Antipyretics for children are prescribed by a pediatrician. But there are emergency situations for fever when the child needs to be given medicine immediately. Then the parents take responsibility and use antipyretic drugs. What is allowed to give to infants? How can you bring down the temperature in older children? What medicines are the safest?
Mastopathy - benign neoplasms in the mammary gland. Pathological tissue growth occurs as a result of hormonal imbalance or other provoking factors. Mastopathy on ultrasound is determined quite clearly, in addition, depending on the type of formations, the form of the disease can be distinguished.
With the help of ultrasound examination of the mammary glands (sonography), structural changes are detected. The decoding of the data occurs due to the different density of the tissues of the mammary glands by passing ultrasound through them and the echo response obtained as a result of capturing the sensor and directing the image to the screen. The echogenicity of different parts of the breast depends on the density of the examined tissues.
During ultrasound examination, it is the echogenicity parameter that becomes the criterion for assessing the state of the organ under study. At high tissue density, echogenicity will also be elevated or hyperechoic, thus indicating poor perceptive ability. Ultrasound does not detect liquid structures.
The advantages of this method include:
- high information content that occurs due to the possibility of conducting research from different angles, so it is likely to detect neoplasms at an early stage of development;
- harmlessness of the method - it can be used even by pregnant and lactating women;
- it is also possible to examine nearby tissues, vessels, nodes, etc., thus guaranteeing a wider scope of diagnosis.
With the help of ultrasound, it is possible to detect formations from 1 mm in diameter and to identify the nature of its origin (cyst, fibroma, fibroadenoma, etc.). At the same time, the location of the neoplasm is clearly determined, which makes it possible to take a puncture for analysis. But it is worth understanding that this is said about modern devices of a new generation. Their predecessors can detect formations from 5 mm.
Indications for the procedure
Most experts recommend breast ultrasound for women over 35 at least once every 2 years. If there is an indication of breast cancer in close relatives in the anamnesis, then the procedure should be repeated more often - annually. For women over 45-50 years of age, the recommendations also change - they should undergo an ultrasound scan at least once a year, but better every six months.
Also, an ultrasound examination is prescribed for suspected mastopathy. Pathology can manifest itself in the following symptoms:
- soreness of the mammary glands, especially in the premenstrual period;
- violations in the menstrual cycle;
- asymmetry with breast augmentation;
- the appearance of a single or multiple seals in the mammary gland.
These signs are not specific for mastopathy, they can mean other diseases. Ultrasound is prescribed to confirm the diagnosis, as well as to assess the course of the disease and the effectiveness of the therapy used. The method is used to exclude the possibility of malignancy of the neoplasm.
- if the girl has an irregular menstrual cycle;
- there is a hereditary predisposition to mastopathy.
Thanks to this procedure, it is possible to detect the pathology, as well as its complications, in a timely manner.
It is also necessary to urgently undergo an ultrasound when:
- chest injuries and chest;
- sudden onset of pain in the mammary glands;
- sudden enlargement of the breast or regional lymph nodes;
- gynecological diseases detected during the passage of ultrasound of the pelvic organs.
Criteria for decrypting data
Depending on the presence of pathologies in the mammary gland or their absence, the picture that appears on the screen is different. It is on her that the specialist establishes the diagnosis.
Mammary glands are normal
With the help of ultrasound, you can see that the female breast consists of three layers. The top is located directly under the skin. It is made up of adipose tissue. The breast skin itself is an echogenic zone about 2 mm thick, but in the nipples in the areola area, it is slightly larger.
Below is the mammary gland itself, which is the middle layer. It has a parenchymal component, which is divided into about 20 lobes. It is in them that the location of the duct and the washing passages leading to the nipples. Normally, the width of the ducts on ultrasound should vary from 1 to 2 mm. The top two layers are connected by fibrous septa that support the gland. In the third layer are derivatives of fat lobes.
It should be understood that the structure of the breast of each woman is individual, in addition, it undergoes age-related changes and depends on the hormonal background. And so in different ages norm is interpreted in different ways. During the onset of menopausal changes, they also affect the chest area: atrophy of the parenchymal component occurs. As a result, the breast becomes sagging, it loses its former firmness and elasticity, as the glandular tissue is replaced by fatty tissue. On ultrasound examination echogenicity will be increased, but this is one of the options for the norm.
Pathological changes
Depending on the nature of the neoplasms, mastopathy can be nodular and diffuse. Moreover, the latter form is divided into fibrous, cystic and mixed. On ultrasound images, they also look different.
With pathological changes, the uzist observes blackouts in the picture. So he can conclude that in this area there is an inflammatory process and swelling of the tissues. With increased density, on the contrary, the specialist observes light and sometimes white spots on the screen.
In the glandular layer, it is possible to observe echogenic areas in the following cases:
- seals are formed as a result of the replacement of fat cells with normal ordinary tissues or when they are scarred;
- areas of accumulation of calcium salts and calcifications.
In the parenchymal areas and in the lobes of the mammary glands, pathological changes. Increased echogenicity indicates a hormonal imbalance in a woman. This is what can be mastopathy.
The specialist must describe the number of seals, their contours, localization. An uneven seal contour indicates an inflammatory process. In the case of an uneven edge of the neoplasm, the uzist can call malignancy into question. To confirm or refute it, an additional procedure under ultrasound control is required - a biopsy.
Nuances of interpretation and pathological zones on the echogram
Each form of pathology has a different picture on the echogram, so you can distinguish them.
Diffuse form of mastopathy
The diffuse form is the most common among all types of mastopathy. It mainly affects young women.
On ultrasound, the following picture is most often observed: the predominance of the glandular component in the form of enlarged glandular lobules in a wide reservoir and the average intensity of echo signal reflection. They are surrounded by less pronounced connective tissue, having the appearance of more echogenic structures.
With the predominance of the fibrous component, there is a thickening of the connective structures of the mammary gland, a lot of bright, clear linear structures are visualized. This distinguishes them from the usually “delicate” structure of the mammary glands, which has an uneven heaviness with no clear boundaries.
With a mixed form of diffuse mastopathy, an increase in the proportions with diffuse fibrotic changes. A uniform expansion of the ducts is possible due to the pressure of the proliferating component, which leads to the formation of cysts. This is a typical picture of fibrocystic mastopathy.
With the nodular form of mastopathy, separate areas with small seals are found, which have fuzzy contours and a homogeneous structure, the reflective intensity is also different. Calcifications are also found in the areas that are visualized.
In some cases, color Doppler imaging is used. When using it, it is observed that the vessels have a linear orientation, the vascular pattern is not weakened or strengthened.
As a result of the growth of fibrous tissues, the milk ducts are squeezed, which expand and cysts form. In this case, there are areas that have an irregular shape, with cysts and dilated ducts, which are surrounded by a local zone of fibrosis.
Fibroadenomas
Fibroadenoma is a benign neoplasm that most often occurs at a young age. Combines the proliferation of connective and epithelial tissues.
Depending on the type of connective tissue growth around the ducts or inside them, the formation of a pericanalicular or intracanalicular fibroadenoma may occur. Reverse processes can occur in them, which lead to fibrosis, calcification, hyalinosis. Malignancy of this kind of formations is extremely rare.
Ultrasound signs of fibroadenomas include clear and even contours of the formation, horizontal location, oval shape, uniformity of structure, reduced ultrasound signal, which can be enhanced by reflection behind the formation.
In the active phase of proliferation, the fibroadenoma is quite large, while giving a significant amount of echo-positive vascular signals.
