Mastopathy is not treated. Can fibrocystic breast disease be cured? Types of breast mastopathy

Mastopathy is a fibrocystic pathology that develops in the mammary glands. The disease is accompanied by abnormal processes that alter the epithelium and connective tissues. Like other diseases of the breast, mastopathy can lead to the development of a malignant tumor. Initially, the process is benign, but neglect of health, ignorance of symptoms and lack of therapy lead to serious complications. When diagnosed with "mastopathy" treatment folk remedies at home can help, but only with a competent and comprehensive approach.

The stage of development of the pathology affects the method of treating mastopathy in women. The severity of the disease changes its symptoms, features of the course. In the advanced form of the disease, the risk of complications increases several times. Mental and emotional disorders, worries, and irregularities in the menstrual cycle can also aggravate the situation.

At the initial stage of the development of the disease, obvious manifestations of mastopathy may be absent. Breast swelling and soreness before the onset of menstruation is possible, but often such symptoms are associated with menstruation. This becomes the reason for the late diagnosis of pathology and untimely initiation of treatment. Regular examination by a gynecologist or mammologist (every six months) will reveal the disease at the initial stage and carry out competent therapy.

If you suspect the development of the disease, mammography is prescribed. Before the hardware diagnostics is carried out, a woman may notice the following signs of mastopathy, which already indicate a progressive pathology:

  • chest pain of varying intensity;
  • unreasonable discharge from the nipples (in the absence of pregnancy and lactation);
  • thickening of the glands, probing knotty bumps in the chest.

Pain syndrome during the development of pathology can spread to the upper limbs, give to the scapula... The absence of painful sensations is not excluded - in medical practice more than 15% of such cases were recorded.

The color of the discharge can be:

  • transparent;
  • whitish;
  • brownish;
  • green;
  • with blood streaks.

In the latter case, the symptom speaks of a complex form of pathology, which requires immediate medical attention, since it is urgent to treat severe breast mastopathy. Surgery may be required.

Venous congestion causes coarsening of the tissues of the gland, as well as an increase in their size. Touching the chest causes discomfort, the sensitivity is increased.

Why does mastopathy develop?

In medical practice, most cases of mastopathy are associated with hormonal imbalance in women. Disruptions in the production of female hormones lead to general dysfunctions of the female reproductive system, and breast diseases occur for the most part because of this. Therefore, before treating mastopathy, women first of all determine the state of hormonal levels. If the causes of the pathology are associated with deviations in this regard, then a hormonal complex is selected according to individual deviations to normalize the condition.

There are a number of other factors that can cause the formation of fibrous tissue in the breast:

  • menstruation that began before the age of 12;
  • miscarriage or artificial termination of pregnancy;
  • late menopause;
  • genetic predisposition;
  • absence of childbirth up to 30 years;
  • short lactation period (less than two months) or lack of milk after childbirth;
  • prolonged stress and anxiety, emotional disorders;
  • traumas and diseases of the mammary glands;
  • wrong lifestyle;
  • lack of vitamins and iodine;
  • uncomfortable underwear;
  • gynecological disorders;
  • dysfunction and tumor processes in the thyroid gland, liver;
  • overweight;
  • stagnation of blood in the pelvic organs due to irregular sexual activity.

The risk factors include the woman's age. After 35 years, the likelihood of developing mastopathy increases three times.

With a competent approach to therapy, you can get rid of mastopathy forever, and therefore you should not panic when it is detected. By eliminating risk factors, restoring the balance of hormones, the disease can be stopped without resorting to conservative methods.

You can successfully treat mastopathy at home using folk remedies. You can use the methods of traditional medicine. Treatment, as a rule, is determined by the form of pathology, which can be diagnosed through ultrasound studies, mammography, or a physical examination by a doctor.

If the disease has not reached an extreme stage, then you can apply methods of treating mastopathy with folk remedies, the recipes of which have helped more than one woman in the fight against the fibrotic process.

Cabbage

Self-treatment of mastopathy with a cabbage leaf is considered almost the most effective folk way. The vegetable copes well with edema, reduces pain and has an antitumor effect... Ordinary cabbage for mastopathy is often used in the form of compresses, but you can also use freshly squeezed juice. For a therapeutic effect, you need to drink 100 ml of juice three times a day. Such treatment of mastopathy with cabbage should last at least two months.

There are several recipes for compresses, and each of them has long been proven to be effective.

  1. It is necessary to mix grated raw beets with honey, observing a 3: 1 ratio. Apply the resulting mixture evenly on a cabbage leaf, and then fix the compress on the chest using ordinary cling film. The course of treatment in this way is a month.
  2. Cabbage with the addition of yogurt will help relieve pain and cure the disease. For a compress, mix 2 tbsp. spoons of yogurt and 7 tbsp. tablespoons of finely chopped cabbage. For fixing, it is better to use a natural fabric on which the product is applied and apply at night. Night time is optimal for treatment, since you need to apply the cabbage leaf for at least 10 hours. The procedures continue for 20 days.
  3. It is necessary to carefully spread the cabbage leaf with butter. After that, the compress is sprinkled abundantly with "Extra" salt and applied to the chest. The compress is done at night with a course duration of a week.

Very often, cabbage leaves are used in pure mastopathy. It is thoroughly washed, large veins are removed and slightly beaten off with a kitchen wooden hammer. Such a compress is considered one of the best remedies for mastopathy among all folk recipes. It needs to be changed as soon as the sheet is completely dry. The duration of treatment is two weeks.

With mastopathy, treatment with folk remedies at home can give the same effect as drug therapy. If you make cabbage compresses regularly and correctly, then the result will not be long in coming and the disease will be cured.

Iodine therapy

With mastopathy, home treatment often involves the use of iodine. Its curative efficacy has long been proven for tumor and fibrous formations in the mammary gland. Iodine allows you to safely regulate and restore the functions of the thyroid gland, which is responsible for the production of hormones.

Often, breast mastopathy develops when the body suffers from a lack of iodine. But it is possible to use funds based on this component only after the approval of a doctor.

You can independently find out that the body lacks this element. An iodine grid drawn on any part of the body will help in this. If after the night it has completely disappeared, then the body is deficient in iodine. You can draw a grid on the chest within a week, which will make up for its lack, relieve painful sensations and get rid of mastopathy.

You can also focus on nutrition by including iodine-containing foods in the diet:

  • seaweed;
  • special salt with a high iodine content;
  • seafood.

You can take iodine orally, diluted with water or milk. First, 1 drop of iodine tincture is added to 0.5 cups of liquid, increasing the dose daily for a week by 1 drop. After a week, the number of drops is reduced in the reverse order: starting from seven and reaching 1 drop.

It is possible to treat mastopathy at home using iodine using external applications. To prepare an effective product, you will need the following ingredients:

  • egg yolk;
  • 6 large spoons of rye flour;
  • 6 drops of iodine;
  • a small spoonful of honey.

The components are mixed until a homogeneous dough is formed, after which a cake is formed and applied to the breast. The use of this remedy for mastopathy in women helps with a 2-week course. After a 3-week break, the course of treatment can be repeated.

Salt

The use of a salt compress for mastopathy allows you to quickly get rid of the pain syndrome and glandular thickening. Dissolve 3 large tablespoons of salt in 1 liter of liquid. Salt compresses are used for mastopathy at night, moistening the soft tissue in the solution and fixing the bandage well. The course of treatment is two weeks.

Propolis applications for mastopathy help to quickly cure the disease, provided there is no allergy to this product. It is better to visit a doctor before starting therapy, who will confirm the possibility of using the drug.

You can treat mastopathy with folk remedies from propolis, using different ways: taken internally or for external rubbing. In the first case, tincture will help:

  • 50 g of crushed propolis is poured into 0.5 l of alcohol;
  • place the tincture in a dark place for 14 days;
  • shake the container with the product twice a day.

After preparation, the tincture is removed to the refrigerator. You need to take it twice a day, 1 teaspoon, diluted in a glass of water, 30 minutes before meals. It should be treated with this remedy within a month, since it will not be possible to get rid of mastopathy with propolis quickly.

For rubbing, mix 30 g of grated propolis with 100 g of lard. The product must be put in a water bath for two hours and then filtered. Apply in the morning after sleeping for two weeks.

Essential oils

Any oils with mastopathy can aggravate the pathology. Therefore, when treating a disease folk methods on their basis, a preliminary consultation with a doctor is required. Most dangerous essential oils with a fibrotic process in the breast:

  • coriander oil;
  • cypress oil;
  • incense oil.

For baths and compresses, you can use oils based on:

  • chamomile flowers;
  • fennel;
  • lavender.

Essential oils are rather an addition to the treatment in which folk remedies are used for mastopathy, because they balance the nervous system, helping to get rid of everyday worries and stress.

It should be remembered that all folk recipes for mastopathy will only help if the disease has not reached a critical form of development. Otherwise, only qualified medical attention is needed.

Of all breast diseases, fibrocystic disease, or fibrocystic breast disease, is the most common. It occurs in almost 30% of all women, and in women under 30 years of age - in every fourth case of contacting an antenatal clinic. Among women suffering from chronic gynecological diseases, mastopathy was found in 30-70%.

What is mastopathy

About 30 synonymous terms are combined under the term "mastopathy" - breast dysplasia, dyshormonal hyperplasia of the mammary glands, Schimmelbusch disease, chronic cystic mastitis, masoplasia, cystic mastopathy, mastodynia, etc.

All these and many other terms are used to designate those numerous changes of a morphological nature (proliferative, cystic, fibrous), which are often, but not necessarily, present simultaneously and are united by one common name.

In practical medicine, the term "mastopathy" is used in relation to many benign diseases of the mammary glands, which differ in a variety of clinical manifestations and, most importantly, in histomorphological structure, and are united by the main reason for their occurrence - hormonal imbalance in the body.

Thus, mastopathy is a group of benign diseases, morphologically characterized by a wide range of both regressive and proliferative processes, in which there is a pathological relationship between the connective tissue and epithelial components of the mammary glands with the appearance of changes of a cystic, fibrous and proliferative nature.

Why is mastopathy dangerous? Despite the fact that this disease is benign and is not considered directly precancerous, at the same time, breast cancer develops on average 4 times more often against the background of diffuse diseases of the latter and 40 times more often against the background of cystic forms with signs of proliferation (proliferation) of epithelial cells. The risk of malignancy in non-proliferative forms of mastopathy is no more than 1%, with moderate proliferation of the epithelium - about 2.5%, and in the case of significant proliferation, the risks of breast cancer increase to 31.5%.

From this point of view, prevention and treatment of mastopathy are at the same time real prevention of malignant neoplasms. Unfortunately, women identify 90% of pathological formations on their own and only in other cases are they discovered by medical workers by accident as a result of a preventive examination.

The combination of dyshormonal hyperplasias with malignant neoplasms, identified in most studies, is explained by the common causes and risk factors, the identity of certain variants of mastopathy and malignant tumors, and similar hormonal and metabolic disorders in the body.

Types of mastopathy

Due to the wide variety of morphological forms of the disease, there are different classifications. In practice, depending on the prevalence of certain changes detected by palpation (probing) and / or mammography, as well as taking into account the results of histological examination, there are three main forms of the disease, which some of the authors consider to be different stages of development of the same pathological process :

  1. Diffuse large or small focal, representing an early stage of the development of the disease. The histological picture is determined by areas of the organ with a normal structure, hyperplastic (enlarged) and atrophic lobules, dilated ducts and small cysts, coarsening and proliferation of connective tissue structures and collagen fibers.
  2. Nodular, characterized by the predominance of cystic elements and fibrous tissues, proliferation of glandular lobules and epithelial cells that line the inner surface of cysts and milk ducts. The detection of individual atypical cells is the reason for characterizing this form as a precancerous condition.
  3. Mixed, or diffuse-nodular - nodular formations, more or less pronounced in size, are determined against the background diffuse changes mammary glands.

