Local adenosis. What is sclerosing adenosis - why is it formed in the mammary gland. The main reasons for the development of a diffuse form of adenosis

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 undergo 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 a 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, the stimulus to the onset of the disease are pathological processes in the small pelvis of a woman and in the 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 adenosis of the mammary gland 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 is characteristic, which occurs quite often. The pains 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 \u200b\u200bthe breast, when tissue changes are diffuse, or it increases and engulfs only 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 detected in the breast tissues. 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.

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 detect 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 stated. 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, given 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 an exaggerated degree, that is, excessively, while mixing and including healthy glandular cells. This 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, expectant mothers for the first few weeks may show signs of adenosis of the mammary glands. 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 the functioning of the thyroid gland, namely hypothyroidism.

Sclerosing adenosis of the breast is a form of the disease that affects the lobules of the breast. 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 the 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 lobules of the breast.
Fibrous tissue forms very quickly and in its growth it 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 \u200b\u200bthe 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 \u200b\u200bthe 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 relative 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.
On palpation, seals are found in the tissues of the enlarged breast.
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 breast

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

Seals begin to form in the affected breast, which are characterized by a lobular structure.
The resulting lobules are rather large in size.
Each lobule is surrounded by a fibrous capsule.
Myoepithelial cells are located between the lobules, which are 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 breast is carried out as follows:

In case of any symptoms that bother a woman, she turns to a gynecologist or mammologist. The examination, first of all, includes an examination of the patient's breast and her palpation. If doctors begin to share the 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 of 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 its shape and border are.

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 biopsy the breast tissue.

Breast adenosis treatment

If, with sclerosing adenosis, a single node or nodes are found that do not progress to growth, then surgical intervention 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 surgery, 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 size, 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. A node that was cut out during resection is most often sent for a histological study 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, the 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, one can single out the positive effect of Norkolut, Pregnin, Dufpston, Progesterone in an oil solution. 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 drug treatment 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 adenosis of the breast.

In some cases, doctors resort to homeopathic treatment, such as 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, the drug is prescribed independently.

Focal forms of adenosis are treated only with surgery. There is evidence that the local form 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 all forms of adenosis, the intake of vitamins A, B1, B2, B9, C, E and P.
Also important is a diet that includes a large amount of fiber, namely greens, vegetables, fruits, berries, whole grains.

Prevention

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 the gynecologists twice a year, and also regularly visit the 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 relationship with a good 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 breast tissue. 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, a normal psychological environment at home and at work for a woman. Since it is known that many hormonal disorders in beautiful women 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, as well as 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 you should not 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 complies with 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 background 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. Such progress depends on many factors, including a woman's transition 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 to avoid more serious consequences for women of any age.

To begin with, before considering such a disease as diffuse adenosis of the mammary glands, I would like to say about the existing structural classification of this disease.
According to the structure of pathological changes, doctors distinguish only two main types of this disease:

The first condition is characterized by the fact that benign breast neoplasms have a strictly lobular structure. Moreover, each of the pathologically altered (hyperplastic) lobes turns out to be large enough and has its own fibrous capsule. This condition could also be characterized as a local variant of a condition called adenosis of the mammary gland, since all neoplasms are usually concentrated directly on one area of \u200b\u200bthe breast.
The second condition is when neoplasms in the breast do not have their own clear boundaries or a defining shape. Actually, the extremely uneven growth of such benign neoplasms allows doctors to say that diffuse adenosis of the breast is observed.

So, diffuse variants of pathological changes in the mammary gland are considered by modern mammology as the first (or initial) stage of the development of mastopathy.

At the same time, adenosis of a diffuse form is characterized by chaotic growth, in physiologically normal tissues of the breast, connective tissue elements.

As a rule, such connective tissue elements are presented in the form of non-standard, not fully formed, knots or strands.

Note that such processes can lead to a violation of the physiological structure of the glandular ducts and lobules of the breast, to the subsequent formation of relatively small cysts, and even later, large nodes.

It is important to understand that under certain (favorable for the progression of the disease) conditions, adenosis of the breast of a diffuse form may well transform, developing into nodular forms of mastopathy, with strictly focal seals, and sometimes even nodular proliferates.

When adenosis progresses so quickly, doctors consider the problem as one of the risk factors for the subsequent occurrence of breast cancer.

The main reasons for the development of a diffuse form of adenosis

Adenosis of the mammary gland of any form (including diffuse) is considered a pathology of a polyetiological nature, a pathology that may be associated with:

With a hereditary predisposition.
With external factors of the pathological environment.
With the wrong way of life.
With various endogenous causes.