Ultrasound examination of mastopathy is informative and effective method which is used widely and frequently. It can be used to detect pathology early dates development, due to which to begin timely therapeutic actions. In addition, it determines the shape, size, number of formations and many other parameters, using which you can carry out spot procedures and additional examinations.
Mastopathy- a benign disease that has developed as a result of an imbalance between hormones (progesterone, prolactin and estrogens) in the body. What leads to the growth of connective and glandular tissue in the mammary gland, so seals and / or cysts form in it different size.
Some statistics
In the world, from 70 to 80% of women suffer from mastopathy. That is, - 7-8 women out of 10. Moreover, women from 30 to 45 years old are most often affected by this disease.
It is produced in the pituitary gland (located in the brain). It enhances cell division in the mammary gland, stimulates the production of breast milk, increases the number of estrogen receptors in the mammary gland.
Normally, the synthesis of prolactin is suppressed by dopamine (a biologically active substance that transmits nerve impulse through nerve cells).
They regulate the metabolism of fats, carbohydrates and proteins, increase the production of prolactin, and also increase the sensitivity of mammary gland receptors to it.
Causes of mastopathy
In the formation of mastopathy, the main role is played by a hormonal imbalance between estrogens and progesterone, as well as prolactin. It develops as a result of various diseases.Causes of hormonal imbalance
The production of an estrogen-binding protein is disrupted, so its (estrogen) activity increases significantly.
The production of thyroid hormones is reduced, so their level in the blood falls. As a result, according to the principle of feedback in the pituitary gland, the production of thyrotropic hormone is stimulated, 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 cause increase 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.
Eglonil and Cerucal (used to treat gastritis, stomach ulcers and 12 PC), Reserpine (appointed to lower blood pressure) - drugs of central action (in the brain). They block the influence of dopamine - a biologically active substance, in case of deficiency of which the production of prolactin increases (normally, dopamine, on the contrary, reduces the synthesis of prolactin).
The production of hormones in the pituitary gland increases: FSH, LH and prolactin. Therefore, in the ovaries, the synthesis of estrogen increases, and progesterone, on the contrary, decreases. Under the influence of estrogens and prolactin, breast cells begin to multiply intensively and the milk ducts grow.
In adipose tissue (cells), a partial synthesis of estrogen is carried out. Therefore, the larger the subcutaneous fat layer, the more estrogens are produced.
Women whose close relatives (mother, grandmother) had breast or genital cancer are more likely to develop mastopathy. What is connected with the transfer of mutated (changed) genes from generation to generation.
It leads to impaired blood circulation in the pelvis (blood stagnates). As a result, the work of the ovaries and the production of hormones by them are disrupted.
- The level of aromatase (produced in the adrenal glands) is increased - an enzyme that converts androgens (male sex hormones that are synthesized in small quantities in women) into estrogens.
- The number of receptors and / or their sensitivity to estrogens in the mammary glands is increased.
Types of mastopathy
The most widespread is the division of mastopathy according to radiological (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 nodal 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 seal of the entire mammary gland or only one of its sections. Or small-sized (with rice) fine-grained foci of compaction are found, scattered in the mammary glands (mainly in the upper part).
- A clear or greenish-brown fluid may come out of the nipple.
Nodular mastopathy
It is characterized by the formation in the parenchyma (body) of the mammary gland of cysts and nodes that 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 (it plays the role of a frame, but is not responsible for the function of the organs), which compresses the gland duct, therefore, over time, leads to its blockage. It is most common in young women between the ages of 20 and 30. signs
- Pain and breast enlargement
- A clear or greenish-brown liquid comes out of 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. A form of mastopathy occurs in about 50% of women worldwide. signs
- Pain in the area of cyst formation
- The mammary gland increases in size and is painful
- Enlargement and pain in the armpits lymph nodes, as well as swelling of the tissues around them
- Transparent discharge from the nipples, and in case of infection - purulent.
- When probing the mammary gland, elastic nodes of a round or oval shape are determined
Fibrocystic mastopathy
It is characterized by the formation of dense foci in the parenchyma (body) of the mammary gland, capable of degenerating into cysts, filling with fluid. It develops in approximately 50-70% of women with mastopathy, most often from the age of 30 until the onset of menopause. It has manifestations characteristic of both fibrous and cystic nodular forms of mastopathy.
When probing, both areas of compaction of the mammary gland and nodes of an oval or round shape of a loose and elastic consistency (soft to the touch) can be detected.
Symptoms of mastopathy
The disease can affect both mammary glands, and one, and its signs depend on the type of mastopathy.| Symptom | Manifestations | Origin mechanism |
| Diffuse mastopathy | ||
| Pain and a feeling of fullness (swelling) in the mammary glands, as well as their increase in size | At the beginning of the disease, the symptoms are not expressed, most often they occur a week before the onset of menstruation. However, as the disease progresses, they become almost permanent. For the period of menstruation itself, pain and swelling are somewhat less pronounced. | Estrogens contribute to the accumulation of sodium ions inside the cells of the mammary glands, which attract water molecules to themselves. Therefore, swelling of the breast tissues 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 with pressure on the nipples. | Prolactin promotes the development of milk passages and their production of a liquid similar in composition to breast milk. |
| Foci of compaction | They are small, as a rule, are located in the entire mammary gland. | Under the influence of estrogens and progesterone, the number and length of the milk ducts in the mammary gland increase, and connective tissue grows in it. |
| Nodular mastopathy | ||
| Fibrous mastopathy (fibroadenoma) | ||
| Soreness, sensitivity to touch, and a feeling of fullness in the breasts | 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 worse even from a light touch. | Estrogen leads to the accumulation of sodium inside the cells of the mammary gland, which attracts water to itself. In addition, the growing connective tissue presses on the glandular tissue in the mammary gland. Therefore, swelling and pain increase. |
| Discharge from the mammary glands(clear to brownish green) | At the beginning of the disease are not expressed. However, they increase over time. They can appear on their own (spots on the inside of the bra) or with pressure 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 not soldered to the surrounding tissues. | The increased content of estrogens and prolactin leads to the fact that the connective tissue grows intensively, and the number of milk ducts increases. |
| Joining the infection(can be both with fibroma and with cystic mastopathy) | Increased body temperature, redness of the skin of the breast, bad feeling. The appearance of purulent or yellowish-green discharge from the nipples. | Swelling 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 breast | Most pronounced in the area of cyst formation. At the beginning of the disease, the symptoms increase as the menstruation approaches. With a long course of mastopathy, they become almost permanent. The pain is mostly dull and aching, but sometimes quite pronounced, greatly aggravated even with a light touch. | Estrogens promote the penetration of sodium into cells, which attracts water. In addition, as the cyst grows, it presses on the surrounding tissues, increasing pain. 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 (when infection is attached). More characteristic discharge with multiple or large cysts. Allocations can be arbitrary or appear 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. |
| Change in lymph nodes(in 10-15% of patients) | They enlarge, become 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 | Soft and elastic formations are felt with clear boundaries, round or oval in shape, not soldered to the surrounding tissues, having sizes 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 fluid in it stagnates. Connective tissue then begins to form around the stream, forming a capsule. With the help of a capsule, the body tries to delimit the dilated duct. Thus, fluid accumulates at the site of the enlarged duct. |
| With this variant of the course of the disease, two forms of nodular mastopathy are combined: cystic and fibrous. As a result, both the formation of cysts in the mammary gland and foci of compaction take place. Therefore, there are signs of the disease of cystic and fibrous forms of mastopathy at the same time. | ||
Diagnosis of mastopathy
The reasons for the development of mastopathy are diverse, 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 (who detects and treats only breast diseases). The ideal option is when all specialists take part in the treatment and monitoring of the patient. However, everything depends on the staffing of these specialists in the medical and diagnostic institution.At the doctor's appointment
The doctor will conduct a small survey: he will clarify the details that are necessary to establish the correct diagnosis (when the first menstruation began, whether the sexual life is regular, and so on).This will be 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 refer to an ultrasound of the mammary glands or 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 drugs) and in an operative way (surgery).