In turn, diffuse and nodular forms are classified into types. The diffuse form is subdivided into:

  • adenosis, in which the glandular component predominates;
  • fibroadenosis - fibrous component;
  • fibrocystosis - cystic component;
  • sclerosing adenosis - a compact proliferation of lobules of the gland with preservation of the inner and outer epithelial layers and configuration of lobules, despite the compression of the latter by fibrous tissues;
  • mixed form.

In the nodal form, the following types are distinguished:

  • adenomatous, which is an overgrown glandular passages with the formation of small adenomas, consisting of enlarged elements of the glandular structure close to each other;
  • fibroadenomatous, including leaf-shaped - a fast-growing connective tissue formation of a layered structure containing cellular elements, cysts and glandular passages, which are lined with expanding epithelial cells;
  • cystic;
  • intraductal papilloma, Minz disease, or bleeding mammary gland; is an easily traumatized overgrown epithelium in the dilated excretory duct behind the areola or close to the nipple;
  • lipogranuloma, or;
  • hemangioma (vascular tumor);
  • hamartoma, consisting of glandular, adipose and fibrous tissues.

Despite the fact that malignant tumors of the mammary glands are not necessarily the consequences of fibrocystic changes. However, their presence greatly increases the risk of developing cancer, which largely depends on the severity of epithelial proliferation within the ducts and glandular lobules. According to histological studies of the material obtained during operations, 46% of malignant tumors are combined with diffuse ones. This fact additionally supports the assumption that the prevention of mastopathy is also the prevention of breast cancer.

Causes of the development of the disease and risk factors

The etiology and mechanisms of development of mastopathy have not been fully elucidated, but a direct connection has been established mainly between the development of this pathology and the state of the balance of hormones in the body. Therefore, the hormonal theory of the formation of diffuse fibrocystic disease was the basis for the name of the disease as dyshormonal hyperplasia of the mammary glands.

The latter are an organ highly sensitive to any changes in the level of hormones, especially sexual ones, and at any time in a woman's life. The mammary glands are never in states characterized by functional rest. Their development and condition, physiological changes during the menstrual cycle after puberty, activation of the function during pregnancy and lactation are carried out and regulated by a whole hormonal complex.

These hormones include GnRH (gonadotropin-releasing hormone) of the hypothalamic region of the brain, prolactin, luteinizing and follicle-stimulating hormones of the pituitary gland, thyroid-stimulating and chorionic hormones, glucocorticosteroids and insulin, and, most importantly, sex hormones (androgens, estrogens, estrogens).

Therefore, any hormonal imbalance, especially between progesterone and estrogens, among which estradiol has the maximum effect on the mammary gland, is accompanied by changes in the structure of its tissues and, as a result, the development of mastopathy. The differentiation (specialization) of cells, their division, development and proliferation of epithelial cells of the organ ducts depend on estradiol. This hormone also induces the development of the structural and functional unit of the gland (lobules), the development of the vasculature and the filling of connective tissue with fluid.

Progesterone, on the other hand, prevents the division and proliferation of the epithelium of the milk ducts, reduces the permeability of small vessels, due to the action of estrogens. By reducing the swelling of the connective tissue, progesterone provides lobular-alveolar separation, promotes the development of glandular tissues, lobules and alveoli.

Of greatest importance is the relative (in relation to estrogens) or absolute deficiency of progesterone. Its deficiency is the cause of not only edema, but also an increase in the mass and volume of connective tissues inside the lobules, as well as the growth of the epithelium of the ducts, leading to a decrease in their diameter, blockage and the formation of cysts. The hormone is able to reduce the degree of activity of estrogen receptors, to reduce the local concentration of active estrogens, which helps to limit the stimulation of the proliferation of glandular tissues.

An increased concentration of the hormone prolactin in the blood also plays a role in the development of mastopathy, which leads to an increase in the number of receptors in the tissues of the glands that perceive estradiol. This increases the sensitivity of the cells of the gland to the latter and accelerates the growth of the epithelium in it. In addition, an increase in the level of prolactin is one of the reasons for a violation of the ratio of estrogen and progesterone, which is accompanied by the corresponding symptoms in the second phase of the menstrual cycle - edema, engorgement and tenderness of the mammary glands.

There are many causal risk factors, but the main ones are:

  1. Later (after 16 years) or premature, not age-appropriate, onset of menstrual cycles (up to 12 years), as a result of which the girl's body does not have time to adapt to changes in the hormonal state, to which the mammary gland tissue reacts accordingly.
  2. Later (after 30 years) the onset of sexual activity.
  3. Early (before 45 years) or late (after 55 years) menopause, which is associated with an early imbalance of sex hormones or a longer influence of estrogens.
  4. , absence of pregnancies that ended in childbirth or late (after 30 years) first pregnancy.
  5. Frequent abortions in adolescence or after 35 years. Three artificial interruptions after 6 weeks of pregnancy, when the glandular tissue grows significantly, are the starting factor for the transformation of physiological proliferation into pathological one. Abortions at these times increase the risk of developing mastopathy by 7 times due to the interruption of hormonal changes that occur during pregnancy.
  6. Absence, overly short (less than 5 months) or too long breastfeeding.
  7. Hereditary predisposition and age after 45 years.
  8. Chronic inflammatory diseases of the female genital area (about 40-70%), which are not so much a provoking factor as a factor contributing to or concomitant endocrine disorders;
  9. Genital endometriosis (80%), (85%), the hormones of which affect the mammary glands directly or by influencing receptors that perceive other hormones.
  10. Ovarian tumors and menstrual irregularities (54%).
  11. Hormonal disorders of the hypothalamic-pituitary system, thyroid diseases (found in 40-80% of women with mastopathy), dysfunction of the adrenal cortex, hormonal imbalance in metabolic syndrome.
  12. Violation of the utilization of steroid hormones, in particular estrogens, and their excretion as a result of pathological changes or dysfunctions of the liver, biliary tract and intestines.
  13. Long-term psychological stress and chronic stress conditions, long-term depression and sleep disorders, leading to a disorder of feedbacks between the cerebral cortex, hypothalamus and the rest of the endocrine and autonomic systems. Such disorders are present in almost 80% of women with mastopathy.
  14. Poor nutrition - excessive consumption of food rich in fats, carbohydrates, animal proteins, and insufficient consumption of fruits and vegetables, as well as foods with dietary fiber.
  15. Nicotine intoxication and abuse of alcoholic and caffeinated drinks and products - strong coffee and tea, cola, energy drinks, chocolate.
  16. The negative influence of the external environment (chemical carcinogens and ionizing radiation) is often the impetus for the emergence of mastopathy.

Mastopathy and pregnancy are related to a certain extent. If late or aborted pregnancy, as well as infertility, are risk factors for the development of mastopathy, as mentioned above, then, accordingly, its presence, and even more so repeated pregnancies and childbirth, can be considered a prevention of the disease. In addition, some authors believe that during pregnancy, there may be a delay in the development of mastopathy and a decrease in the degree of its manifestations. This is due to the high content of progesterone in a woman's body during pregnancy and lactation.

Symptoms of mastopathy

Diagnosis of any pathology is based on elucidating the history of the disease when talking with the patient, his subjective feelings and external visual and palpation examinations. All this makes it possible for the clinician to choose further methods of instrumental and laboratory diagnostics in order to establish a diagnosis, provoking factors and concomitant diseases that affect the development of a specific pathology.

The main and most characteristic initial signs of mastopathy:

  1. Mastalgia, or pain in the mammary glands (85%) of varying intensity, forcing women to seek medical attention. They arise as a result of an increased content of estrogens and compression of the nerve endings by edematous connective tissue or cystic formations. Another reason is the involvement of nerve endings in tissues that have undergone hardening.

    Local aching or dull pains, but sometimes intensifies with movement and radiates (gives) to the scapular and axillary regions, shoulder girdle, arm. They occur in the second half of the menstrual cycle - usually a week, and sometimes more before the onset of menstruation. After the onset of menstruation or after a few days, the pains disappear or their intensity decreases significantly. Severe morbidity leads to carcinophobia (a feeling of fear about a malignant tumor), anxiety or depression, emotional imbalance.

  2. Feelings of discomfort, bloating, heaviness, engorgement (mastodynia) of the mammary glands and an increase in their sensitivity are more often disturbed. Sometimes these phenomena are accompanied by anxiety, irritability, headache, nausea and vomiting, discomfort and cramping abdominal pain (). They, as in cases of mastalgia, are associated with the menstrual cycle and result from increased blood filling and swelling of the connective tissue structure of the glands that form the stroma.
  3. Discharge when pressing on the nipples is transparent, whitish, brownish, greenish in color, or even mixed with blood. If there are many of them, they may appear on their own (without pressure). Particularly should be alarming spotting, which occurs in a malignant neoplasm.
  4. The presence of one or more nodules of various sizes, detected by palpation, and sometimes visually. Most often they are determined in the upper outer quadrants of the glands, which are functionally the most active. External examination and palpation examination in horizontal and vertical (with arms lowered and raised) are the main objective and easily accessible research methods, requiring, at the same time, the availability of sufficient practical skills. They allow you to determine the severity of the cutaneous venous network, the consistency and boundaries of the seals, fibrous cords and the severity of the lobules, their soreness.

It should be noted that an increase in regional lymph nodes, their soreness and temperature with mastopathy are not signs of the latter. An increase in local and / or general body temperature, an increase in supra- and subclavian, axillary lymph nodes usually occur in the presence of inflammatory processes in the mammary gland (). In addition, the doctor, examining the mammary glands, always carefully checks the regional lymph nodes, which are the first place of metastasis of the malignant tumor.

Diagnosis of the disease

The easy accessibility of the mammary glands for visual examination and manual examination, the great similarity in different periods of their functioning of physiological changes with many forms of pathology often lead to an erroneous interpretation of the obtained examination results and are the cause of both hyper- and underdiagnostics.

Therefore, the clinical examination data should be supplemented by such basic research methods as X-ray mammography and ultrasound diagnostics, which make it possible to confirm, clarify or reject a preliminary diagnosis.

The X-ray method is the most informative, allowing timely detection of glandular pathology in 85 - 95% of cases. The World Health Organization recommends holding every 2 years for any healthy woman after 40 years, and after 50 years - every year. The study is carried out from the 5th to the 10th day of the menstrual cycle in two projections (direct and lateral). If necessary, sighting (of a certain limited area) radiography is carried out.

For women 35-40 years of age, pregnant women, lactating mothers, it is recommended to carry out an echographic examination every six months. Its advantages are safety and high resolution. On ultrasound, you can accurately distinguish cavity formations from solid ones, examine glands with a high density (in young women, with tissue edema as a result of injury or acute inflammation), and conduct targeted puncture biopsy. In addition, ultrasound allows visualizing X-ray-negative tumor-like formations located close to the chest wall, and regional lymph nodes, and dynamically monitoring treatment results.

Women with breast pathology often need to study hormonal levels. These laboratory tests in some cases make it possible to establish the cause of the disease, risk factors, and adjust the treatment in terms of the use of certain hormonal agents.

How to treat mastopathy

There are no generally accepted standard principles of therapy, despite the prevalence of the disease and the importance of early detection and treatment for cancer prevention.