At the same time, the leading or main pathogenetic link, with the development of a diffuse form of this ailment, is a violation of the so-called neurohumoral regulation, as a result of which hyperestrogenism or a deficiency of progesterone is observed.

With a sharply increased risk of developing adenosis or other forms of mastopathy, women's addiction to smoking or alcohol, exposure to ionizing radiation, excessive tanning, both on the beach and in the solarium itself, and of course, the unfavorable ecology of modern megacities are associated.

At the same time, the main protective factors that can reduce the likelihood of developing diffuse variants of mastopathy are considered to be fairly early childbirth (say, at 20 or 25 years), two or more births accompanied by a full period of physiologically normal lactation, adequate use of oral contraception.

How does the diffuse form of adenosis manifest?

The main manifestations of diffuse adenosis are associated (as closely as possible) with a change in specific phases in a woman's menstrual cycle. The main of the leading complaints of patients is significant pain felt in the mammary gland. In this case, pain occurs, most often, in the middle or in the second half of the current cycle.

In this case, the nature of the mentioned pains can be radically different, from its aching forms, up to the forms of stabbing, bursting, etc.

Sometimes, pain can be radiating directly to the neck, shoulder, hypochondrium or back.

Often, patients have swelling, as well as uniform compaction of the breast tissue itself.

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Usually, on palpation, the patient can palpate small, granular structures. In some cases, with minimal pressure on the nipple, transparent or colostrum-like discharge may appear, the real intensity of which can increase in the period before menstruation.

How is diffuse adenosis treated?

In most cases, with diffuse forms of a condition such as adenosis of the mammary glands, exclusively conservative tactics are indicated, combined with dynamic monitoring of the patient's health.

Primarily, it is recommended to change the previously habitual food ration, with the obligatory inclusion in it of the largest possible amount of correct and safe vegetable fiber, as well as dairy or fermented milk products.

It is desirable, in this case, also a sharp restriction of the use of animal fats. It is believed that at

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the presence of dysbiosis in the intestine in a particular patient, as a result of which the absorption of useful vitamins or microelements is impaired, it may be necessary to receive treatment from a gastroenterologist.

The appointment of full-fledged vitamin and mineral complexes is often shown. Such patients are recommended to use potassium iodide, safe and beneficial dietary supplements.

An increasing number of practicing doctors are inclined to use modern homeopathic remedies for adenosis (such as mastodinone in particular).

Sometimes, doctors can prescribe to patients with adenosis of the mammary glands some phytopreparations (for example, phytolon), or agents that are adaptogens (for example, klamin).

In addition, such patients can be prescribed drugs with a powerful diuretic, sedative or enzymatic effect.

With diffuse adenosis, it is advisable to increase the woman's physical activity. Exercise therapy exercises and full-fledged psychotherapy have an excellent effect on the health of women.

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Adenosis of the breast 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 breast adenosis:

previous abortions and surgical interventions in the form of a cesarean section, traumatizing childbirth;
first pregnancy in women after 40 years;
complete infertility of a woman;
refusal of a woman 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.

Views

By structure

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

Apocrine form 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 \u200b\u200bthe mammary gland and has a clearly defined limited appearance.
Diffuse adenosis the mammary gland is a tumor characterized by the absence of clear boundaries of germination. Diffuse adenosis is a very serious 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 \u200b\u200bfibrous 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 squeezes 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, which worsens 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 formations.
Ultrasound examination is used to examine pathological structures, their consistency. Adenosis of the mammary glands on ultrasound is manifested as 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 of the appearance of 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

Treatment tactics differ 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 surgical intervention.

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 medical correction, but it is also recommended to adhere to a 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. Compresses made from ground pumpkin seeds, chopped beets, or fresh cabbage leaves are widely used as folk methods.

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

Surgical

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

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

Prevention

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.

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. In 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.

Breast adenosis in the early stages of development is well curable and does not pose a significant risk to women's health. However, with a more advanced course, the disease is aggravated, and in the absence of treatment, there is a danger of developing into a malignant form.

Consider what causes adenosis of the mammary glands, how to avoid its manifestation, and what are the features of the treatment of this pathological condition.

What is adenosis of the mammary glands, what exactly can this medical term mean? In accordance with ICD-10, the code - D24 - is one of the varieties of mastopathy, which is characterized by a predominance of a jelly substance (glandular mastopathy). It is a benign tumor that precedes a precancerous condition.