Survey
Questions to be answered in the doctor's office:
- How old are you?
- At what age did the first menstrual bleeding (menarche) occur?
- At what age was the first sexual contact?
- Is sexual activity 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?
- What is the period of breastfeeding?
- How is unwanted pregnancy protected?
- Do close relatives (mother, sister, grandmother) have mastopathy or breast cancer?
- If there is no menstruation (menopause), then at what age?
- Are there chronic diseases? If yes, what medications accepted for their treatment?
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 study 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 feels the lymph nodes. Next, the doctor presses on the nipples, trying to squeeze out the liquid from them.
Recommended terms of examination - from 5 to 9-10 days of the menstrual cycle (the most optimal - from 5 to 7 days). During menopause, the day does not matter.
Signs of mastopathy, detected during examination and palpation of the mammary glands:
- Pain, swelling and tenderness
- The presence of nodular seals in a certain area or throughout the mammary gland
- Detection of rounded cysts in various areas
- Discharge from nipples when pressed
- Presence of areas of retraction of the skin or nipples
- The formation of elevations or depressions on the skin
- Pronounced heterogeneity of the mammary glands (slight asymmetry is the norm)
- Enhancement of skin color of the nipple and areola
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 film x-ray mammography with minimal x-ray exposure is the gold standard for diagnosing breast diseases. The procedure is performed using a special apparatus - a mammograph, which makes it possible to obtain an image of the breast in two projections (frontal and lateral).
Indications for the use of film x-ray mammography
- Complaints of soreness and enlargement of the breast
- Drooping or bulging of breast skin
- Discharge from the nipple
- The presence of seals in the mammary gland
- Women over 30 who received radiation therapy in the chest area for a malignant neoplasm
- For preventive purposes, 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 close relatives 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 tight holders (they squeeze the gland) in order to reduce the thickness of tissues that absorb X-rays. That is, the denser the compression, the more informative the results. Sometimes the procedure in some patients causes pain or discomfort, but such a reaction is acceptable.
Signs of mastopathy
fibrotic changes. There are clear and dense taut shadows that can be located both in separate areas (fibroadenoma) and spread throughout the mammary gland (diffuse mastopathy). In this case, connective tissue strands are located either along the glandular lobules, or along the milk ducts. Whereas the contour of the lobules themselves is uneven. 
Growth of the glandular tissue of the mammary gland (adenosis). There are multiple small focal shadows of irregular shape and jagged edges - enlarged lobules. Sometimes these shadows completely merge with each other, forming foci of compaction of the glandular tissue (lobules). 
cystic changes. The general pattern of the mammary gland parenchyma is chaotic, and against its background, formations of a round-oval shape of the same density are noted. 
Mixed nature of changes in the mammary gland occurs most frequently. In this case, mammography shows both areas of compaction and cystic formations (nodular fibrosis). cystic mastopathy).
Ultrasound of the mammary glands
harmless and painless method, which 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 (the most optimal is from 5 to 7 days), since the state of the mammary glands under the influence of hormones changes during the cycle. During menopause, the day does not matter.
Methodology
The woman lies on her back with her hands behind her head. A transparent gel is applied to the skin of the area under study, which ensures tight contact of the ultrasound sensor. Next, the doctor presses a sensor to the skin, the waves of which penetrate the tissues at different angles and, reflected from them, are displayed on the monitor.
Indications for use
- Diagnosis of cysts or seals detected by palpation of the breast
- 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
- Enlarged axillary lymph nodes
Diffuse mastopathy
On ultrasound, there are numerous small seals that correspond to the growth of connective tissue, or small cysts (cavities with fluid), which are located evenly 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 change their shape when pressed.
Fibrocystic mastopathy It is characterized both by the presence of cavities filled with liquid and by areas of compaction. Education has clear boundaries.
Biopsy and morphological examination
Small tissue samples are taken from the affected areas of the breast and then examined under a microscope.The method with great certainty 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
- Mammogram or ultrasound shows suspicious areas with altered breast tissue
- The presence of large cysts and / or areas of compaction of the breast tissue (more than 1-1.5 cm), identified by palpation by a doctor
- The appearance of crusts, peeling or ulcers on the nipple, or spotting out of him
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 the glass, stained and examined under a microscope.
The puncture is performed using a special disposable needle, which is attached to the puncture gun. During the procedure, the gun fires 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
Cells are mononuclear, have the usual size and color. They contain a normal amount of chromatin (located inside the nucleus of cells and is involved in the transfer of genetic information during division). There are no zones of coronary cell growth (increased cell growth along the edges of the formation). Calcium deposited in the tissues can be detected (a sign of a possible future degeneration of mastopathy into a malignant tumor).
Laboratory blood tests
Several hormones affect the mammary gland, but their levels fluctuate 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 taken 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)
- thyroid stimulating hormone (TSH)(produced in the pituitary gland and stimulates the production of thyroid hormones)
- Follicle stimulating (FSH) and luteinizing (LH) hormone(produced in the pituitary gland and regulate the functioning of the ovaries)
- Prolactin synthesized in the pituitary gland and regulates the production of breast milk in the mammary gland
Additional examination methods
They help determine the function of an organ that produces hormones: the presence of inflammation, adhesions, tumors, and so on. Since such changes can lead to disruption of their work and, accordingly, changes in hormonal levels. However, they are not mandatory.
Additional Research
Ultrasound of the pelvic organs assigned to determine the presence inflammatory process or tumors in the ovaries, fallopian tubes, uterus.Thyroid ultrasound 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.
Others are appointed additional methods research, but as needed.