Treatment of women with nodular forms begins with a puncture (using a fine needle) aspiration biopsy. If signs of dysplasia are detected in the node (abnormal development of connective tissue structures), it is recommended surgery- sectoral resection or complete removal of an organ (mastectomy) with obligatory urgent histological examination of the removed tissues.

Diet

Diet has a preventive and therapeutic value for mastopathy, since nutrition largely affects the metabolic processes of sex hormones, especially estrogens. A limited intake of carbohydrates and fats, meat products is recommended, which helps to reduce the content of estrogens in the blood and normalize the ratio of androgens and estrogens. In addition, the anti-cancer properties of coarse fiber types of fiber found in vegetables and fruits, especially in some grain products, have been proven.

It is important to eat food that contains a large amount of vitamins and minerals, especially iodine, zinc, selenium, magnesium, titanium, silicon. To replenish them, additional intake of special food supplements and vitamin-mineral complexes in dragees is desirable. One of these drugs is Triovit in peas, enclosed in capsules.

Taking hormonal drugs

Since the main cause of mastopathy is hormonal disorders, the main goal of therapy is to correct them. For this, gestagenic hormonal drugs are most often used, the mechanism of effect of which is based on suppressing the activity of the pituitary-ovarian system, reducing the degree of stimulating effect of estrogens on breast tissue.

For these purposes, Utrozhestan, Dyufaston and especially Gel Progestin are used. The latter contains micronized plant progesterone, identical to endogenous and acting at the cell level. At the same time, it does not increase the serum hormone levels. It is applied to the skin for 3 months from 16 to 25 days of the menstrual cycle or daily.

Homeopathy

V last years a certain place in the prevention and treatment of diffuse forms of mastopathy was taken by homeopathy, based on the use of small doses of active ingredients contained in plants, minerals, substances of animal origin, etc. They do not cause negative side effects. Their action is aimed at stimulating and maintaining the protective abilities of the body itself. Homeopathic remedies include mastopathy pills such as:

  • Mastopol, prescribed for 2 months, 1 tablet three times a day, half an hour before meals or 1 hour after meals; it contains alkaloids of spotted hemlock, thuja, canadian yellow root and has a sedative effect, significantly reduces the severity of mastalgia;
  • Mastodinon, available in tablets and drops, is prescribed for taking for three months twice a day, 1 tablet or 30 drops; it is a complex of products, the main ingredient of which is an extract from the common rod (Abraham's tree, sacred Vitex).

    Active substances help to reduce the synthesis of prolactin by acting on the pituitary gland, thereby improving the function of the corpus luteum of the ovaries and normalizing the ratio of estrogen to progesterone; this medicine leads to the elimination of signs of premenstrual syndrome, a decrease or elimination of discharge from the nipples, to the normalization of the menstrual cycle, helps to reduce the intensity of proliferation processes in the mammary glands and regression of pathological processes in mastopathy;

  • Cyclodinone containing only the extract of the same plant, moreover, in a higher concentration;
  • Klimadinon, the main component of which is an extract from the black cohosh rhizome, or cimicifuga; treatment of mastopathy with menopause often turns out to be highly effective, since the cimicifuga well eliminates vascular-vegetative disorders, slightly inferior only to hormonal agents; the mechanism of its action is based on modulation of the function of estrogen receptors in the central nervous system, suppression of excess secretion of luteinizing hormone involved in the mechanism of climacteric disorders and worsening of the course of mastopathy among women 45-50 years of age.
  • Gelarium in dragees containing St. John's wort extract; it helps to eliminate mild depression that accompanies premenstrual syndrome, normalizes sleep and appetite, increases psycho-emotional stability;
  • Femiglandin, derived from evening primrose oil - contains vitamin “E” and polyunsaturated fatty acids;
  • Femivell - consists of soy isoflavonoids, mahogany extract and vitamin "E"

After agreement with the doctor, the treatment of mastopathy at home can be carried out with the help of infusions prepared independently from the above or other individual medicinal plants or a collection of herbs that are offered by the pharmacy network.

Often, patients are asked the question, is it possible to do massage with mastopathy? Physiotherapy, ointments, massage, compresses not only in the area of ​​the mammary glands, but also soft tissues in the area of ​​the thoracic spine lead to the expansion of small and medium vessels, an increase in the volume of blood supplied to the tissues of the organ. This helps to increase tissue nutrition, accelerate metabolic processes, which stimulates the growth of already existing tumor-like formations. Therefore, mastopathy is a contraindication for the use of such remedies for the named zones and areas.

With engorgement and swelling of the mammary glands, accompanied by pain, Dimexide can be used from external agents, but not compresses or ointment, but in the form of 25 or 50% of a gel produced in tubes. The drug has anti-inflammatory and moderate analgesic effects when applied to the skin of the mammary glands.

Studies of women of reproductive age and suffering from various gynecological pathologies revealed a diffuse form of mastopathy on average in 30%, mixed (diffuse-nodular) - in the same number of patients, nodular forms of mastopathy were usually combined with uterine myomatosis, endometrial hyperplasia and genital endometriosis. Thus, the choice of treatment methods depends on the form of the pathology, the presence of hormonal imbalance and concomitant diseases.

Breast mastopathy cannot be eliminated on its own and almost always needs treatment. According to various statistics, in recent years, from 50 to 90% of women suffer from this ailment, and the main danger of this breast disease is the ability of neoplasms to degenerate into a cancerous tumor. That is why any form of this pathology is considered by mammologists as a precancerous condition and needs constant monitoring and treatment. In this article, we will acquaint you with the principles of treating breast mastopathy. Having received this information, you can ask your doctor if you have any questions.

The risk of tumor malignancy increases with the appearance of cystic formations. The degree of growth (proliferation) of the epithelium of the mammary glands and the appearance of signs of calcification of neoplasms are also of great importance in tissue malignancy.

There is no single treatment regimen for mastopathy, its tactics depend on many factors:

  • woman's age;
  • form of mastopathy;
  • character ;
  • the presence of concomitant diseases: gynecological, endocrine, extragenital;
  • desire to maintain reproductive function or achieve a contraceptive effect.

In some cases, in women of reproductive age, according to the ANDI classification, some fibrocystic changes in the mammary glands may refer to a variant of the norm. But in the presence of a significant deterioration in the quality of life, the presence of severe complaints and a high risk of malignancy (for example, in the history), the approach to monitoring and treating such patients should be more thoughtful and comprehensive.

If mastopathy is detected in women by chance, as a concomitant pathology, and is not accompanied by complaints, then treatment is usually not prescribed. Such patients are recommended to regularly undergo an ultrasound of the mammary glands or mammography (sometimes a diagnostic puncture) at least 1 time per year and be monitored by a mammologist.

If mastopathy is moderately cyclic or constant and fibrocystic changes (without obvious microcysts) in the mammary glands are diffuse, then conservative therapy can begin with correcting physiological cycles and prescribing a diet. As a rule, this approach is acceptable when treating young and healthy women.

Patients with severe mastopathy, accompanied by constant or cyclical pain, the presence of palpable changes in the structure of the gland or discharge from the nipples, treatment is always prescribed. With a diffuse form of this ailment, a woman is recommended conservative therapy. The tactics of prescribing certain drugs in such cases depends on the data of a comprehensive examination of the patient. And when fibrocystic forms of mastopathy are detected, a woman can be prescribed conservative treatment, but in some cases it is necessary to perform a surgical operation.

Conservative therapy

Non-hormonal drugs

Diet

Foods containing methylxanthines contribute to breast swelling and tenderness in women with mastopathy.

Many clinical studies on the treatment of mastopathy indicate the fact that there is a close relationship between the appearance of structural changes in breast tissue and the consumption of products containing methylxanthines (theophylline, caffeine and theobromine). That is why avoiding foods with high levels of methylxanthines (coffee, cocoa, chocolate, tea, cola) can significantly reduce breast swelling and soreness. Many experts always recommend such a correction of the diet in the treatment of any form of mastopathy.

Nutrition and this disease of the mammary glands have another relationship. Eating food that contributes to the development of chronic constipation and disturbance of the intestinal microflora also contributes to the development of mastopathy and. It is likely that this relationship is dictated by the reabsorption in the intestine of estrogens already excreted in the bile. That is why experts recommend that their patients introduce more fiber-containing foods into their daily diet and drink enough water (up to 2 liters per day).

The condition of the liver is also important for the normal functioning of the mammary glands, since estrogen is utilized in this organ. That is why patients with mastopathy are advised to exclude from their diet any foods that adversely affect the functions of this organ. These include alcoholic beverages, fried and fatty foods, hepatotoxic substances. And to improve liver function, women are advised to additionally take B vitamins and dietary supplements based on them.

  • fish (preferably sea);
  • vegetable oils (linseed, olive, pumpkin, nut);
  • low-fat meats;
  • dairy products: sour cream, cottage cheese, milk, cheeses, goat milk;
  • cereals: buckwheat, wheat, oat, etc.;
  • mushrooms;
  • legumes;
  • spinach;
  • bell pepper;
  • carrot;
  • cabbage;
  • beet;
  • eggplant;
  • zucchini;
  • seaweed;
  • nuts;
  • fruits and berries.
  • fatty meats;
  • flour products;
  • semolina;
  • salty dishes;
  • smoked meats;
  • margarine;
  • conservation;
  • coffee;
  • mayonnaise;
  • ketchup;
  • carbonated drinks;
  • alcoholic drinks.

Choosing the right bra

Every woman should pay attention to the correct choice of a bra, especially for patients with mastopathy. It is recommended to wear it for all women with such a disease of the mammary glands.

Having a bra that is out of size or has an irregular shape leads to deformation and compression of the breasts. In addition, such a piece of clothing contributes to the overload of the ligamentous apparatus. This point is especially true for women with large and drooping breasts.

  • the product must fully comply with the required size;
  • preference should be given to natural or absorbent fabric;
  • it is better to abandon the choice of models with a foam seal;
  • the fabric should not fade;
  • wear strapless products as rarely as possible;
  • choose models with wide straps (especially with large breasts);
  • after purchase, adjust the length of the straps;
  • do not sleep in a bra;
  • do not wear a bodice for more than 12 hours a day.

In some cases, choosing the right bra can help reduce or completely eliminate the symptoms of mastopathy.

Lifestyle change


Women with mastopathy should quit smoking.

Women suffering from mastopathy should make lifestyle changes:

  • quitting smoking and drinking alcohol;
  • balanced diet;
  • sufficient physical activity;
  • refusal to visit baths and saunas;
  • elimination of stress;
  • rejection of natural and artificial tanning.

In addition, physiotherapy and massage are contraindicated for them.

Vitamins

Taking vitamin products for mastopathy:

  • helps to normalize metabolism and hormonal levels;
  • has an antioxidant effect;
  • strengthens the immune system;
  • stabilizes the activity of the central nervous system;
  • normalizes the functions of the thyroid gland, liver, ovaries and adrenal glands;
  • normalizes the reproduction and maturation of epithelial cells.

Diuretics

It is possible to weaken the manifestations of cyclic mastopathy that occurs with premenstrual syndrome and accompanied by swelling of the feet and hands a few days before menstruation, using mild diuretics. It is advisable to use diuretic medicinal herbs or preparations based on them for this. In addition, during this period, a woman needs to limit the amount of salt consumed.