The development of the disease begins with the spread of connective tissues, followed by the formation of strands and small seals.

Experts call the main reason for the manifestation of adenosis a failure in the functions of the endocrine system, as a result of which an imbalance of hormones develops.

According to doctors, adjusting the lifestyle, emotional background and nutrition during pregnancy contributes to the independent disappearance of glandular mastopathy, without the use of medications. For other women, late seeking medical help increases the risk of transformation of a benign tumor into cancer.

There are several types of breast adenosis:

Diffuse.
Local.
Nodal.
Focal.
Sclerosing.

Each form of the disease has its own clinical picture.

Views	Features of manifestation
Diffuse	Nodules are present throughout the entire breast area, but they are not able to appear in certain areas of the body.
	They do not have clear contours. With its progression, the disease affects healthy tissues adjacent to the seals.
	Can affect the milk ducts, which entails.
Local	The appearance of seals in the breast tissue with a lobular structure.
	When probing the breast, large lobules of nodes are easily differentiated.
	Each lobule is located inside the fibrous capsule.
	On hardware examination, yellow myoepithelial cells between mature lobules are clearly visible.
	The tumor forms in any one part of the breast and does not have the ability to spread throughout its entire area.
	Swollen lymph nodes above the collarbones and armpits.
Nodal	The presence of a local or heavy dense and formation (pain appears on palpation).
	.
	Deformation of the breast.
	The chest increases in volume, swells, acquires soreness and sensitivity 10-14 days before the onset of menstruation, while the pain radiates to the scapula and shoulder.
	Education is formed in the vicinity of the lymph nodes.
Focal	Strongly noticeable asymmetry between healthy and damaged breasts.
	On palpation, single or multiple seals are palpated.
	Usually the nodes are located near the milk ducts.
	Tumors are mobile and have clear contours.
Sclerosing	Only the lobules of the breast are damaged.
	The proliferation of tissues is observed. In this case, myoepithelial and epithelial, thanks to the basement membrane, are not affected, therefore the seals are located around them.
	Clear differentiation of the breast lobules during examination.
	Rapid proliferation of fibrous cells in combination with the glandular substance.
	When probing, the seals are small focal and mobile.
	There may be swelling of the lymph nodes in the armpit.

In most situations, breast adenosis is a consequence of a malfunctioning hormonal system. The proliferation of connective tissues is triggered by increased production of the hormone estrogen. In addition, increased levels of prolactin and progesterone contribute to the appearance of glandular mastitis.

Based on this, it can be said that at certain stages of a woman's life, when there are sharp fluctuations in hormones, there is a danger of adenosis.

As a rule, this pathology is observed:

In young girls during puberty.
In women in the first trimester of pregnancy.
For women after 30-40 years.

The decline in the synthesis of sex hormones occurs from the moment of the onset of menopause, therefore, in women of the older age category, adenosis is rare.

However, in the presence of certain pathological conditions in the body, even during menopause, the risk of manifestation of the disease remains:

Benign proliferation of the endometrium of the uterus due to high estrogen levels.
Disruption of the ovaries due to malfunctioning of the endocrine system.
Chronic ailments and inflammation of the genitals.
Late pregnancy or complete absence of pregnancy / childbirth (at 35+ years).
Pathologies of the endocrine structure, such as hypothyroidism, adrenal insufficiency, a tumor in the pituitary gland of the brain, etc.
Long-term breastfeeding (more than a year) without the introduction of complementary foods in the baby's diet.
Chronic stress, regular nervous tension.
Abnormalities in the reproductive system (abortion, prolonged absence of intimate life, the use of hormonal contraceptives).
Reduced ability of the immune system, unfavorable climatic conditions.

The risk of developing adenosis is highest in women with gynecological pathologies of a hyperplastic nature (endometriosis, uterine myoma, etc.) - almost 100%. In childbearing age, from 30 to 70% of women are faced with this disease.

Due to the fact that glandular mastopathy can manifest itself in different forms, all of them have individual symptoms. However, there are also general signs by which specialists can differentiate a preliminary diagnosis.

Of the common symptoms, doctors call:

7-14 days before the onset of menstruation, the breast swells and its sensitivity increases.
On palpation of the mammary glands, seals are found.
Concerned about itching in the nipples and aching pain in the breast, regardless of the menstrual cycle.
Breast enlargement and the appearance of a feeling of heaviness.
A cloudy brown or green exudate flows out of the nipples. At the advanced stages of pathology, there are blotches of blood in the discharge, which indicates the presence of complications.
A slight increase in regional lymph nodes and a change in the color of the paraareolar zone are clear signs of infection in the breast.