Treatment of mastopathy
It can be conservative (with the use of drugs) and operational (with the help of surgery).Medical treatment of mastopathy
Goals - suppression of the action of estrogen and progesterone on breast tissue, normalization of the thyroid gland and the immune system. Means for the treatment of mastopathy
| Drug groups | Representatives | How is it prescribed | Mechanism of action |
| Hormonal drugs | |||
| Antiestrogens -drugs that reduce the effect of estrogen on the mammary gland | Tamoxifen, Toremifene | Long-term injections and / or tablets twice a day. The dosage is determined by the doctor. Treatment continues two more months after the appearance of signs of regression of mastopathy. | The drug blocks the receptors (specific areas on the cell membrane) of cells in the mammary gland that estrogens must bind to. |
| Combined oral contraceptives(KOKi) - birth control pills for oral administration, containing synthetic analogues 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. Then 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 for a month. A stable effect is achieved with prolonged 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, Dufaston - 1 tablet twice a day. Reception begins on the 14th day of the menstrual cycle and continues for 14 days. Then the drug is canceled. The course is from 3 to 6 months. | Ovulation is blocked, and cyclic fluctuations of sex hormones during the month are also excluded. Therefore, the increased cell division in the mammary gland and the growth of the milk ducts stop. |
| Externally: Progestogel | 1 dose through the applicator is applied to the skin of the breast. The drug is rubbed until complete absorption. Applied twice a day. | Blocks estrogen receptors. As a result, the reverse development of the milk ducts occurs. In addition, the drug reduces swelling of the mammary glands and acts as an analgesic. | |
| Drugs that inhibit prolactin synthesis(appointed only with elevated prolactin) | Parlodel (Bromocriptine), Dostinex | 1-2 tablets three times a day with meals. | Stimulates the production of dopamine in the hypothalamus, which, in turn, inhibits the synthesis of prolactin. |
| Gonadotropin-releasing hormone antagonists) | Diferelin, Zoladex, Buserelin | Zoladex - once every 12 weeks, subcutaneously into the abdominal wall. Diphereline - one injection once every three months. | It 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 analogues of thyroid hormones | L-thyroxine, Euthyrox Used for hypothyroidism - insufficient production of hormones by the thyroid gland | In the morning on an empty stomach half an hour before meals. Reception schedule: daily or with a two-day break once a week. The dosage of drugs and the duration of treatment is determined by the doctor. | The increased production of thyritotropic hormone and prolactin by the pituitary gland is inhibited. |
| Not hormonal preparations | |||
| Iodine preparations prescribed for thyroid insufficiency | Iodomarin, Klamin (BAA) | Iodomarin - 1-2 tablets per day after meals. Klamin - 2 capsules three times a day. Course - 2 months. If necessary, it is repeated. | Iodine is involved in the synthesis and release of thyroid hormones. |
| Mamoclam® | Applied orally before meals, a single dose - 1-2 tablets, 2-3 times / day at regular intervals during the day ( daily dose 3-6 tab.), 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 manifestations of mastalgia, relieves premenstrual syndrome. It leads to regression of cysts, normalizes the processes of proliferation of the epithelium of the mammary glands. | |
| Homeopathic preparations | Mastodinon | It is taken either 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 reverse development. |
| Mastopol | Dissolves one tablet under the tongue half an hour before meals three times a day. Course - 8 weeks. If necessary, the treatment is repeated after 4-6 months. | Reduces swelling, inflammation and soreness in the mammary glands. It improves the supply of nutrients and oxygen to all tissues, and also normalizes the functioning of the immune system. As a result, the milk passages undergo reverse development, 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 soreness of the mammary glands. It leads to the reverse development of the milk ducts. |
| Vitamin complexes containing vitamin A or beta-carotene (precursor of vitamin A), C, E, D, P and selenium | Triovit, Aevit and others | 1 capsule 2 times a day. Course - 8 weeks. During the year, it is recommended to carry out up to 3 courses of treatment. | Normalize the level of estrogen, improve the functioning of the liver and the immune system. 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 (vitamin 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. | Reduce 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 drugs
- 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 illness, non-hormonal preparations (vitamins, iodine preparations, homeopathic remedies) are mainly used. Hormonal drugs are rarely used.
Whereas with severe symptoms of the disease (especially with a diffuse fibrocystic form), hormonal preparations (gestagens, COCs, thyroid hormones, and so on) are often added to the treatment. - Nodal forms of mastopathy
Treatment is long and complex, as a rule, including both the use of medications and surgical treatment.
Treatment of fibroadenoma (nodular fibrous mastopathy)
Mainly carried out surgical treatment. However, if there are few nodes (one or two) and they are small in size (up to 1-1.5 cm in diameter), then treatment with medicines is possible: hormonal and homeopathic preparations, vitamins and others.
Treatment of nodular cystic mastopathy
Cysts up to 1.5-2 cm in size 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 are usually punctured with a fine needle. Further treatment is carried out with drugs (hormones, vitamins, and others).
Treatment of nodular fibrocystic form of mastopathy
The most difficult and lengthy, 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 sizes of cysts and seals are small, then treatment with drugs alone is preferred.
In the treatment of any form of mastopathy, the choice medicinal product(especially hormonal) always depends on the identified hormonal disorders (progesterone, estrogen, prolactin levels) and the presence of other diseases in a woman.
Surgical treatment of mastopathy
It is carried out with nodular mastopathy (cystic, fibrous and cystic-fibrous forms) under general or local Indications for surgery
- More than doubling in size of nodules and cysts in three months
- Suspicion of a malignant tumor according to biopsy data, regardless of the size of the formation
- Cysts larger than 1.5-2 cm
- Nodes larger than 1.5-2 cm
- Cysts puncture using a thin needle and suck out the internal fluid. Subsequently, the walls of the cyst are subjected to sclerosis (gluing the walls of the cyst by introducing special substances into the cavity). If cysts form repeatedly, then their cavities are husked, but the surrounding tissues are preserved (in the absence of 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. At the same time, the gland tissue is removed, stepping back from the edge of the tumor by 1-3 cm.
Rehabilitation after surgery
1.5-2 hours after the operation, a woman may feel pain and discomfort in the area of manipulation. As a rule, sensations are not expressed, therefore, do not require the use of painkillers. However, if necessary, painkillers are prescribed.
The woman is discharged home on the day of the operation or after a few days (it all depends on the extent of the intervention). The stitches are removed on the 7th day after the operation.
It must be remembered that the operation does not eliminate the cause of the development of the disease. Therefore, after it, mandatory treatment of mastopathy with drugs (hormones, vitamins, iodine-containing drugs, and others) and the underlying disease (for example, hepatitis) is necessary. It is also important to choose the most optimal method of preventing unwanted pregnancy and follow a diet.
Diet for mastopathy
It is recommended to reduce 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 is reduced. It is desirable to limit sweet, starchy foods, fatty foods, since these products 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 deficiency of iodine in the body (seafood, iodized salt).
You should reduce the consumption 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 dealing with 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, normalize the functioning of the body and the immune system. | Name | How to cook | How to use | What effect to expect |
| Pine nut shell tincture | Pour half a glass of fresh pine nut shells or fresh walnuts into half a liter of vodka. Then insist in a dark and warm place (near a battery or stove) for 10 days. | Half an hour before meals, ½ -1 tablespoon for two female cycles. | Improves the functioning of the immune and circulatory system, as well as the thyroid gland. Has antitumor activity. |
| scarlet elixir | Aloe leaves (age - 3-4 years) wrap in gauze and place in a plastic bag, but close it loosely (so that air enters). Then keep in the refrigerator at t + 4-8C for 2 weeks. Then pass the leaves through a meat grinder and squeeze the juice. Then mix one part of aloe juice with two parts of liquid honey (1:2). | 1 tsp 30 minutes before meals twice a day. Course - 30 days. | Improves the functioning of the immune system and has antitumor properties. |
| Burdock root decoction | 2 tbsp crushed burdock root pour 3 cups of water, then boil and decant. | 50-60 ml 3 times a day half an hour before meals. Course - 1 menstrual cycle. | Reduces swelling and pain in the mammary glands, has antitumor properties. |
Prevention of mastopathy
What do we have to do?
News healthy lifestyle life and nutrition
Eat foods rich in vitamins and minerals, as well as a sufficient amount of iodine. Enter an active lifestyle, play sports, get enough sleep and rest (sleep duration - less than 7 hours a day). It will strengthen immune system- the main protector from all illnesses.
Have a regular sex life
During intercourse, a woman experiences an orgasm, so blood circulation in the pelvis and ovarian function 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 are from the nerves” is a true statement for mastopathy. Since stressful situations are a trigger for the development of the disease. While healthy sleep, eating delicious food, sexual satisfaction, positive emotions contribute to the production of dopamine, which blocks the increased synthesis of prolactin in the pituitary gland.
Perform self-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.
Stages of self-examination
Wear the right bra
Choose a bra according to size, non-rigid, not pressing and not rubbing. Because the mammary gland is injured.
