. The purpose of this study is the early detection of pathological changes in the mammary gland. On a mammogram, each breast disease has its own characteristic picture.

Ultrasound examination allows you to clarify the nature of changes in the mammary glands. The method is simple and safe, the advantage is the identification of differences between hollow (cyst) and solid formations (tumor).

Differential diagnosis

Differential diagnosis is considered the most important in making a diagnosis. This diagnostic method allows you to distinguish diseases from each other, since the same symptoms can be associated with different diseases.

During the examination, the specialist gradually excludes diseases that are not suitable for one or another symptom, which, as a result, makes it possible to make the final only probable diagnosis.

Sclerosing adenosis of the mammary gland, usually the doctor detects on examination, palpation reveals dense nodes of the correct shape. The patient's complaints of pain are also taken into account (nature, in what period of the cycle it manifests itself, etc.). An ultrasound scan is usually done to confirm the diagnosis, as there is a high risk of incorrect results on mammography (adenosis can be mistaken for breast cancer).

Treatment of sclerosing adenosis of the breast

Features of treatment depend on the stage, age and general health of the patient. In most cases, sclerosing adenosis of the mammary gland is not treated, and the woman must have an ultrasound scan and visit a doctor every year.

In some cases, multivitamins, sedatives, combined oral contraceptives or hormones, drugs to improve the immune system, diuretics may be prescribed.

With dyshormonal pathologies, oral combined contraceptives can be prescribed (Lindinet 30). Such drugs contain a certain level of hormones that equalize the hormonal background and prevent monthly hormonal fluctuations in the body.

Lindinet 30 contains a synthetic analogue of estradiol, which regulates the menstrual cycle, as well as gestodene (an analogue of progesterone). The drug helps prevent a number of gynecological diseases, including the growth of tumors. 1 pill is taken. daily (preferably at the same time) for 21 days, then after a week's break the course is repeated.

Gestagens (Duphaston, Norkolut) - steroid hormones that suppress the production of luteinizing hormone, have antiestrogenic, gestagenic, androgenic and antiandrogenic effects.

After admission, swelling, nausea, high arterial pressure... In case of violations of the liver and a tendency to thrombosis, such drugs are contraindicated.

Duphaston contains dydrogesterone, which is similar in properties to natural progesterone, the drug does not side effects common to most synthetic progesterone analogs.

You need to take Duphaston 10mg 2-3r per day for 20 days (from 5th to 25th day of the cycle) or constantly.

Norkolut blocks the production of gonadotropin and prevents follicular maturation.

Assign 1-2 tablets on certain days of the cycle.

In some cases, the doctor decides on the surgical treatment of adenosis (usually if a malignant process is suspected).

Drug treatment

When choosing hormone therapy, specialists prefer Lindinet 30, which helps to reduce the clinical manifestations of sclerosing adenosis.

After 2 months from the beginning of taking the drug, the symptoms of the disease disappear and the normalization of menstruation.

During the intake, some side reactions of the body may occur: increased pressure, thromboembolism (including myocardial infarction, stroke), hearing loss is also possible.

Lindinet 30 is taken according to the scheme - every day for 1 ton. within 21 days, then a 7-day break is taken and the course is repeated. The average duration of treatment is 6 months, the decision to continue treatment is made by the attending physician.

In addition to Lindinet 30, other oral contraceptives can be prescribed, which include dienogest (2 mg): Zhenegest, Janine Silhouette.

Gestagens are used for more pronounced symptoms of adenosis, which are especially aggravated before menstruation.

Among such drugs are Norkolut, Pregnin, Duphaston, Progesterone (oil solution), which are prescribed from 16 to 25 days of the cycle. The effect of the treatment appears after 2 months - discharge from the nipples, engorgement and pain of the mammary glands decreases (sometimes completely stops). The course of treatment is from 3 to 6 months.

Pregnin belongs to the group of progestogens and is analogous to the hormones of the corpus luteum. Prescribe 1-2 tablets 2-3 times a day, with an increase in dosage, an increase in pressure, swelling, and a brief increase in uterine bleeding are possible.

Progesterone (oil solution) - the corpus luteum hormone has a gestagenic effect. Usually prescribed at 5 mg daily, it can cause drowsiness, apathy, headaches, impaired vision, a decrease in the menstrual cycle, swelling, increased pressure, weight gain, and allergies.

Sclerosing adenosis of the mammary gland with gestagenic drugs is treated within 3 - 6 months, at the discretion of the doctor, the intake of drugs can be extended.

Traditional treatment

You can try to cure sclerosing adenosis of the mammary gland with folk remedies, but it is worth remembering that any recipes, even harmless at first glance, should be carried out after consulting a doctor.