If a woman systematically checks the condition of her breasts, this will help detect the disease in the early stages and take appropriate treatment measures.

If adenosis is suspected, even if a single symptom appears, a woman should not delay visiting a doctor. It is necessary to seek advice from a mammologist or gynecologist, and in some situations to an oncologist.

Diagnostics is carried out in the following sequence:

Examination and palpation of the mammary glands.
Laboratory tests.
Instrumental examination.

From laboratory tests, a biochemical blood test is taken, which helps to identify the cause of the deviations and select the optimal therapeutic option.

From hardware methods it is practiced:

Instrumental research	Features:
Ultrasound	The breast and enlarged lymph nodes are examined. The form of compaction and the nature of changes in the lymph nodes are determined. The use of ultrasound is practiced in the presence of single nodes that are difficult to palpate.
MRI or CT	An assessment of the state of the breast is carried out and the possible presence of some additional pathological processes is revealed.
Mammography	A chest x-ray can help determine the exact location of tumors and the size of the affected area.
Mammoscintigraphy	It is used if you suspect a cancerous form of the seal.
Biopsy	A tissue sample is taken to determine the presence of malignant cells.

Features of the treatment of a painful condition

Breast adenosis therapy is based on an integrated approach. The following treatment methods are used:

Lifestyle changes.
Medicinal intervention.
Surgery.
Folk methods.

Correcting life habits

It is necessary to be treated for the disease not only with the help of medications. With a mild course of adenosis, you can do without drugs, carefully observing medical recommendations:

Observe the dietary table, which is selected individually.
Refuse from excessive consumption of alcoholic beverages and smoking.
Stick to a rest and activity regimen.
Eliminate stressful situations and other psycho-emotional stress.
Avoid excessive physical exertion.
Increase the time spent in the fresh air (walks, etc.).

With regard to whether it is possible to sunbathe with breast adenosis, ultraviolet rays can provoke an aggravation of the disease. The possibility of using sunbathing depends on the severity of the disease and the individuality of the patient's body, therefore it is better to check this question with your doctor.

With the initial development of adenosis, medications are prescribed that have certain medicinal characteristics:

Sedatives.
Vitamin complexes.
Hormonal.
Homeopathic.
Estrogen-containing.
To eliminate the symptomatic picture (pain reliever, antipyretic, etc.).

The appointment of certain drugs depends on the form and stage of glandular mastopathy, for example:

With a mild course of the disease, taking contraceptive drugs lasts at least 6 months. Most often, the doctor prescribes Lindinet 30, which can slow down the growth of the seal, normalize the menstrual cycle, and eliminate the symptoms of the disease.
In advanced stages and with increased symptoms before the onset of menstruation, gestagens are recommended: Dufaston, Pregnin, Norkolut, Progesterone (oil solution). You need to take these funds according to the instructions, that is, during the luteal phase of the cycle, starting from 16 to 25 days. The duration of treatment is 3-6 months.
With the manifestation of diffuse adenosis, hormonal agents are recommended - gestagens and oral contraceptives of combined action.
Prescribed oral contraceptives are similar in their action to Janine, like Zhenegest, Silhouette and others. They contain dienogest (2 ml).
Homeopathic medicines such as Mastodinon may also be recommended. However, it only temporarily suppresses the symptoms of the disease, but when combined with hormonal medicines, the effect is more stable and lasting.

It should be borne in mind that substitution therapy often leads to the development of side effects, therefore, taking a specific type of medication must be agreed with the attending physician.

The method of taking drugs can be: pre-oral, injection, transdermal. Their effectiveness differs depending on the problem (source of pathology) and the mechanism of action.

With any therapeutic methods of various forms of adenosis, it is imperative to take vitamins (A, B1, B2, B9, P, E and C), best of all in complex remedies.

Surgery

The operation is practiced in rare cases - in most situations, gentle methods are sufficient, provided that the patient carefully complies with the medication and diet.

The expediency of surgery depends on the type of adenosis:

Sclerosing with a single node or the seals do not increase - the operation is not performed. Regular observation by a mammologist and an ultrasound scan once every six months is shown.
A sclerosing one with multiple pathological foci is eliminated by sectoral resection under local or general anesthesia.
Focal is cured exclusively by surgery.
The local one is not capable of independent disappearance even with properly selected hormonal agents, therefore, the nodular formations are eliminated by excision of the pathological area or the entire breast. A puncture with aspiration is pre-assigned, and the selected material is examined for the presence or absence of cancer cells.
With fibroadenomatosis, an excisional biopsy is performed to exclude the malignant course of the seal. In this situation, immediate histology is performed.