Pass an annual medical examination (cancer 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 examination of the rectum
- Examination of a smear for flora from the vagina and for cytology (detection of cancerous or precancerous cells) from the cervical canal
Since it improves the functioning 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 be avoided?
- Breast trauma.
- Contact with pesticides and chemicals that may be contained 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), because ultra-violet rays can provoke the development of mastopathy and / or a cancerous tumor. Whereas short-term sunbathing in the morning and evening hours is allowed.
- smoking, abuse alcoholic drinks and taking drugs (even light ones), as the metabolism in the body and the functioning of the immune system are disturbed.
Every third or fourth woman childbearing age from 30 to 45 years old is faced with a common pathology affecting the mammary glands, with a long and incomprehensible name. Therefore, you should find out in time what fibrocystic mastopathy is with medical point vision.
Fibrocystic disease or fibrocystic mastopathy of the mammary glands (FCM) is a focal formation with a non-malignant condition of breast tissues, which is formed against the background of an imbalance of hormones produced by the body, in which cystic formations and nodes of various shapes, structures and sizes appear. In this case, an abnormal relationship is observed between the epithelium and connective tissue in the gland, both due to proliferation (growth) and due to atrophy (reduction).
To understand what fibrous mastopathy and cystic mastopathy of the mammary glands are, you need to imagine the structure of the gland.
The mammary gland is formed by three types of tissue, the ratio of which is directly affected by age, hormonal fluctuations, condition reproductive organs. What are these fabrics?
- The parenchyma is directly the glandular tissue itself, divided into lobes.
- Stroma is a connective frame tissue that is located between the lobes and lobules.
- The stroma and parenchyma are enveloped and protected by adipose tissue.
Most often, cystic and fibrotic changes in the mammary glands are observed in the parenchyma, less often under the influence of hormones, stromal fibrosis occurs.
The diffuse process is defined in medicine as extensive, affecting a large array of breast tissue.
Fibrous - means an abnormal growth of the connective tissue of the mammary gland. Such stromal fibrosis can disrupt the structure of the lobes and ducts, leading to the appearance of abnormal structures in them.
The term cystic denotes the appearance characteristic of mastopathy.
Causes
The main causes of fibrocystic mastopathy of the mammary glands are due to an imbalance of hormones - a lack of progesterone, an abnormally high production of estradiol, prolactin, somatotropin and prostaglandins. Deviations from the normal ratio between the amounts of these hormones lead to fibrocystic changes in the mammary gland.
Glandular mastopathy appears after a sufficiently long period of time, since a combination of provocative factors of hormonal disorders and their long-term influence is required.
Such factors provocateurs of fibrocystic changes include:
- premature puberty in girls, because early (up to 11-12 years old) menarche (the first menstrual cycle) gives too high a hormonal load on the body, which also affects the condition of the mammary glands;
- menopause later than 55 years due to prolonged exposure to hormones on fibrous adipose tissue;
- frequent abortions and miscarriages (due to abrupt hormonal changes);
- lack of childbirth and pregnancy in general;
- gynecological diseases depending on hormonal disorders (endometriosis, menstrual dysfunction);
- a short period of feeding the baby with breast milk, refusal of breastfeeding in general;
- hereditary factor (on the mother's side);
- age over 35 - 38 years;
- frequent or prolonged stressful situations, often provoking endocrine disorders;
- obesity (hormonal activity of adipose tissue leads to hyperproduction of estrogen);
- neoplasms in the hypothalamus, (these tumors can disrupt the proper production of estrogen, FSH and LH);
- diseases of the liver, genitourinary organs, thyroid gland (hypo- and hyperthyroidism, thyrotoxicosis), diabetes mellitus;
- trauma, compression, inflammation of the mammary glands;
- uncontrolled intake of hormonal drugs, birth control pills;
- iodine deficiency;
- sluggish intimate life, lack of orgasms (blood stagnation occurs in the vessels of the reproductive organs, causing ovarian dysfunction and subsequent changes in hormonal levels).
General symptoms
The severity of symptoms of fibrous mastopathy is determined by the form of pathology and concomitant internal diseases.
The following main features dominate in diagnosing mastopathy of the mammary glands:
- Mastodynia (soreness of the mammary glands).
At the first stage of the disease, every tenth woman has pain in the mammary glands before menstruation, and this manifestation is falsely considered as a sign of premenstrual syndrome.
The pain is moderate, intense, has a different character (stabbing, aching, jerking), which is associated with the depth and activity of the process. With severe pain, it is sometimes impossible to touch the chest. After menstruation, the pains subside, but as the mastopathy deepens, they become permanent, and their degree depends on the phase of the monthly cycle.
- Swelling of the mammary glands (engorgement) associated with stagnation of blood in the veins.
- Discharge from the breast.
This characteristic symptom the disease manifests itself only in half of the patients, indicating the defeat of the fibrocystic process of the lactiferous ducts.
Most often, the amount of discharge from the mammary gland is insignificant, and the fluid appears spontaneously or when the nipple is squeezed. The contents resemble watery colostrum. Greenish, yellow color indicates the development of infection. A menacing symptom is the appearance of a brownish bloody fluid from the nipple, which raises the suspicion of possible damage, capillary lesions, tumor development and requires immediate examination.
- Enlargement, soreness and tension of the lymph nodes closest to the chest. This symptom is usually mild.
- Depression, tearfulness, emotional instability, irritability (especially often manifested in pain).
- The appearance of mobile and fixed seals, nodes in the thickness of the mammary gland, on palpation of which the diagnosis of fibrocystic mastopathy is made during a routine examination by a mammologist.
You are using folk remedies treatment?
YesNo
Forms and types of mastopathy
The classification of glandular mastopathy of the mammary gland provides for the allocation of the main forms of pathology: and nodular.
Initial stage for both forms
The primary stage of the disease is characterized by the development of limited processes in the chest.
When painful changes are limited to a certain area, focal breast fibrosis is diagnosed. In this case, seals with dimensions of 20-30 mm (more often single ones) of a round, oval shape are usually formed in the upper outer and inner quadrant (zone) of the gland.
It is in this area that the thickness of fibrous-adipose tissue is especially pronounced, a large number of lymph nodes and large vessels are located, around which inflammatory and tumor processes occur. Such local fibrosis of the mammary gland is considered as the initial stage of deep multiplication of fibrocytes (stromal cells).
The leading causes of such a pathology are considered to be an excessive release of estrogens and a lack of progesterone, as well as a violation of neurohumoral regulation (the relationship between metabolic processes and neurogenic activity).
Fibrous form and its types
Adenosis, in which hyperplasia (growth) of the glandular epithelium of the lobes and milk ducts is pronounced. At the same time, the tissue of the organ retains its structure, and the excessive growth of the parenchyma is characterized by a significant increase in the size of the breast.
Manifestations of adenosis of the mammary glands can be moderately tolerable (in girls) and pronounced, which manifest themselves in the development of a sclerosing variety of adenosis. It is characterized by damage to the breast by accumulations of microcalcifications (salt deposits), with a certain degree of probability of the appearance of potential foci of cancerous degeneration of cells.
Fibroadenomatosis is a fibrous mastopathy of the mammary glands, in which the fibrous component dominates. It is characterized by growths of the stroma, and in a later stage - multiple appearance. It's benign cystic formation mammary gland - rounded, mobile, with a fairly clear contour and density, the appearance of which means that the disease has passed into a nodular form. 