For adenosis, compresses can be used:

apply pumpkin pulp to the affected breast for 3-5 days
cabbage leaf, oiled butter and sprinkled with salt to apply at night to the chest for a week (usually in the morning the pain is relieved).
grated fresh beets with 2 tablespoons warm vinegar is applied to the chest for 8 to 10 days.

These methods help to reduce unpleasant symptoms diseases.

Herbal treatment

Today, treatment of various forms of mastopathy, including sclerosing adenosis of the mammary gland, can be carried out using medicinal herbs, but in this case, an integrated approach is mandatory.

Herbal medicine can use plants of several groups - gonadotropic (selectively affect female sex hormones), anticancer herbs, immunomodulators.

Gonadotropic plants are poisonous (they have a quick healing effect and a large number of side effects) and ordinary (they act more slowly, have mild properties and a minimum of side effects).

Poisonous plants of this group: black cohosh Daurian, prince of Okhotsk, lumbago meadow, twisted kirkazon, common oregano, lemon balm, boar uterus, fragrant woodruff, lavender, radiola, zyuznik, chandra, angelica.

Herbs with an antitumor effect: plantain, St. John's wort, elecampane, calendula, lemon balm, hawthorn, nettle, wormwood, horsetail, mint, aloe, immortelle, calamus rhizomes, etc.

To increase immunity, calamus, Manchurian aralia, aloe, echinacea, chamomile, hawthorn, ginseng are used.

The following recipe helps to relieve the symptoms of adenosis: valerian root, string, celandine, St. John's wort, nettle, rose hips, mint, hawthorn flowers 1 tablespoon each. Mix all components, take 1 tbsp. and pour 1 liter of boiling water, leave for 15-20 minutes, take 2 times a day (between meals).

Homeopathy

Sclerosing adenosis of the mammary gland can be treated with homeopathy; this method is recommended by a number of specialists, recognizing it as effective in the case of this pathology.

With this type of adenosis, the homeopathic drug Mastodinon is usually prescribed.

The product is available in the form of tablets or drops. The therapeutic effect is achieved due to natural ingredients - multi-colored iris, alpine violet, bitter brisket, prutnyak, pebble-leaved stalk, tiger lily (it should be noted that the composition also contains alcohol). The drug reduces the production of prolactin and has a positive effect on breast tissue, preventing pathological processes.

After about six months, you can observe healing effect, while Mastodinon can be used both as part of complex therapy and independently.

Side effects during admission are extremely rare, most often expressed in allergic reactions. Sometimes nausea, stomach pains, weight gain, headaches, acne may be disturbing.

You can not take the drug to girls under 12 years old, during feeding, pregnant women, as well as with individual intolerance to some components.

It is worth noting that drinking and smoking negatively affect any treatment, homeopathy is no exception, despite the fact that all homeopathic remedies have natural ingredients.

You usually need to take Mastodinon 2 times a day, 1 tab. or 30 drops each.

The drops should first be shaken well before use and diluted with water.

Mastodinon must be taken for at least 3 months, but noticeable improvements are observed after six months of continuous treatment.

Operative treatment

Sclerosing adenosis of the breast is rarely treated with surgery. When choosing this method Treatment is usually a sectoral resection.

The operation can be performed under local or general anesthesia (depending on the number and size of nodes, age, concomitant diseases).

During the operation, the surgeon always cuts the edge of the areola, the removed node is subsequently sent for histology to clarify the nature of the neoplasm or determine further treatment tactics.

Usually the next day after the operation, the patient is discharged from the clinic, the doctor may prescribe pain medication.

If a woman has one node or multiple nodes that are not prone to growth, the disease is not treated, and the woman is assigned a regular examination (ultrasound and examination by a mammologist every 6 months).

Prophylaxis

Hormonal changes in the female body occur regularly, but such dyshormonal diseases as sclerosing adenosis of the mammary gland can be prevented, both in a teenage girl and after 40 years.

Preventive measures are quite simple, it is necessary to timely identify and treat gynecological and other diseases. It is also necessary to remember the following measures that help reduce the risk of developing dyshormonal diseases: the first pregnancy (necessarily full-term), the absence of abortions, regular examination by the gynecologist, and the reduction of stressful situations.

Are important physical exercise swimming has a good effect on the general health of a woman. Do not forget about proper nutrition.

Forecast

Sclerosing adenosis of the mammary gland does not pose a danger to a woman's life, but nevertheless, the pathological process can degenerate into a malignant formation, therefore, in this case, timely diagnosis and regular monitoring by a mammologist is extremely important.

Sclerosing adenosis of the mammary gland is a benign process in which the glandular structure grows. The disease is associated with hormonal changes in the woman's body, especially prolonged hormonal imbalance leads to the development of adenosis. Pathology in most cases does not require treatment, sometimes sedatives can be prescribed (if hormonal disorders are associated with stress), hormones, treatment of existing concomitant diseases is also indicated, in rare cases, surgical treatment is prescribed.

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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 of the breast.

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.