Means for improving blood circulation

In patients with mastopathy, local changes in blood circulation in the mammary glands are often observed. They usually occur due to impaired venous outflow. To normalize it, many experts recommend that their patients take products containing vitamin P (black currants, citrus fruits, raspberries, cherries, rose hips, chokeberry), and preparations based on it (Ascorutin). Often, their use allows you to stabilize blood circulation and with repeated thermographic studies, such violations are not detected.

Homeopathic remedies

To eliminate hyperprolactinemia, normalize the condition of the ducts of the mammary glands and eliminate pathological division of endometrial cells, women may be advised to take drugs based on various medicinal plants (prutnyak, cyclamen, tiger lily, iris and chilibuhi). The most popular homeopathic remedy prescribed for mastopathy is Mastodinon. In addition to it, the following means may be recommended:

  • Biocycline;
  • Remens;
  • Cyclodinone, etc.

Non-steroidal anti-inflammatory drugs

In some cases, to reduce cyclic mastalgias, specialists prescribe their patients to take non-steroidal anti-inflammatory drugs a few days before menstruation. For this can be used:

  • Diclofenac;
  • Nurofen;
  • Nise et al.

However, such appointments cannot be long-term and permanent, and complex treatment of mastopathy is recommended to eliminate unpleasant symptoms.

Means for normalizing liver function

Hepatoprotectors can be used to eliminate liver dysfunctions that affect hormonal levels and stabilize its functioning. A woman can be assigned:

  • Essentiale;
  • Legalon;
  • Gepabene;
  • Carsil and other drugs.

Adaptogens and iodine preparations

To normalize the functioning of the intestines, liver, thyroid gland and the immune system with mastopathy, various iodine-containing preparations and adaptogens may be recommended:

  • Klamin;
  • rhodiola extract;
  • tincture of eleutherococcus;
  • Iodomarin;
  • Iodine-active, etc.

Sedatives


Chronic fatigue, stress at work contribute to increased chest pain with mastopathy.

In women, the state of the mammary glands is often influenced by the psycho-emotional background. Troubles in the family and at work, frequent depression, dissatisfaction with oneself - all these factors can contribute to increased pain. To eliminate them, experts often recommend taking sedatives to their patients. Usually, preference is given to the prescription of light drugs based on medicinal herbs:

  • tincture of valerian, motherwort, peony;
  • Persen;
  • Alvogen Relax;
  • Novo-passite;
  • Sedariston;
  • Dormiplant;
  • Nervoflux, etc.

Only if they are ineffective can patients be recommended stronger sedatives:

  • Afobazole;
  • Adaptol;
  • Tenoten et al.

Dietary supplements

To stabilize the menstrual cycle and hormonal levels, the normal functioning of the immune system, liver and intestines, various dietary supplements may be recommended:

  • Indinol;
  • Mastofit Evalar;
  • Stella;
  • Kelp;
  • Diures;
  • Garzisan;
  • Lecithin Choline;
  • Brest Care +;
  • Biozyme;
  • Indogrin;
  • Citrus pectin, etc.

The choice of dietary supplements should be made only by a doctor who is guided by the data on the patient's health, obtained during the examination.

Hormone therapy

The processes of development of mammary gland tissues, their differentiation, maturation and growth are fully coordinated by the interaction of the following hormones:

  • estrogen;
  • progesterone;
  • prolactin;
  • androgens;
  • a growth hormone;
  • thyroxine, etc.

A certain influence on these processes is exerted by the metabolism and the activity of the reticular formation and the limbic system. Many facts indicate the significant influence of hormonal levels on the development of mastopathy:

  • the tissues of both glands undergo changes;
  • the severity of symptoms depends on the phase of the menstrual cycle;
  • pains decrease after menopause;
  • mastopathy is often combined with other hormone-dependent diseases (, infertility);
  • taking hormonal agents affects the condition of the mammary glands.

Based on the above facts, the following hormonal agents can be used to treat mastopathy:

  • antiestrogens;
  • oral contraceptives;
  • androgens;
  • gestagens;
  • prolactin inhibitors;
  • LHRH (or gonadotropin-releasing factor analogs).

Hormonal drugs can only be prescribed by a doctor who is guided by the results of the patient's examination.

Antiestrogen drugs

Antiestrogens such as Tamoxifen and Fareston can be used to block estrogen receptors in breast tissue. With hyperestrogenism, these drugs do not allow estrogens to bind to receptors and reduce their effect on the gland tissue.

Antiestrogens have been used to treat mastopathy since the 70s. First, Tamoxifen was used, which proved to be effective in 65-75% of cases. 2-3 months after taking it, the patients showed a decrease in mastalgia (in 97% of cases), stabilization of the menstrual cycle and a significant weakening of blood loss during menstruation.

Sometimes at the beginning of admission, patients noted an increase in the sensations of chest swelling and pain, but over time, these side reactions diminished. In addition to these side effects, taking Tamoxifen can cause dizziness, nausea, increased sweating and hot flashes.

In a number of publications, data have appeared that this drug can have a carcinogenic effect on endometrial tissue and lead to the development of its induced hyperreplasia and cancer. That is why another antiestrogen drug was created - Fareston (ORION PHARMA INTERNATIONAL, Finland). According to many experts, its active component Toremifen is more effective and has fewer side reactions. The first therapeutic effects from taking this drug appear within a month after the start of taking, and side effects are much less common.

Oral contraceptives

This group of hormonal agents is usually prescribed for women under 35 years of age. In addition to protecting against unwanted pregnancy, oral contraceptives help to normalize the menstrual cycle and reduce the manifestations of mastopathy already in the first 8 weeks after the start of admission. When prescribed correctly, drugs suppress ovulation, steroidogenesis, the synthesis of ovarian androgens, and the synthesis of endometrial estrogen receptors. In some cases, with the wrong choice of an oral contraceptive in women, signs of mastopathy increase, in such situations it is necessary to select another drug.

The following drugs can be used for treatment:

  • Femoden;
  • Marvelon (or Mersilon);
  • Silest;
  • Janine and others.

When choosing an oral contraceptive, preference is given to drugs in which the content of estrogen is the lowest, and the content of gestagens is higher. The drugs are prescribed for at least 3 months. For the treatment of mastopathy, the appointment of mini-pill oral contraceptives is not recommended, since the dose of hormones in them is extremely low to affect the disturbed hormonal background of a woman.

Gestagens

These drugs help suppress estrogen production and slow down the gonadotropic function of the pituitary gland. According to statistics, in 80% of cases, they are effective in the treatment of mastopathy. The drugs are prescribed in courses with breaks, the duration of which is determined by the doctor individually for each woman.

Previously, gestagens - testosterone derivatives - Danazol, Linestrinol and Norgestrel were used more often. However, now the preference is usually given to derivatives of progesterone - medroxyprogesterone acetate. In addition, for the treatment of mastopathy, a progesterone-based external drug such as Progestogel (gel) can be used. When using it, a woman does not have to experience the side effects that are observed when taking hormones orally.

Androgens

These drugs are estrogen antagonists and suppress their activity. Usually, Danazol is prescribed for the treatment of mastopathy, which reduces the synthesis of gonadotropic hormone. As a rule, the therapeutic effect is observed in 2 out of 3 women - the structure of the mammary gland becomes homogeneous, and the risk of cysts decreases.

When taking Danazol, the following side effects may occur:

  • nervousness;
  • weight gain;
  • swelling;
  • sweating;
  • vaginitis, etc.

The doctor must warn the patient about their possible appearance. In addition, a woman should be informed that the contraceptive effect of the drug is very low and an unwanted pregnancy while taking it without additional methods of contraception may occur.

Prolactin inhibitors

Drugs in this group can be prescribed only with laboratory proven prolactinemia. To obtain more accurate test results, it is recommended to administer thyroid-stimulating hormone releasing factor (TRP test) before blood sampling.

With proven prolactinemia, patients with mastopathy may be prescribed the following prolactin inhibitors:

  • Bromocriptine;
  • Parlodel.

After taking them, the synthesis of prolactin decreases, the balance between progesterone and estrogen is normalized, the menstrual cycle is stabilized, mastalgia and nodular formations in the tissues of the glands decrease.

Gonadotropin-releasing factor (or LHRH) analogs

Taking these drugs is usually recommended for severe mastopathy and ineffectiveness of other hormonal drugs. These drugs help lower estrogen and testosterone levels. However, LHRH preparations have a large amount of side effects in the form of hot flashes, amenorrhea, dizziness and arterial hypertension. That is why their appointment should always be balanced and focused on a specific clinical situation.

Surgery


In some cases, women with mastopathy cannot do without surgical intervention.

In recent years, most specialists are wary of surgical methods of treating mastopathy. Interventions do not completely eliminate the causes of the disease, and even after several operations, relapses may develop.

As a rule, surgical treatment of mastopathy can be recommended for some patients with a nodular form of this disease and a long absence of the expected effect of conservative therapy. In addition, the operation is indicated for accumulations of microcalcifications, intraductal papillomas, detection of epithelial growths during cytological analysis and the presence of large cysts with hemorrhagic contents. The treatment of such patients should be carried out in an oncological hospital.

The amount of surgery can vary. Sectoral resection of the gland (i.e., removal of the affected area) is usually recommended. During the operation, an urgent histological examination of the removed tissues is performed, and if malignant cells are detected, the scope of the intervention can be expanded.

With multiple cysts and nodes, intraductal papillomas, an extended resection of the gland is performed, and in some cases its complete removal is performed. After such interventions, the patient may be recommended reconstructive plastic surgery - mammoplasty.

When solitary cysts are detected, the patient undergoes sclerotherapy of the cysts.

After surgical treatment of mastopathy, dispensary observation is necessarily recommended to all patients and a course of conservative therapy is prescribed, since the intervention allows only the foci of neoplasms to be eliminated, but not the cause of the disease. If atypical cells are detected during the histological analysis of the removed tissues, the patient is recommended a course of chemotherapy.

Is it possible to cure mastopathy on your own?

Self-medication of mastopathy is unacceptable, since it is impossible to identify the cause and form of the disease without a comprehensive examination and consultation with a mammologist. Many women try to treat this ailment on their own with the help of folk remedies, but such an attitude towards their health can become the reason for the development of breast cancer, since mastopathy is considered by all specialists as a precancerous disease.

Only long-term and complex treatment aimed at eliminating the causes of the disease will help to get rid of mastopathy. In some cases, it can be supplemented with folk methods, but their use should always be discussed with a doctor and combined with the main therapy.

Patients with mastopathy may be recommended sedatives, choleretic, diuretic and restorative herbal preparations, which in some cases can be an alternative to pharmacological agents. Before using them, you must exclude all possible contraindications to their components.

Linseed oil

Flax contains substances that help normalize hormonal levels, and Omega-3, which help activate the body's anti-cancer defenses. Flaxseed oil can be administered in capsule form or in pure form.

Infusion or decoction of cold rhodiola (or red brush)

This medicinal plant has an anticarcinogenic effect and contributes to:

  • normalization of estrogen and progesterone levels;
  • restoration of the functions of the endocrine glands;
  • elimination of inflammatory reactions in the mammary glands;
  • strengthening immunity;
  • elimination of toxic substances from the body.

One or more courses of taking an infusion or decoction of a red brush helps to eliminate pain and swelling of the glands, to stop nipple discharge and to reduce the size of the nodes. In addition, taking this herb is recommended for concomitant diseases such as uterine fibroids, cervical erosion, inflammation in the genitals and infertility.

Horse chestnut flower infusion

To eliminate inflammatory processes in the mammary glands and pain in mastopathy, it may be recommended to take an infusion of horse chestnut flowers. A teaspoon of plant materials is poured into a glass of boiling water and infused for half an hour. The filtered infusion is taken between meals for 1/3 cup three times a day.