Fibrous pathology includes periductal fibrosis (plasmocytic), more common in women during menopause. With it, growths in the form of infiltrates (clusters) of plasma cells form around the milk ducts. Perivascular fibrosis is a type of periductal fibrosis in which there is an abnormal growth of stroma around the milk ducts, blood and lymphatic vessels in the form of seals of collagen fibers.
Separately, it is necessary to highlight the state of fibro-fatty involution (reverse development). This is a physiological (not pathological) process in the mammary glands when a woman reaches the age menopause in normal terms. The essence of the ongoing structural changes is the replacement of parenchyma cells with connective and adipose tissue cells.
Leading signs of fibrous mastopathy:
- change in color and sensitivity of the skin over the affected area;
- heaviness, bursting;
- colostrum-like discharge from the nipple (colorless to colored);
- moderate pulling pains, aggravated before "menstruation" with a possible return to the armpit and shoulder;
- determination by palpation of enlarged, tense mammary glands with a noticeable allocation of lobes and fine granularity.
cystic form
With cystic mastopathy, small cavity structures form in the mammary gland.
The main signs of fibrocystic mastopathy in this form are:
- single and multiple small neoplasms in the form of dense blisters, well defined when probing in a vertical position;
- tension of the mammary glands;
- sometimes - significant soreness of the seals when probing;
- a slight increase in formations with this type of mastopathy and axillary lymph nodes before menstruation;
- the formation of dense strands (linear stranded fibrosis).
According to the intensity of changes, fibro-fatty and glandular-cystic mastopathy is divided into degrees: minor, moderate and severe, and its types depend on the nature of structural changes in the tissues.
The cystic form often includes fibroadenomatosis with a dominant cystic rather than fibrous component, as well as linear (interlobular) fibrosis, in which nodes and strand structures are formed against the background of stroma growth between the lobes and inside the ducts. At the same time, clear echo signs of fibrocystic mastopathy are revealed on ultrasound.
Mixed form of fibrocystic mastopathy
This type of mastopathy often occurs in a mixed form, characterized by a combination of fibrous-fatty and cystic forms of the disease and their characteristic features. Fibrous disease of the mammary gland is well defined independently and can be seen on the pictures during mammography.
Nodular mastopathy
Nodular mastopathy or localized adenomatosis in most cases is a further development of the disease. of this type is a focal form of the disease, which in oncology is considered as a precancerous process. Knots in the tissues are easily palpable.
The types of nodular mastopathy include:
- cystic formations;
- fibroadenoma with a dominant cystic component;
- papillomas inside the milk ducts;
- leaf-shaped tumors;
- hamartoma, lipogranuloma, lipoma, angioma.
Features of nodular formations
- If the nodes are of cystic origin, then they have a dense elastic structure, clear contours and a shape delimited from adjacent tissues.
- Nodes in the form of foci of seals are probed as formations with pronounced lobes without obvious boundaries.
- The dimensions of the foci of seals reach 60 - 70 mm.
- The pain syndrome is either insignificant or absent.
- They can be single, multiple, detected on one or both sides (two-sided FCM).
- Before the menstrual cycle, seals may increase, swell, and become painful.
- It is difficult to palpate if the patient is in a horizontal position during examination.
- Peripheral lymph nodes are not enlarged.
Bilateral mastopathy
The defeat of the fibro-fatty and glandular tissue of both glands means that bilateral fibro-cystic mastopathy develops, indicating a persistent and serious hormonal disorder. Therefore, treatment involves the mandatory normalization of the level and ratio of hormones, as well as identifying the cause of such an imbalance, including dysfunction of the ovaries, the pituitary-hypothalamus system, the thyroid gland, and the adrenal glands.
The bilateral process almost doubles the risk of cancerous degeneration of diseased cells.
What is dangerous fibrous mastopathy
Initially, glandular mastopathy was not considered as a condition with a high risk of oncology.
But medical practice and research have revealed that breast fibrosis should be considered and treated as an intermediate precancerous condition that can, with varying degrees of probability, lead to malignancy (acquiring the properties of a malignant tumor by cells).
At an early stage, the disease responds well to therapy, so it is recommended that all diagnostic procedures at the mammologist and start treatment of fibrocystic mastopathy without waiting for complications.
Nodular pathology can be proliferating (progressive) and non-proliferating.
The proliferative form is more often unfavorable, when the tissue actively grows with the formation of neoplasms in the milk ducts and on the inner walls of the cavity structures, with the further development of cystadenopapillomas. Such changes carry the threat of malignant degeneration.
Diagnostics
Before Appointment diagnostic measures the doctor will examine, palpate the chest and take an anamnesis. Already during the initial examination, the patient can be diagnosed with asymmetry of the mammary glands, edema, venous pattern, changes in the position and shape of the nipples.
Palpation of the chest should be carried out in the first phase of the monthly cycle. Probing is carried out in two positions - standing and lying down. This is due to the fact that some neoplasms can be detected only in one of the positions of the body. Also, during the examination, the doctor may squeeze the nipples to determine the presence or absence of discharge.
To confirm the diagnosis, the following studies may be prescribed:
- mammography;
- Ultrasound of the mammary gland and pelvic organs;
- puncture. Puncture biopsy is necessary in order to differentiate FCM from, cancerous tumors and other formations. During this procedure, the specialist will take a fragment of the neoplasm, which will later be sent for histological examination;
- determining the level of hormones;
- blood chemistry;
- ductography;
- pneumocystography;
- thermography;
- MRI or CT.
Medical treatment of FCM
In order for the treatment of mastopathy to be as effective as possible, it is necessary to conduct a thorough diagnosis, based on the results of which the doctor will prescribe complex therapy. Conservative treatment can be carried out with the help of non-hormonal or hormonal drugs.
Non-hormonal drugs that are used to treat FCM:
- Vitamins. Vitamin A has an antiestrogenic effect, vitamin E enhances the effect of progesterone, vitamin B6 reduces the concentration of prolactin, vitamin P and ascorbic acid strengthen the walls of blood vessels, relieve swelling of the gland, improve blood circulation in it. All of these vitamins have a positive effect on the functioning of the liver, namely, estrogens are inactivated in it.
- Iodine preparations normalize the functioning of the thyroid gland, and also participate in the synthesis of its hormones. In this connection, doctors prescribe Iodine active, Iodomarin.
- Sedatives and adaptogens. Sedatives - valerian, motherwort, peony tincture improve the psycho-emotional state of a woman, minimize the effect of stress on the body. Adaptogens (Rhodiola rosea, Eleutherococcus) increase immunity, have a positive effect on metabolism and normalize liver function.
- Phytopreparations (Mastodinon, Remens, Cyclodinon) stabilize the hormonal background, reduce the production of prolactin, stop pathological processes in the mammary gland.
- Non-steroidal anti-inflammatory drugs (Nise, Indomethacin, Diclofenac) relieve puffiness and reduce pain syndrome by reducing the concentration of prostaglandins.
- Diuretics (kidney tea, lingonberry leaf or Lasix) relieve pain by removing excess fluid from the body, which leads to a decrease in swelling.
Hormonal Therapy:
- Gestagens (Pregnil, Utrozhestan, Norkolut, Dufaston). Preparations of this group reduce the production of estrogens in the second phase of the menstrual cycle. Experts recommend taking these drugs for at least 4-6 months. Also in gestagens are prescribed for local use(Progestogel gel). This gel must be applied to the mammary glands for several months. This use ensures 90% absorption of progesterone and eliminates possible side effects seen with oral administration.
- Prolactin production inhibitors (Parlodel). It is prescribed for overt hyperprolactinemia.
- Androgens (Danazol, Methyltestosterone, Testobromlecit). They are prescribed for older women.