After the operation, the pathologically altered area is monitored, drug and supportive therapy is prescribed.

With the initial development of adenosis, the use of folk healing decoctions and compresses helps to completely get rid of the pathology. In advanced stages, herbal remedies can only be used as an adjunct to medications.

For internal use, the following homemade recipes are used:

Chestnut broth (horse). For 5 tbsp. take 1 liter of chestnut inflorescences. purified water. Bring to a boil over low heat, pour into a thermos and leave for 8-12 hours. Drink 1 tbsp. every hour throughout the day. The next day, prepare a new broth. The duration of treatment is 7 days.
Burdock infusion. You need 10 gr. Pour boiling water over chopped fresh burdock leaves (200 ml). Insist 3 hours, filter and take 15 ml. 20-30 minutes before meals. The duration of the course is 10 days.
Collection. Mix 1 tablespoon each. nettle, plantain and sage and 2 tbsp. wormwood. For brewing, take 1 tbsp. mixture for 250 ml. boiling water, leave for 1-1.5 hours. The drink is drunk during the day for 1/3 of the prepared volume at regular intervals, the course is 1 month.

Beetroot and honey application. You will need 3 parts raw beetroot and 1 part honey. Pass the vegetable through a meat grinder (you can grate it on a fine grater), add honey, mix. Apply the resulting gruel to the chest in the place where the seal is localized (at night). Compresses should be done every other day for 2-3 weeks.
Simple compresses. It is useful to apply a mashed cabbage leaf (only juicy layers from the middle of the vegetable) or freshly picked burdock to the breast. Their inner part can be greased with natural honey, grated carrots and beets can be added, or sprinkled with castor oil - the compositions can be alternated.
Salt lotion. Dissolve 3 tbsp in a liter of lukewarm water. salt (you can take any), soak a towel or clean cloth in the liquid, then apply to the sore breast for 5-6 hours. Course - a week.

Possible forecast and presence of danger

With the timely detection of adenosis, and well-chosen treatment, doctors predict a favorable outcome:

In pregnant women, the lump disappears in the second trimester.
If all medical recommendations are followed, with a local or diffuse form, there are good chances for a complete recovery.
With gynecological or endocrine problems, it is possible that the disease reappears even with successfully completed treatment.
After surgery, the formation of glandular tissues completely stops, subject to proper nutrition, maintenance of hormonal levels and the absence of stressful situations.

However, it should be borne in mind that the disease is characterized by a latent stage of development, therefore, the pathological process is often diagnosed already at advanced stages, which significantly complicates therapy and increases the risk of complications:

A significant change in the configuration of the mammary gland.
The manifestation of inflammatory processes.
Degeneration of the seal into a malignant form.

Prevention of adenosis involves:

Be attentive to your health.
It is imperative to maintain the first pregnancy followed by hepatitis B for at least 6 months.
Prevent unwanted pregnancy through contraceptive drugs, which must be selected by a doctor, which will help prevent hormonal imbalances.
Refuse abortion.
Perform a self-examination of the breasts regularly.
Do not miss scheduled examinations by a gynecologist and mammologist (at least 1 time per year), and in case of disorders in the endocrine system - 2 times a year, including an endocrinologist.

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 a form of 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 WHO, 25% of women have breast pathologies (MF), and mastopathy prevails among them.

It has 50 varieties, and adenosis is one of them. He 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, the connective tissue is more 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 disorders, namely in a decrease in the production of sex hormones.

In women, throughout their lives, total hormonal shifts occur at different age periods: menopause, postmenopause, pregnancy, lactation, and less often the early puberty period.

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 is 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.

It also plays a role:

heredity and bad ecology;
abortion (especially during long periods of pregnancy);
early labor or overstimulation of labor;
rejection 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 under 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. With such processes, not only the glandular tissue is damaged, but also the milk 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. Rapid proliferation of fibrous tissue is noted.

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. There is soreness 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 breast; 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 has no 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 \u200b\u200blobular 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 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 the conservative type of treatment, in advanced cases and with the rapid growth of the tumor, 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. 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 mild forms of the disease, homeopathic treatment is used. By itself, it is weak, but when it is combined with hormones, the effect is more pronounced and lasting. The most commonly used drugs are "" and "Mammoleptin".

Surgical treatment is a sectoral resection of the affected area of \u200b\u200bthe 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 the ducts are affected, 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.