Compresses with cabbage leaves

To reduce pain in mastopathy, you can use cabbage leaves. They are applied to the chest in the evening or at night and secured with a bra. Instead of cabbage leaves, you can use burdock, and to enhance the effect, put a mixture of 3 parts grated beets and 1 part honey under the leaf.

Lotions with wormwood infusion

You can eliminate mastalgia with lotions from the infusion of wormwood. For this, 5 tablespoons of plant materials are poured with 3 cups of boiling water and left to infuse overnight. After that, the infusion is filtered, a little warm water is added, a linen or cotton cloth is moistened in it and applied to the chest for 15 minutes three times a day.

Compresses from burdock leaves, honey and castor oil

Such compresses are prepared from crushed burdock leaves (100 g), two lemons, castor oil (100 g) and honey (100 g). The components are mixed, applied to a linen or cotton napkin and applied to the chest overnight.

Herbal tea from wormwood, nettle, sage and plantain

To prepare the collection, take two parts of wormwood and one part of nettle, sage and plantain. A tablespoon of the collection is poured into 220 ml of boiling water and left for an hour. Strain the infusion and take ½ glass 20 minutes after meals three times a day. The course of admission is 2 months. After 14 days, the course can be repeated.

Mastopathy belongs to precancerous diseases and needs complex treatment from a specialist. The therapy plan may include non-hormonal and hormonal drugs, the reception of which is aimed at eliminating the causes of the disease. In some cases, a woman may be advised to have surgery.

Which doctor to contact

If signs of mastopathy appear - periodic or constant swelling of the mammary glands, pain, discharge from the nipples, lumps in the chest - you should definitely consult a mammologist. To draw up a plan for effective treatment of the patient, the following diagnostic tests can be prescribed: ultrasound of the mammary glands, mammography, tests for hormone levels, biopsy with histological examination, etc.

And a mammologist. And after the onset of menopause, you need to be examined every 5-6 months. Unfortunately, many patients neglect this rule and miss the onset of mastopathy.

What is mastopathy. ICD-10 code

In the ICD-10, the disease was assigned the code N60 – N64. Infectious and non-infectious pathologies in the genitourinary system fall into this category.

The very term "mastopathy" is collective. Doctors use it to refer to benign and malignant growths in the mammary glands. The main feature is that it refers not to inflammatory, but to hormonal diseases. It is hormonal disruptions in the female body that change the structure of the glandular tissue and cause it to grow.

Types of mastopathy

The disease is divided into two types:

  • diffuse mastopathy;
  • nodular mastopathy.

The diffuse variety is the first stage of pathology. Small-diameter granular seals form in the glandular tissue. It is very difficult even for a gynecologist to detect nodules during examination and palpation of the breast.

Characteristic symptoms help to recognize diffuse mastopathy: before menstruation, asymmetric nipple arrangement, change in the shape of the breast. Signs of the disease also include a venous pattern that appears on the skin.

Adenosis is most common in young girls. Such a diagnosis is made with the growth of glandular tissue. With fibroadenomatosis, the amount of connective tissue in the breast increases. This leads to blockage of the nipples and stagnation of fluid in the mammary glands.

In the cystic form, small, fluid-filled capsules form in the breasts. Cysts can be small or large. Some capsules deposit calcium salts, which lead to the formation of dense nodules and swellings.

Fibrocystic breast disease is one of the most common types. With this type, connective tissue grows in the chest, and cysts form inside it.

Diffuse variety without correct treatment develops into. This is the second stage of the disease, which is characterized by nodules and indurations. Neoplasms are well felt when. The nodules vary in size, from small peas to large, walnut-sized tumors.

Breast with nodular mastopathy increases and swells, discomfort appears. In the armpits, the lymph nodes become inflamed, which limit the mobility of the trunk. Especially the upper limbs.

Pain with mastopathy

Discomfort is one of the first symptoms of mastopathy. On early stages pain appears only before menstruation. It either spreads over the entire chest, or is localized in some small area.

Pain in mastopathy can be different: acute or dull, pulling or shooting. It all depends on which part of the breast is affected by the overgrowth of glandular or connective tissue. Seals can touch the circulatory system or press on nerve endings.

The more granular growths and nodules, the more painful. Over time, the discomfort only increases. The pain does not go away after menstruation. On the contrary, it remains and intensifies with every movement. Painful sensations also appear in the shoulders and forearms, in the area of ​​the shoulder blades and armpits.

In the later stages, a woman is worried not only about discomfort, but also. They can be clear, greenish or brownish. The most dangerous are spotting. They warn that mastopathy needs to be treated urgently, otherwise it will turn into a time bomb.

At what age does the disease occur?

The most dangerous age is considered to be 30-50 years. During this period, the concentration of estrogen and progesterone decreases in the female body, and the concentration of FGS (follicle-stimulating hormone) increases. Hormonal changes make the genitourinary system more sensitive and susceptible to gynecological diseases.

Fibrocystic mastopathy in 50–70 cases out of 100 begins precisely at 35–40 years of age. Hormonal disruptions can provoke a diffuse type of disease at an earlier age. They, in turn, arise from frequent stress, dieting, sedentary lifestyles, and obesity.

Hormonal disruptions can have other, more serious reasons:

  • diseases of the thyroid gland;
  • infertility;
  • liver problems;
  • pregnancy;
  • miscarriages and abortions;
  • chest trauma;
  • uncontrolled use of oral contraceptives;
  • endometriosis.

In young girls, mastopathy develops due to heredity and early menstruation. If menstruation began at 10-11 years of age, the family doctor should closely monitor the patient's health and the state of her genitourinary system.

Why is mastopathy dangerous?

If a gynecologist or mammologist diagnosed "diffuse mastopathy", it means that the woman is definitely not. But this is not a reason to refuse treatment. Launched mastopathy often degenerates into benign and malignant formations. Especially the nodal shape.

Also, the disease sometimes causes inflammation in the mammary glands. The temperature and soreness of the breast rises, purulent discharge from the nipples appears.

In addition, diffuse mastopathy is a sign of hormonal disruptions in the body. And if the doctor does not determine which organ is functioning incorrectly, the woman will have additional health problems.

Does mastopathy happen in men?

Mastopathy in men is called gynecomastia. This is hypertrophy and overgrowth of adipose tissue located in the mammary glands. A man's chest increases in size and takes on a feminine shape. The nipples become tender, swollen, and discharge clear or greenish-brown fluid. Areoles darken, and painful sensations appear in the mammary glands.

Gynecomastia is common in adolescents and elderly patients. In adult men, the disease appears in two cases: due to obesity or due to serious hormonal disruptions in the body. If the weight is within normal limits, the patient is referred for a comprehensive examination of internal organs and a biochemical blood test.

Gynecomastia is not only a cosmetic problem. It is hazardous to health. Nodules and cysts can form in adipose tissue, which, if untreated, degenerate into malignant tumors.

Diagnosis of mastopathy at home

If a woman's breasts often hurt, increase in size, swell and become dense, she needs to be monitored. The easiest way to diagnose at home is by visual examination and palpation of the mammary glands. It is carried out on the 7-10th day of the menstrual cycle, when the hormonal background is normalized and the edema disappears.

It is best to arrange a check-up after a shower. The woman bares her torso and stands in front of a large mirror. She looks at how symmetrical the nipples are and if the shape of the breasts has changed. Then the woman raises one hand and puts it behind her head. With the other free hand, she slowly presses on the raised chest, moving from the nipple in a circle.

A woman should be alerted to painful sensations in small areas and strange seals. It doesn't matter what size they are. After palpation, you need to slightly squeeze the nipple. If a woman is not pregnant or breastfeeding for over a year, there should be no discharge.

Diagnosis of mastopathy in the laboratory

Patients complaining of pain and lumps in the chest are offered to go through. It is a safe and simple procedure that allows even small nodules to be seen. The study will tell you about the stage, type of mastopathy and will help the gynecologist choose a treatment.

Also, the doctor may prescribe a blood test for the woman. He will tell you about the level of estrogen and progesterone, and also help you understand if there are any problems with the thyroid gland. Sometimes the gynecologist recommends examining the liver and making it located in the mammary glands.

Treatment of mastopathy

Diffuse mastopathy is treated with conservative methods. The mammologist examines the patient's history, test results and ultrasound, and then selects drugs that normalize hormonal levels and resolve cysts.

A woman can be assigned:

  • Antiestrogens. Means reduce the level of estrogen, remove painful sensations in the chest and reduce the risk of cancer.
  • Oral contraceptives. The drugs are prescribed for young girls, after 35 OC are prescribed very rarely. The tablets normalize menstruation and stop the development of mastopathy.
  • Gestagens. The funds reduce the concentration of estrogen and remove even large cysts. Doctors believe that gestagens are some of the best drugs for combating mastopathy. They work 80% out of 100.
  • FGS analogs. The drugs are prescribed for women with fibrocystic disease. These are the most powerful drugs, so they are prescribed if other medications have not worked.

Hormonal drugs are often supplemented with vitamins, diuretic and sedative pills, and dietary supplements.

If the conservative method does not cope with mastopathy, the woman is recommended surgical treatment. The operation is performed under general anesthesia. The patient is removed the overgrown connective tissue or part of the breast in which cysts have formed.

After surgery, the woman is prescribed hormone therapy to prevent relapse.

Mastopathy and pregnancy

Gynecologists do not forbid girls with diffuse mastopathy to become pregnant and have children. On the contrary, some doctors believe that motherhood can stop the disease. The body of a pregnant and lactating woman secretes a lot of prolactin. Analogs of this hormone are used to make some drugs for mastopathy.

Girls with diffuse form the disease does not always succeed in conceiving a child the first time, because the proliferation of connective tissue begins due to hormonal disruptions in the body. And this, in turn, sometimes leads to infertility. A comprehensive examination of the reproductive system and timely consultation with a gynecologist can increase the chances of pregnancy.

Doctors recommend postponing the birth of a child only in one case - with an advanced form of fibrocystic mastopathy. Pregnant women are contraindicated in hormonal agents that are used to treat the disease. And the abolition of drugs can provoke an exacerbation of mastopathy or even its transformation into a malignant tumor.

If seals in the mammary glands appear during pregnancy, gynecologists advise not to interrupt it. In 70–80%, nodules resolve during breastfeeding. Only a woman should maintain lactation for at least 6-10 months of the baby.

Women with mastopathy should give up bad habits: smoking, alcohol abuse and dieting. You can't starve. It is better to switch to a balanced and low-calorie diet, give up fatty foods, starchy foods and fried foods, love vegetables and fruits.

With mastopathy, it is impossible to massage the back and collar zone, so as not to load the pectoral muscles and not to increase the proliferation of connective tissue. It is also forbidden to sunbathe in the sun. Especially topless. Ultraviolet light increases the risk of breast cancer and can provoke the degeneration of a benign formation into a malignant one.

Mammologists also advise wearing only comfortable bras that do not squeeze the breasts, do not chafe or injure the skin. Tight underwear can be one of the causes of exacerbation of mastopathy.

Women with a diffuse and nodular form of the disease should eat a lot of foods containing vitamin C. Ascorbic acid improves blood circulation in the mammary glands and removes discomfort. Healthy foods should be supplemented with yoga or meditation. Eastern practices help to get rid of stress and protect against hormonal disruptions in the body.