- Antiestrogens (Tamoxifen).
- Combined oral contraceptives (Rigevidon, Marvelon). These medications are recommended for women under 35 who have irregularities in the second phase of the menstrual cycle.
Methods for removing neoplasms in the breast
An operation to remove fibrocystic mastopathy is rarely prescribed. Surgical intervention it is advisable in the absence of a positive effect from conservative treatment or in the case when there is a suspicion of a malignant process in the mammary gland.
Also, the removal operation is indispensable in the following cases:
- a woman or girl is diagnosed with nodular fibrocystic mastopathy in the late stage;
- the presence of painful sensations that interfere with the patient;
- inflammatory process;
- suppuration of neoplasms in the chest or their rupture.
Operations to remove fibrocystic mastopathy are carried out in the following ways:
- Enucleation. In this case, surgeons remove the neoplasm itself, while healthy breast tissue is not affected.
- sectoral resection. Together with the formation, part of the affected tissue is removed.
- Radical resection (the mammary gland is completely removed).
With fibrocystic mastopathy, enucleation is often used. This intervention lasts no more than an hour, after which the woman is left in the hospital for several hours for medical supervision. If no complications have arisen during this period, then she is discharged home. After 10-12 days postoperative sutures removed.
Consequences and recovery after surgery
In the recovery period after surgery, it is recommended to strictly follow all the recommendations of the attending physician:
- Regularly change the dressing and treat postoperative sutures to speed up the healing process of wounds and prevent infection.
- Take all medications prescribed by your doctor. These can be antibiotics, hormonal agents, agents for accelerating tissue regeneration, anti-inflammatory drugs.
- Keep calm. Bed rest must be observed for at least 4-5 days to prevent the sutures from coming apart.
- Eat properly and fully, follow a diet prescribed by a specialist.
At the time appointed by the doctor, the patient must undergo a medical examination, during which the stitches will be removed and a further course of therapy will be prescribed.
As a rule, the recovery period after removal of fibrocystic mastopathy passes without complications. The trace after the operation remains hardly noticeable, it can be quickly eliminated with the help of modern medical cosmetology.
But even after the operation, it is necessary to regularly undergo examinations by a mammologist, since the risk of cell degeneration into a malignant tumor still exists.
Since the removal of fibrocystic neoplasms in the chest is still an operation, it can provoke the following complications:
- bleeding;
- the appearance of a hematoma in the chest cavity;
- inflammation and suppuration of the wound;
- asymmetry of the mammary glands;
- atrophy of the pectoral muscle;
- nerve or vascular injury.
A recurrence of the disease can be observed in the presence of foci of pathologically altered tissue, which can occur with an incorrectly defined border of surgical intervention.
If the disease is not treated in a timely manner, the consequences of FKM can be very serious. The most dangerous complication of the disease may be breast cancer. The initial stages of the malignant process are usually non-invasive, and important organs are not affected, so the early stages are treated quite successfully. But in medicine, there are cases when cancer is invasive, and then the following forms of oncology may occur:
- Ductal cancer, which is localized in the wall of the duct. Characterized rapid growth. The tumor in a short time can spread outside the lactiferous duct.
- Lobular cancer initially affects the breast tissue, but gradually extends beyond it.
- Inflammatory cancer is rare. It has a similar clinical picture with mastitis, which is why differential diagnosis is so important.
- Ulcerative form of cancer (Paget's cancer).
Prevention and contraindications
First of all, the prevention of fibrocystic mastopathy is to eliminate the underlying diseases that give impetus to its development. It is also necessary to exclude external provoking factors.
Every woman must regularly conduct an independent examination of the mammary glands and, if the shape of the breast changes, soreness, discharge from the nipples and other alarming signs appear, immediately seek advice from a mammologist.
It is important for girls to choose the right bra - it is desirable that it be made of natural fabrics, and also that it does not deform or strongly compress the mammary glands.
Good prevention of fibrocystic mastopathy is childbirth and a long period of breastfeeding. It is necessary to avoid abortions, live a full sexual life, try not to react to stressful situations, eat right and lead an active lifestyle. Patients are advised to give up coffee, strong tea, flour and sweets. Many doctors associate the occurrence of fibrous structures in the chest with abnormalities in the work of the intestines, so girls should eliminate constipation, normalize the bacterial flora.
In the presence of fibrocystic mastopathy, it is not recommended to drink alcohol, smoke and heat the mammary glands (visit saunas and baths).
Fibrocystic mastopathy is a pathology that requires immediate treatment. Delay and uncontrolled medication can only worsen a woman's condition and lead to the transformation of a benign neoplasm into a malignant one.
Mastopathy is a disease that affects the mammary glands. Seals occur due to violations in hormonal background women. To establish the final diagnosis, the doctor compares his preliminary data with an ultrasound examination.
About the procedure
Ultrasound passes through the breast tissues, reflects from them and the result of the examination is visible on the monitor of the ultrasound machine. Echogenicity depends on tissue density. Hyperechoic, when dense and hypoechoic, when the permeability of ultrasound is less. But the liquid, ultrasound will not be able to see.
Who needs a breast ultrasound?
If you are 35 years old or older, then try to do echography 1 or 2 times a year. It doesn't matter that nothing bothers you. Hurt on initial stage no cancer. Especially those who are over 50 should regularly undergo ultrasound or mammography.
Seals in the chest, you can find yourself or a gynecologist during examination. These may be benign cysts or neoplasms in the form of nodules. More precisely, the specialist will say after deciphering the results of the study.
"Advice. Immediately ask the doctor for a referral for an ultrasound."
If you are diagnosed with mastopathy, the doctor will offer to be examined 1-2 times a year to trace the dynamics. It is important to know if the situation has worsened, has breast cancer begun?
Ultrasound must be done when:
- Feeling pain in your chest;
- There were injuries in this area;
- Breasts or nearby lymph nodes have increased;
- You have done a pelvic ultrasound and there are problems in gynecology;
- Mastopathy in your closest relatives, which means you have a predisposition.
Ultrasound will show different seals that occur with mastopathy. In structure, they can change and it depends on what day of the menstrual cycle it is today. The most effective ultrasound examination is carried out in the period of 5-14 days.
"Advice. During menopause, pregnancy or breastfeeding, ultrasound can be done any day."
Mastopathy of certain forms on ultrasound
Mastopathy is nodular or diffuse. With the latter, it is divided into fibrous with cystic mixed. Ultrasound will show them in different ways. With diffuse mastopathy on the monitor, the uzist will see many formations evenly distributed over the chest.
A recognizable sign of such a mastopathy of this type: there are seals in the connective tissue, small cysts, the ducts in the mammary glands are dilated. Often, an ultrasound examination shows that there is mastopathy in a mixed form. Fibrocystic mastopathy on ultrasound will be visible.
With a cystic form, many small cysts will be visible on the screen of the device. They appear due to the fact that the connective tissue grows. If the mastopathy is nodular, then there is a risk that one, several or many nodules will develop into neoplasms. Most often, such a degeneration is observed with diffuse mastopathy. If the doctor finds 2-3 or more of these neoplasms, he will diagnose fibroadenomatosis.
Fibrocystic mastopathy. Puncture
The puncture is done with a needle. She is thin. The method is called aspiration. From the inside, the contents of the cyst will be removed. In addition to diagnostics, therapy is also performed.
The contents of the cyst are most often yellowish-gray, but if the cyst has been in the chest for a long time, the fluid may be greenish or brownish-black. Cytological fluid examination is done very rarely, since the information content of the method is low.