Mastopathy is not as terrible and dangerous as it seems to many patients. If a woman takes care of her body, regularly visits a doctor and takes prescribed medications, she will be able to get rid of lumps and cysts in the mammary glands, even without surgery.

Mastopathy- a benign disease that has developed as a result of the existing imbalance between hormones (progesterone, prolactin and estrogen) in the body. What leads to the proliferation of connective and glandular tissue in the mammary gland, therefore, seals and / or cysts of different sizes form in it.

Some statistics

In the world from 70 to 80% of women suffer from mastopathy. That is, - 7-8 women out of 10. Moreover, most often women from 30 to 45 years old are susceptible to this disease.

It is produced in the pituitary gland (located in the brain). Strengthens cell division in the mammary gland, stimulates the production of breast milk, increases the number of receptors in the mammary gland for estrogen.

Normally, prolactin synthesis is suppressed by dopamine (a biologically active substance that transmits nerve impulses through nerve cells).

  • Thyroid hormones (thyroxine and triiodothyronine)

    They regulate the metabolism of fats, carbohydrates and proteins, increase the production of prolactin, and also increase the sensitivity of breast receptors to it.

    • On a note Changes in the mammary gland are closely related to the menstrual cycle, since it is regulated by these same hormones.

    Causes of mastopathy

    In the formation of mastopathy, the main role is played by the hormonal imbalance between estrogens and progesterone, as well as prolactin. It develops as a result of a variety of diseases.

    Causes of hormonal imbalance

    The production of a protein that binds estrogen is disrupted, therefore its (estrogen) activity increases significantly.

  • Reduced function of the thyroid gland (hypothyroidism) and endemic goiter (damage to the thyroid gland with a lack of iodine in the body)

    The production of hormones by the thyroid gland is reduced, so their level in the blood falls. As a result, according to the principle of feedback, the production of thyriotropic hormone is stimulated in the pituitary gland, which activates the thyroid gland. However, along with this, the production of prolactin by the pituitary gland is also stimulated.

    On a note

    • According to statistics, hypothyroidism is the most common reason increasing the level of prolactin in the body.
    • With endemic goiter, mastopathy develops in 70% of cases. Since with a lack of iodine, the production of hormones in the thyroid gland decreases.
  • Increased prolactin levels with certain medications

    Eglonil and Cerucal (used to treat gastritis, stomach ulcers and 12 PCs), Reserpine (prescribed to lower blood pressure) are centrally acting drugs (in the brain). They block the effect of dopamine, a biologically active substance, with a deficiency of which, the production of prolactin increases (normally, dopamine, on the contrary, reduces the synthesis of prolactin).

  • Malignant and / or benign tumors of the hypothalamic-pituitary region (eg, pituitary adenoma)

    The production of hormones in the pituitary gland increases: FSH, LH and prolactin. Therefore, the synthesis of estrogen increases in the ovaries, and progesterone, on the contrary, decreases. Under the influence of estrogens and prolactin, mammary gland cells begin to multiply and the milk ducts grow.

  • Obesity

    In adipose tissue (cells), a partial synthesis of estrogens is carried out. Therefore, the larger the subcutaneous fat layer, the more estrogens are produced.

  • Hereditary predisposition

    Women whose close relatives (mother, grandmother) had breast or genital cancer are more likely to develop mastopathy. What is associated with the transmission of mutated (altered) genes from generation to generation.

  • Irregular sex life, sexual dissatisfaction

    Leads to impaired blood circulation in the small pelvis (blood stagnates). As a result, the work of the ovaries and the production of hormones by them are disrupted.

  • Hormone levels are normal, but mastopathy develops
    • The effect of estrogen is enhanced for two reasons:
    1. The level of aromatase is increased (produced in the adrenal glands) - an enzyme that converts androgens (male sex hormones, which are synthesized in small quantities in women) into estrogens.
    2. The number of receptors and / or their sensitivity to estrogen in the mammary glands is increased.

    Types of mastopathy

    The most widespread is the division of mastopathy according to X-ray (reveals changes in the structure of the mammary glands) and clinical (complaints and examination) signs.

    There are two main forms of the disease: diffuse and nodular mastopathy.

    Diffuse mastopathy

    It is characterized by changes in the entire mammary gland. As a rule, it precedes the development of the nodular form.

    Types of diffuse mastopathy

    Symptoms of diffuse mastopathy

    • Engorgement, tenderness (mastalgia), swelling and tenderness of the mammary glands (mastodynia).
    • When probing, there is a compaction of the entire mammary gland or only one of its parts. Or, small-sized (with a grain of rice) fine-grained foci of compaction, scattered in the mammary glands (mainly in the upper part), are found.
    • A clear or greenish-brown liquid may be discharged from the nipple.

    Nodular mastopathy

    It is characterized by the formation of cysts and nodes in the parenchyma (body) of the mammary gland, which have clear boundaries, not soldered to the skin and surrounding tissues. It can develop in one or both mammary glands.

    Fibrous mastopathy (fibroadenoma)

    The glandular tissue (lobules) is replaced by connective tissue (plays the role of a frame, but is not responsible for the function of organs), which compresses the duct of the gland, therefore, over time, leads to its blockage. It is most common in young women between the ages of 20 and 30.

    Signs

    • Painful sensations and enlargement of the mammary gland in size
    • A clear or greenish-brownish fluid secreted from the nipples
    • When probing the mammary gland, dense nodes are determined

    Cystic mastopathy

    Cavities appear, which are filled with liquid inside, and are surrounded by a dense shell (capsule) from the outside. The form of mastopathy occurs in about 50% of women worldwide.

    Signs

    • Painful sensations in the area of ​​formation of cysts
    • The mammary gland is enlarged and painful
    • Swelling and tenderness of the axillary lymph nodes, as well as swelling of the tissues around them
    • Transparent discharge from the nipples, and in case of infection, purulent.
    • When palpating the mammary gland, elastic nodes of a round or oval shape are determined

    Fibrocystic breast disease

    It is characterized by the formation of dense foci in the parenchyma (body) of the mammary gland, which can degenerate into cysts, filling with fluid. It develops in about 50-70% of women with mastopathy, most often, from the age of 30 to the onset of menopause.

    Has manifestations characteristic of both fibrous and cystic nodular forms of mastopathy.

    When palpating, both areas of breast compaction and nodes of an oval or round shape of a loose and elastic consistency (soft to the touch) can be found.

    Symptoms of mastopathy

    The disease can affect both mammary glands and one, and its symptoms depend on the type of mastopathy.
    Symptom Manifestations Mechanism of occurrence
    Diffuse mastopathy
    Pain and a feeling of fullness (swelling) in the mammary glands, as well as an increase in their size At the beginning of the disease, the symptoms are not pronounced, most often they occur a week before the onset of menstruation. However, as the disease progresses, they become almost constant. During the period of menstruation itself, pain and swelling are somewhat less pronounced. Estrogens promote the accumulation of sodium ions inside the cells of the mammary glands, which attract water molecules to them. Therefore, swelling of the breast tissue develops and pain appears.
    Discharge from the mammary glands(transparent or greenish brown) They appear on their own (spots on the inside of the bra cup) or when pressing on the nipples. Prolactin promotes the development of milk ducts and their production of fluid, similar in composition to breast milk.
    Sealing foci They are small, as a rule, located throughout the mammary gland. Under the influence of estrogens and progesterone, the number and length of the milk ducts in the mammary gland increases, and connective tissue grows in it.
    Nodular mastopathy
    Fibrous mastopathy (fibroadenoma)
    Soreness, sensitivity to touch, and a feeling of fullness in the mammary glands
    		 At the beginning of the disease, the symptoms are most pronounced a week before the onset of menstruation. With the further development of mastopathy, they are present almost throughout the cycle. They can be aching and dull, but sometimes they are aggravated by even a light touch. Estrogen causes sodium to build up inside breast cells, which attracts water. In addition, the expanding connective tissue presses on the glandular tissue in the mammary gland. Therefore, the swelling and painful sensations increase.
    Discharge from the mammary glands(transparent to brownish green) At the beginning of the disease, they are not expressed. However, they intensify over time. They can appear on their own (spots on the inside of the bra) or when pressing on the nipples. Prolactin increases the number of milk ducts, as well as their production of breast milk.
    Knot formation
    		 When probing, dense nodes are determined, which have sizes from 0.2 to 5-7 cm. They have clear boundaries, they are mobile and are not soldered with the surrounding tissues. The increased content of estrogens and prolactin leads to the fact that the connective tissue grows vigorously, and the number of milk ducts increases.
    Attachment infection(can be both with fibroma and with cystic mastopathy) Increase in body temperature, redness of the skin of the mammary gland, feeling unwell. The appearance of purulent or yellowish-green discharge from the nipples. Edema and stagnation of fluid in the mammary gland leads to impaired blood circulation in it, so infection easily joins
    Cystic mastopathy
    Pain, swelling and burning in the mammary gland Most pronounced in the area of ​​cyst formation. At the beginning of the disease, the symptoms worsen as menstruation approaches. With a long course of mastopathy, they become almost constant. The pain is mostly dull and aching, but sometimes quite pronounced, it increases significantly even with a light touch. Estrogens promote the entry of sodium into cells, which attracts water.
    In addition, as the cyst grows, it presses on the surrounding tissue, increasing the painful sensations. If the cysts are small, then, as a rule, they do not cause any discomfort, and there is no pain.
    Discharge from the mammary glands Transparent, greenish-brown, purulent (with infection). Discharge with multiple or large cysts is more typical. Discharge can be arbitrary or appears when pressing on the nipples. Under the influence of prolactin, the number of milk ducts increases - and they begin to produce breast milk more intensively.
    Breast enlargement One or both, depending on the location of the cyst or cysts. The cyst presses on the milk ducts, so the fluid is retained, leading to the development of edema.
    Lymph node changes(in 10-15% of patients) They become enlarged, painful, and the tissues around them swell. Most often, cysts are located in the upper and lateral lobes of the mammary glands, disrupting the outflow of lymph and leading to the formation of inflammation in them.
    Cyst formation One can feel soft and elastic formations with clear boundaries, round or oval in shape, not soldered to the surrounding tissues, measuring from 0.2 to 5-7 cm. The cyst can be a single formation or in the form of multiple foci. Under the influence of estrogens and progesterone, one duct expands, and the liquid in it stagnates. Then connective tissue begins to form around the stream, forming a capsule. With the help of a capsule, the body tries to delimit the enlarged duct. Thus, liquid accumulates at the site of the expanded duct.
    With this variant of the course of the disease, two forms of nodular mastopathy are combined: cystic and fibrous. As a result, there is both the formation of cysts in the mammary gland and foci of compaction. Therefore, there are signs of the disease of cystic and fibrous forms of mastopathy at the same time.

    Diagnostics of the mastopathy

    The reasons for the development of mastopathy are varied, therefore, a thorough study is carried out to establish an accurate diagnosis.

    Which doctor should I contact in case of breast problems?

    Three specialists are involved in the diagnosis and treatment of mastopathy: a gynecologist, a gynecologist-endocrinologist and a mammologist (detects and treats only breast diseases). The ideal option is when all specialists are involved in the treatment and monitoring of the patient. However, everything depends on the staffing of the medical and diagnostic institution with these specialists.

    At the doctor's appointment

    The doctor will conduct a short survey: he will clarify the details that are necessary to establish the correct diagnosis (when the first menstruation began, whether regular sex life, and so on).

    This is followed by examination and palpation (palpation) of the mammary glands, lymph nodes (axillary, cervical) and the thyroid gland (located on the front of the neck).