Taking a puncture is a popular procedure. Samples will be sent for cytological with histological examination. If the aspiration result is negative, then the cell biopsy is ordered again.
Do you feel pain during a breast puncture? It will be felt a little, but to find out if you have fibrocystic FCM, the procedure is necessary.
Decrypting the data
Why does a specialist perform an ultrasound of your mammary glands? To make sure there are no cysts or growths in the connective tissue. And if they are, then prescribe treatment in time, if necessary, then an operation and save your life. On the screen of the ultrasound machine, the image will be in black and white. The specialist will decipher the received data.
The data is decrypted according to certain criteria:
- Formation of the correct or irregular form?
- The contours are even or of different shapes. Are they clearly defined or blurry?
- Does the skin on the chest have a different color than the main one?
- How echoic are the tissues?
If the specialist sees a bright area on the screen, it means that the tissues are dense there. Echo density is normal for each organ. The uzist knows these. he has been specially trained for a long time and will decipher them for you.
Echogenicity can be:
- Normal or isoechoic. These areas are gray on the monitor;
- Below normal or hypoechoic. Displayed in black on the monitor;
- High or hyperechoic. Light or white areas are visible on the screen.
With low echogenic fat lobules will have an elliptoid shape. Hyperechoic is the "working area", where the nursing mother will produce milk. A woman stays at different ages and, depending on changes in her body, the echogenicity of different zones changes.
For example, when a woman is pregnant or breastfeeding, the mammary glands contain an increased amount of the glandular element. After menopause, breast tissue is fatty connective tissues. Areas that are anechoic and appear black are most likely cysts containing fluid.
Pathological zones on the echogram
When the uzist sees dark zones in the picture. He understands that there is inflammation in those areas, there is swelling. If the breast tissues are very dense, then light, almost white spots are visible on the screen. It could be cysts.
In glandular breast tissue, increased echogenicity occurs when:
- Seals can form when normal cells in a certain area are replaced by fatty tissue or scarred;
- There are areas where calcifications or calcium salts accumulate.
In the parenchyma or "working area" of the breast, pathological changes can occur. If the echogenicity is increased, then there is a hormonal imbalance in the woman's body. It could be mastitis.
Visible on ultrasound and mastopathy fibrocystic mastopathy. It's anechoic, which means it's a cyst. Sometimes these are signs of pus accumulation or galactocele - a disease of nursing mothers. It is located in the breast, where the milk is located.
When the ultrasonographer finds this anechoic formation on ultrasound, the attending physician will send you for a biopsy procedure. If this is a neoplasm, then it will need to be removed.
It is important for the specialist to accurately describe the contours of the lump or several in your breast. With an uneven contour, the specialist understands that inflammation occurs in the gland. If the seal has uneven cuts, this may indicate that the neoplasm is malignant.
"Advice. When the doctor offers you to do an ultrasound of the mammary glands, agree. If you have a cyst, inflammation or tumor, the pathology will be detected and treatment will be prescribed."
Watch the video about the details of breast ultrasound:
Echo signs of fibrocystic mastopathy are determined using ultrasound (sonography), which is highly informative, safe, non-invasive and modern method breast examinations
Echo signs of diffuse mastopathy are indicators of the disease that were revealed in the process ultrasound diagnostics breast gland of the patient (sonographic method). They may vary depending on the timing of the development of the disease, the age of the patient and the state of health.
The essence of the disease and the causes of occurrence
Fibrocystic mastopathy (FCM) is considered a pathological condition of the breast and a benign formation. Symptoms accompanying the disease:
- seals in the chest;
- cysts that differ from each other in size and shape;
- pain in the chest area;
- discharge from the nipples;
- changes in the contours and size of the breasts.
Important: with bilateral mastopathy, both mammary glands change and are affected, but the changes can be expressed in different ways.
Mastopathy of the mammary glands is common in women of reproductive age. It also occurs in menopausal women.
The main reason for the development of the disease is a violation of the hormonal balance in the body of a woman. Important indicators of the concentration of hormones:
- progesterone;
- estrogen.
The need for ultrasound diagnostics
FCM is treatable if the disease is detected early. Some time ago, mastopathy was not associated with the occurrence of oncological formations in the breast. But modern research in this area allows us to consider this disease as a condition preceding oncological. A mammologist prescribes a study.
Important: FCM is an intermediate stage between a pathological condition and oncology.
For transformation benign education in a malignant, a combination of certain factors must occur. In order to prevent complications of the disease and the onset of an oncological condition, it is necessary to contact a specialist as soon as possible and undergo all the necessary examinations.
For ultrasound of the mammary glands, see the video.
Echo signs of the disease
Important: what are the echo signs of fibrous mastopathy and what they will mean, in each case, you need to check with the mammologist.
The patient is able to determine the symptoms of diffuse fibrocystic mastopathy on her own, probing the chest, standing and lying down.
Used in medical diagnostics:
- analysis of blood composition for hormonal substances and other indicators;
- mammography;
- ultrasonography.
All methods are applied in a complex, guaranteeing the accuracy of the diagnosis.
Important: the diagnosis of fibrocystic mastopathy can occur only after the patient has passed all the studies.
Mastopathy is diagnosed by carefully examining the tissues of the gland using an echographic method, following from peripheral departments glands to the nipple area. The research method is always bilateral, both mammary glands are examined. Even if, the patient only complains about one breast.
With a diffuse form of the disease, the study can show the predominance of one or another tissue, and in this way a diagnosis will be made.
Fibrocystic mastopathy on ultrasound will be determined by the following echo signs:
- thick layer of glandular breast tissue;
- an indicator of the density of breast tissues;
- fibrosis of sections of the milk ducts;
- discrepancy between the condition of the breast, the age of the patient;
- damage to the nipple and its area;
- expansion of the ducts of the gland;
- the presence of cysts.
The study demonstrates that the echo signs of fibrocystic mastopathy differ, depending on the age of the patient.
The older the woman, the smaller the thickness of the glandular layer and the greater the density of the tissues. The highest density figures are reached by the age of 55 women.
Advantages of the method
Ultrasound is the safest, it can be done by young girls and women who are expecting a baby.
Informativity is determined by high resolution. Fibrocystic mastopathy is clearly visible on ultrasound, this method also makes it possible to assess the condition of breast implants, to assess the area of inflammation. In addition, the study can show the condition of the lymph nodes located in the immediate vicinity of the chest.
Important: preventive ultrasound examinations are necessary; to monitor the condition of the breast, a healthy woman should be checked once a year.
This method is indispensable for clarifying the diagnosis of fibrocystic mastopathy. An ultrasound examination is necessary to compile a complete picture of the manifestations of the disease.
Knowing the index of the thickness of the tissue layer and the indicators of echo density will make it possible to draw up a plan for competent treatment and achieve a state of remission of the disease. Gives you the opportunity to live a fulfilling life.
For more information about the disease, see the video.
It is important to know! In women who have not given birth before the age of 25-30, fibrocystic disease (mastopathy) does not cause much concern, but closer to 30, especially during pregnancy and after childbirth, 80 percent of women develop a complication of mastopathy. Along with women who have not given birth, many mothers who devote almost all their time to their baby forget about their health or think that this problem is trifling and will pass by itself. Expectant mothers are in an even more difficult situation - during pregnancy and breastfeeding, many pharmaceutical preparations prohibited. Did you know that mastopathy, if it is not treated in time, making the prevention of the disease, can cause breast cancer. About an all-natural remedy for mastopathy (fibrocystic disease), compatible with breastfeeding and pregnancy read here...