    If necessary, the doctor will send for an ultrasound of the mammary glands either a mammography (X-ray of the mammary glands with a lower radiation level), or even a biopsy (excision of a piece of altered tissue followed by examination under a microscope).

    After receiving all the results of the study, the doctor will prescribe treatment, which can be carried out both conservatively (with the help of medications) and operatively (surgery).

    Survey

    Questions to be answered in the doctor's office:

    • How old are you?
    • In what year of life did the first menstrual bleeding (menarche) appear?
    • At what age was the first sexual intercourse?
    • Is your sex life regular?
    • Are there menstrual irregularities?
    • On what day of the menstrual cycle does the examination and consultation take place?
    • How many pregnancies and births were there? At what age?
    • How many abortions and / or miscarriages were there?
    • What is the period of breastfeeding?
    • How is protection against unwanted pregnancy carried out?
    • Do close relatives (mother, sister, grandmother) have mastopathy or breast cancer?
    • If there is no menstruation (menopause), then at what age?
    • Are there any chronic diseases? If so, what medications are being taken to treat them?
    Here is only the basic information that interests the doctor, but sometimes it is not enough. Therefore, the doctor may ask additional questions.

    Examination, palpation of the mammary glands by a doctor

    It is carried out in a standing and lying position with the help of fingertips with a sequential examination of each quadrant of the mammary gland: upper outer, upper inner, lower inner, lower outer.

    During examination and palpation, the doctor asks the woman to either raise her hands or put them on her belt. Then he compares the changes in both mammary glands, and also palpates the lymph nodes. Next, the doctor presses on the nipples, trying to squeeze out the liquid from them.

    The recommended examination time is from 5 to 9-10 days of the menstrual cycle (the most optimal - from 5 to 7 days). During menopause, the day doesn't matter.

    Signs of mastopathy detected during examination and palpation of the mammary glands:

    • Soreness, swelling, and tenderness
    • The presence of nodular lumps in a specific area or throughout the breast
    • Detection of rounded cysts in different areas
    • Discharge from the nipples when pressing on them
    • The presence of areas of retraction of the skin or nipples
    • Lumps or sinks in the skin
    • Severe unevenness of the mammary glands (slight asymmetry is the norm)
    • Enhanced skin color of the nipple and areola
    Most often, changes in mastopathy are found in the upper sections of the mammary glands.

    Mammography

    A study used to diagnose breast diseases, which is informative even at the earliest stages of the development of the disease.

    There are several methods of mammography, depending on the method of conducting: projection, digital and film.

    However, the most commonly used X-ray film mammography with minimal X-ray exposure is the gold standard for diagnosing breast disease. The procedure is performed using a special apparatus - a mammograph, which makes it possible to obtain an image of the mammary gland in two projections (frontal and lateral).

    Indications for the use of film x-ray mammography

    • Complaints of soreness and enlargement of the mammary gland
    • Recessed or swollen areas of the breast skin
    • Discharge from the nipple
    • The presence of lumps in the mammary gland
    • Women over 30 who have received radiation therapy in the area chest for malignant neoplasm
    • With a preventive purpose, it is carried out for all women annually, starting from 40 years old, and for women over 50 years old - twice a year
    • Women with a close family member with breast and / or ovarian cancer


    Carrying out technology

    The patient stands in front of the device, and the mammary gland is located between two dense holders (they squeeze the gland) in order to reduce the thickness of the tissues that absorb X-rays. That is, the denser the squeezing, the more informative the results. Sometimes, performing the procedure in some patients causes painful or unpleasant sensations, but such a reaction is acceptable.

    Signs of mastopathy

    Fibrous changes. There are clear and dense heavy shadows, which can be located both in separate areas (fibroadenoma), and spread throughout the mammary gland (diffuse mastopathy). In this case, the connective tissue cords are located either along the glandular lobules, or along the course of the milky ducts. Whereas the contour of the lobules themselves is uneven.

    Overgrowth of the glandular tissue of the breast (adenosis). There are multiple small focal shadows of irregular shape and uneven edges - enlarged lobules. Sometimes these shadows completely merge with each other, forming foci of compaction of glandular tissue (lobules).

    Cystic changes. The general pattern of the parenchyma of the mammary gland is chaotic, and against its background formations of a rounded-oval shape of the same density are noted.

    The mixed nature of changes in the mammary gland occurs most often. In this case, mammography shows both areas of compaction and cystic formations (nodular fibrocystic mastopathy).

    Breast ultrasound

    A harmless and painless method that is used to study the structure of the mammary glands and identify formations in them.

    The recommended timing for menstruating women is from 5 to 9-10 days of the menstrual cycle (most optimal - from 5 to 7 days), since the state of the mammary glands under the influence of hormones changes during the cycle. In the period of menopause, the day does not matter.

    Methodology

    The woman lies on her back with her hands thrown over her head. A transparent gel is applied to the skin of the investigated area, which provides a tight contact with the ultrasound sensor. Then the doctor presses the sensor to the skin, the waves of which penetrate at different angles into the tissue and, being reflected from them, are displayed on the monitor.

    Indications for use

    • Diagnosis of cysts or lumps detected on palpation of the mammary gland
    • Examination of the mammary glands in women under 30 years of age, as well as during pregnancy and lactation
    • Recommended for all women over 35 years old once every 1-2 years, over 50 years old - twice a year
    • Swollen axillary lymph nodes
    Signs of mastopathy

    Diffuse mastopathy

    On ultrasound, there are numerous small seals that correspond to the proliferation of connective tissue, or small cysts (cavities with fluid), which are evenly distributed throughout the mammary gland.

    Nodular mastopathy

    Fibroadenoma represented by a limited area of ​​compaction in the mammary gland, which has clear boundaries.

    Cystic form of mastopathy manifests itself in the form of the formation of cavities filled with liquid, which, when pressed, change their shape.

    Fibrocystic breast disease characterized by both the presence of cavities filled with liquid and sealing areas. Formations have clear boundaries.

    Biopsy and morphological examination

    Small tissue samples are taken from the altered areas of the breast, which are then examined under a microscope.

    The method with great reliability allows you to distinguish mastopathy from a malignant tumor of the mammary glands. In 80-90% of cases, changes in the mammary gland are benign.

    Indications for use

    • There are suspicious areas with altered breast tissue on a mammogram or ultrasound
    • The presence of large cysts and / or areas of thickening of the breast tissue (more than 1-1.5 cm), identified by palpation by the doctor
    • The appearance of crusts, peeling or sores on the nipple, or spotting from it
    Biopsy types: fine-needle aspiration biopsy (the doctor takes a piece of tissue from a palpable mass), under the control of ultrasound, mammography or MRI, surgical biopsy.

    Most commonly used in mammology fine needle aspiration biopsy method: a piece of tissue is taken from the palpable formations of the mammary gland, then it is applied to glass, stained and examined under a microscope.

    The puncture is performed using a special disposable needle, which is attached to a puncture gun. During the procedure, the gun shoots a knife, which cuts a thin column of tissue from the formation. Typically, the procedure is performed under local anesthesia.

    Signs of mastopathy on a biopsy

    The cells are mononuclear and have the usual size and color. They contain a normal amount of chromatin (it is located inside the cell nucleus and is involved in the transfer of genetic information during division). There are no zones of coronary cell growth (increased cell growth at the edges of the formation). Calcium deposited in the tissues can be detected (a sign of a possible further degeneration of mastopathy into a malignant tumor).

    Laboratory blood tests

    Several hormones affect the mammary gland, but their levels change throughout the cycle. Therefore, the hormonal status is determined in the first follicular phase - from 5 to 9 days, or in the second luteal phase - from 20 to 22 days of the menstrual cycle. Blood is drawn from a vein.

    What hormones in the blood need to be determined?

    • Estradiol produced in the ovaries and adipose tissue
    • Thyroid hormones- thyroxine (T4) and triiodothyronine (T3)
    • Thyriotropic hormone (TSH)(produced in the pituitary gland and stimulates the production of hormones by the thyroid gland)
    • Follicle-stimulating (FSH) and luteinizing (LH) hormone(produced in the pituitary gland and regulate the work of the ovaries)
    • Prolactin synthesized in the pituitary gland and regulates the production of breast milk in the mammary gland
    Tumor markers for the mammary gland are also determined- specific substances (molecules) produced in the body in response to the presence of a malignant tumor. These include CA 15-3
    Additional examination methods

    They help to determine the function of the hormone-producing organ: the presence of inflammation, adhesions, tumors, and so on. Since such changes can lead to disruption of their work and, accordingly, a change in hormonal levels. However, they are optional.

    Additional research

    Ultrasound of the pelvic organs it is prescribed to detect the presence of an inflammatory process or tumor in the ovaries, fallopian tubes, uterus.

    Ultrasound of the thyroid gland reveals the size of the lobes and isthmus, the presence of nodes.

    CT (computed tomography) or MRI (magnetic resonance imaging) of the brain to detect tumors. For example, pituitary adenomas.

    Other additional research methods are prescribed, but as needed.

    Treatment of mastopathy

    It can be conservative (with the use of drugs) and operational (with the help of an operation).

    Drug treatment of mastopathy

    The goals are to suppress the action of estrogen and progesterone on breast tissue, normalize the functioning of the thyroid gland and the immune system.

    Means for the treatment of mastopathy

    Groups of drugs Representatives How is assigned Mechanism of action
    Hormonal drugs
    Antiestrogens -drugs that reduce the effect of estrogen on the mammary gland Tamoxifen, Toremifen Long-term in injections and / or tablets twice a day. The dosage is determined by the doctor. Treatment continues two months later after signs of reverse development of mastopathy appear. The drug blocks receptors (specific areas on the cell membrane) of cells in the mammary gland, with which estrogens must bind.
    Combined oral contraceptives(COCs) - oral contraceptive pills containing synthetic analogs of natural estrogens and progesterone Ovidon, Diana - 35, Tri-regol, Regulon. Lindinet - 20 and others It is taken for a long time, starting from the first day of menstruation, as a rule, for 21 days. This is followed by a break for 7 days. Further, taking the drug is resumed. Suppress the production of LH and FSH hormones in the pituitary gland. Therefore, there is no change in the level of hormones in the body throughout the month. A stable effect is achieved with long-term use: from several months to 1-2 years.
    Gestagens(progesterone) For oral administration:
    * Utrozhestan - natural progesterone
    * Duphaston is a synthetic analogue of natural progesterone    		 Utrozhestan is prescribed ½-1 tablet twice a day, Duphaston - 1 tablet twice a day. Reception begins on the 14th day of the menstrual cycle and lasts for 14 days. Then the drug is canceled. The course is from 3 to 6 months. Ovulation is blocked, and cyclical fluctuations of sex hormones during the month are excluded. Therefore, the increased cell division in the mammary gland and the growth of the milk ducts stop.
    Outwardly:
    Progestogel    		 1 dose through the applicator is applied to the skin of the breast. The drug is rubbed in until complete absorption. It is applied twice a day. Blocks estrogen receptors. As a result, there is a reverse development of the milk ducts. In addition, the drug reduces swelling of the mammary glands and has an analgesic effect.
    Drugs that suppress prolactin synthesis(prescribed only with increased prolactin) Parlodel (Bromcriptine), Dostinex 1-2 tablets three times a day with meals. Stimulates the production of dopamine in the hypothalamus, which in turn suppresses prolactin synthesis.
    Gonadotropin-releasing hormone antagonists) Dipherelin, Zoladex, Buserelin Zoladex - once every 12 weeks, subcutaneously into the abdominal wall.
    Diphereline - One injection every three months.
    		Inhibits the release of gonadotropin-releasing hormone from the hypothalamus. As a result, LH and FSH are not produced in the pituitary gland. Thus, ovarian function and ovulation are inhibited. That is, a temporary reversible menopause occurs, which contributes to the reverse development of signs of mastopathy.
    Synthetic analogs of thyroid hormones L-thyroxine, Eutirox Used for hypothyroidism - insufficient production of hormones by the thyroid gland In the morning on an empty stomach half an hour before meals. Reception scheme: daily or with a two-day break once a week. The dosage of drugs and the duration of treatment are determined by the doctor. The increased production of thyritotropic hormone and prolactin by the pituitary gland is inhibited.
    Non-hormonal drugs
    Iodine preparations prescribed for thyroid insufficiency Iodomarin, Klamin (dietary supplement) Iodomarin - 1-2 tablets per day after meals. Klamin - 2 capsules three times a day. The course is 2 months. Repeat it if necessary. Iodine is involved in the synthesis and release of thyroid hormones.
    Mamoklam®Administered orally before meals, a single dose - 1-2 tablets, 2-3 times / day at regular intervals during the day (daily dose 3-6 tablets), the duration of the course of treatment is from 1 to 3 months. If necessary, it is recommended to repeat the courses of treatment after a break of 2 weeks to 3 months.Reduces the manifestations of mastalgia, relieves premenstrual syndrome. Leads to regression of cysts, normalizes the processes of proliferation of the epithelium of the mammary glands.
    Homeopathic remedies Mastodinon It is taken either in 30 drops, or one tablet twice a day. The course is 1.5-2 months. Reduces the production of prolactin in the pituitary gland, normalizes the secretion of LH and FSH. As a result, the menstrual cycle is normalized, and the lactiferous ducts undergo a reverse development.
    Mastopol One tablet is absorbed under the tongue half an hour before meals three times a day. The course is 8 weeks. If necessary, the treatment is repeated after 4-6 months. Reduces swelling, inflammation and tenderness in the mammary glands. It improves the supply of nutrients and oxygen to all tissues, as well as normalizes the functioning of the immune system. As a result, the milk passages are reversed and the menstrual cycle is normalized.
    Herbal preparations Mammoleptin 5 capsules three times a day, 30-60 minutes after meals. Course - 2 months Reduces pain, swelling and tenderness of the mammary glands. Leads to the reverse development of the milk ducts.
    Vitamin complexes containing vitamin A or beta-carotene (the precursor of vitamin A), C, E, D, P and selenium Triovit, Aevit and others 1 capsule 2 times a day. The course is 8 weeks. It is recommended to carry out up to 3 courses of treatment during the year. Normalize estrogen levels, improve liver and immune system function. They stabilize the walls of blood vessels, preventing the development of edema in the mammary glands (vitamin C). With prolonged use, they prevent the transition of mastopathy to a malignant tumor (vitamins A and D, selenium). They slow down the aging of body cells and enhance the effect of progesterone (vitamin E and selenium).
    Non-steroidal anti-inflammatory drugs (NSAIDs) Aertal, Indomethacin, Diclofenac and others As a rule, 1 tablet is prescribed twice a day after meals. Reduces pain, inflammation and swelling in the mammary glands.

    The listed medicines are used both for the treatment of diffuse and nodular forms of mastopathy. The course is from 2 to 4-6 months, depending on the severity of the disease.

    Principles of Prescribing Medicines

    • Diffuse forms of mastopathy

      Treatment of adenosis, fibroadenomatosis, diffuse cystic and cystic fibrous mastopathy carried out only with the use of drugs (conservatively) They are prescribed depending on the stage and severity of the symptoms of the disease. For example, with the initial signs of an ailment, mainly non-hormonal preparations (vitamins, iodine preparations, homeopathic remedies) are used. Hormonal drugs are rarely used.
      Whereas with severe symptoms of the disease (especially with diffuse fibrocystic form), hormonal drugs (gestagens, COCs, thyroid hormones, and so on) are often added to the treatment.

    • Nodal forms of mastopathy

      Treatment is long-term and complex, as a rule, including both the use of medications and surgical treatment.

      Treatment of fibroadenoma (nodular fibrous mastopathy)

      Surgical treatment is mainly carried out. However, if there are few nodes (one or two) and they are small in size (up to 1-1.5 cm in diameter), then it is possible to carry out treatment with drugs: hormonal and homeopathic medicines, vitamins and others.

      Treatment of nodular cystic mastopathy

      Cysts up to 1.5-2 cm they are treated conservatively, depending on the identified cause: vitamins, homeopathic medicines, hormones, iodine preparations and others are prescribed.

      Cysts with a diameter of more than 1.5-2 cm, as a rule, punctured with a fine needle. Further, treatment with drugs (hormones, vitamins and others) is carried out.

      Treatment of nodular fibrocystic mastopathy

      The most difficult and long-lasting, since both areas of compaction and cysts are present in the mammary glands. As a rule, seals are first removed and / or cysts are punctured, and then conservative treatment is prescribed. However, if the size of the cysts and seals is small, then preference is given to treatment with only drugs.

      When treating any form of mastopathy, the choice medicinal product(especially hormonal) always depends on the identified hormonal disorders (the level of progesterone, estrogen, prolactin) and the presence of other diseases in a woman.

    Surgical treatment of mastopathy

    It is carried out for nodular mastopathy (cystic, fibrous and cystic-fibrous forms) under general or local

    Indications for surgery

    • Increase in the size of nodes and cysts more than doubled in three months
    • Suspicion of a malignant tumor on biopsy data, regardless of the size of the tumor
    • Cysts larger than 1.5-2 cm
    • Knots larger than 1.5-2 cm

  • Need to have a biopsy result
    • Surgical methods
    • The cysts are punctured using a thin needle and suction the internal fluid. In the future, the walls of the cyst are subjected to sclerotherapy (gluing the walls of the cyst by introducing special substances into the cavity). If cysts re-form, then their cavities are exfoliated, but the surrounding tissues are preserved (if there is no suspicion of cancer).
    • Nodes are removed, and in severe cases (multiple and / or large nodes), a sectoral (partial) removal of the mammary gland is performed. In this case, the tissue of the gland is removed, stepping back from the edge of the tumor by 1-3 cm.
    After the operation, the removed tissue must be sent for morphological (histological) examination.

    Rehabilitation after surgery

    After 1.5-2 hours after the operation, the woman may feel pain and discomfort in the area of ​​manipulation. As a rule, sensations are not expressed, therefore, they do not require the use of painkillers. However, pain relievers are prescribed as needed.

    The woman is discharged home on the day of the operation or a few days later (it all depends on the volume of the intervention). The stitches are removed 7 days after the operation.

    It must be remembered that the operation does not eliminate the cause of the development of the disease. Therefore, after it, it is necessary to treat mastopathy with drugs (hormones, vitamins, iodine-containing drugs and others) and the underlying disease (for example, hepatitis). It is also important to choose the most optimal method of preventing an unwanted pregnancy and follow a diet.

    Diet for mastopathy

    It is recommended to lower your fat intake and increase the amount of fiber (fresh vegetables and fruits, whole grains). As a result, the effect of estrogen on the mammary gland decreases.

    It is advisable to limit sweet, starchy, fatty foods, since these foods lead to an increase in the subcutaneous fat layer (obesity), in which estrogens are produced.

    It is better to eat foods rich in vitamins A, B, D, E (liver, yolk, milk, cottage cheese, cheese, vegetable oil, seafood, fresh vegetables and fruits of red or orange color).

    It is important to replenish the iodine deficiency in the body (seafood, iodized salt).

    You should reduce your intake of cocoa, chocolate, tea and coffee, as they contain methylxaptins - substances that can provoke the progression of the disease and increase pain.

    Treatment with folk remedies

    It is not an independent method of combating mastopathy, since it cannot affect all links in the mechanism of the development of the disease. However, when taken in combination with drugs, they reduce the manifestations of mastopathy, promote recovery, and normalize the body and the immune system.

    Name How to cook How to use What effect to expect
    Tincture of pine nut shells Pour half a glass of fresh pine nut shells or fresh walnut partition into half a liter of vodka. Then insist in a dark and warm place (near a battery or stove) for 10 days. Before meals for half an hour, ½ -1 tablespoon for two female cycles. Improves the functioning of the immune and circulatory system, as well as the thyroid gland. It has an antitumor effect.
    Scarlet Elixir Wrap aloe leaves (age - 3-4 years) in gauze and place in a plastic bag, but close it loosely (so that air can flow). Then keep in the refrigerator at t + 4-8C for 2 weeks. Then mince the leaves and squeeze the juice. Then mix one part of aloe juice with two parts of liquid honey (1: 2). 1 tsp each. 30 minutes before meals, twice a day. The course is 30 days. Improves the functioning of the immune system and has anti-tumor properties.
    Burdock root decoction 2 tbsp Pour the chopped burdock root with 3 glasses of water, then boil and strain. 50-60 ml 3 times a day half an hour before meals. The course is 1 menstrual cycle. Reduces swelling and pain in the mammary glands, has antitumor properties.

    Prevention of mastopathy

    What do we have to do?

    Lead a healthy lifestyle and eat well

    Eat foods rich in vitamins and minerals, as well as a sufficient amount of iodine. Introduce an active lifestyle, play sports, get enough sleep and rest (sleep duration - less than 7 hours a day). This will strengthen the immune system - the main protector against all ailments.

    Have a regular sex life

    During intercourse, a woman experiences an orgasm, therefore, blood circulation in the small pelvis and the work of the ovaries improve. In addition, biologically active substances are present in the seminal fluid, which also improve the functioning of the ovaries.

    Eliminate strong emotions

    "All diseases from the nerves" is a true statement for mastopathy. Since stressful situations are a trigger for the development of an illness. While healthy sleep, eating tasty food, sexual satisfaction, positive emotions contribute to the production of dopamine, which blocks the increased synthesis of prolactin in the pituitary gland.

    Conduct an independent examination of the mammary glands

    For a menstruating woman, a monthly self-examination is recommended from 5-6 to 9-12 days of the cycle (the most optimal - on days 5-7), since these days the mammary gland is in a relaxed state. During menopause, on the same calendar day.

    Self-examination stages

    Wearing the right bra

    Choose a bra that is sized, non-rigid, not crushing or chafing. Since the mammary gland is injured.

    Undergo an annual medical examination (oncological examination)

    The inspection includes:

    • Examination of the skin and visible mucous membranes
    • Inspection and palpation of the mammary glands, thyroid gland and lymph nodes (axillary, cervical, inguinal)
    • Gynecological examination and digital rectal examination
    • Examination of a smear for flora from the vagina and for cytology (detection of cancerous or precancerous cells) from the cervical canal
    Keep breastfeeding

    Since it improves the work of the mammary glands and the course of mastopathy (though not always), leading to recovery. Breastfeeding is beneficial when it lasts up to one to two years (minimum 6 months).

    What should i avoid?

    • Breast injury.
    • Contact with pesticides and chemicals that may be in food. Because they increase the production of aromatase, which increases the sensitivity of breast receptors to estrogen.
    • Prolonged exposure to the sun during dangerous hours (from 11.00 to 16.00), since ultraviolet rays can provoke the development of mastopathy and / or cancer. Whereas short sunbathing in the morning and evening hours is allowed.
    • Smoking, abuse alcoholic beverages and taking drugs (even light ones), as the metabolism in the body and the work of the immune system are disrupted.


    Recommended to read