Do mastopathy (fibrocystic disease) need to be treated?

The growth that occurs in the tissues of the mammary glands, which is benign in nature, but has the ability to progress to the stage of oncology, is called mastopathy. This is a serious disease that requires consultation with a doctor and following his prescriptions.

The method of treating mastopathy is selected based on the level of severity of the disease and concomitant diseases. The main methods are drug treatment and surgery. Diffuse forms of the tumor can be treated with medications. Nodular neoplasms are treated through surgery.

Fibrocystic mastopathy requires a systematic approach to treatment, especially conservative treatment. Drugs and dosage are selected individually, based on the presence of concomitant pathologies, tumors and other factors. Considering the relationship between the endocrine system and gynecology, the prescribed treatment is carried out with hormonal drugs.

Antiestrogens occupy a special place - Tamoxifen is the most well-known drug aimed at eliminating the increased amount of estrogens. Raloxifene is another drug that blocks alpha-estrogen receptors in the endometrium and mammary gland, eliminating benign neoplasms. "Bromocriptine" is also widely used in gynecology, and for mastopathy it is prescribed to suppress excess hormones.

Gonadotropins successfully show themselves in the treatment of mastopathy. Danazol, Nafarelin, Buserilin and their analogues block the function of the pituitary gland, suppressing the production of unnecessary hormones. Livial is used to treat women with menopausal disorders. The drug suppresses the secretion of gonadotropins.

Hormonal contraceptives play an important role in the treatment process - it has been proven that regular use of drugs throughout the year reduces the possibility of getting sick by 75%, and the development of breast cancer by 2 times.

Progestogens are also actively involved in the treatment process - Progestogel and Duphaston contain progesterone, which is necessary to restore the function of the mammary glands. The purpose, dosage and method of administration are prescribed by the attending physician.

Non-hormonal drugs are used to reduce swelling and pain, respectively, and to prevent fibrotic changes. Indomethacin, Naproxen and Ibuprofen do an excellent job of these tasks.

Enzymes, as practice and regular monitoring of patients show, also play a significant role in treatment - Wobenzym and its analogues help relieve inflammation, swelling and boost the immune system.

Phytohormones contained in sprouted wheat grains, seeds and berries have anti-cancer properties, so they should be added to the diet of patients.

general information

The formation of the mammary glands begins in the perinatal period, at 6 weeks from conception. From birth to puberty, the ducts lengthen and the nipples increase in size. When puberty begins, the ducts branch, glandular lobules are formed, and the morphological structure of the organ changes. The intercellular and interlobar segments consist of connective tissue. These areas are subject to hormonal changes.

Full development of the mammary glands ends after puberty and the second trimester of pregnancy. During the period from the end of puberty to the third trimester of pregnancy, epithelial tissues are considered immature. They cannot produce progesterone, which increases the risk of developing breast cancer.

Cyclic physiological processes in the body have a huge impact on changes in connective tissues. The structure of the mammary glands is constantly changing. This does not depend on the period of life and age. Often, dysplastic processes develop under the influence of such factors:

• sensitivity to hormonal levels;
• hormones produced by the thyroid gland;
• presence of sexual life and satisfaction with it;
• emotional background.

Benign changes in the mammary glands are called mastopathy or fibrocystic disease. The anatomical features and clinical manifestations of these changes differ significantly. Malignancy occurs, which is manifested by the appearance of pathologically altered tissues and cells. There is a risk of cells degenerating into malignant ones, so experts consider mastopathy as a precancerous disease.

Nowadays, it is a rare woman who does not have mastopathy. The complicated course of mastopathy today increasingly often ends with puncture of the cyst or even removal of the affected sector of the mammary gland. Therefore, every woman should know the signs of mastopathy and the possibilities of its treatment and prevention.

Mastopathy is a benign disease of the mammary gland, manifested in the pathological proliferation of its tissues. It affects about 8 out of ten women and can, without exaggeration, be called the companion of the modern woman. Mastopathy has a significant impact on overall well-being, and in some cases leads to the development of a serious disease - breast cancer.

One of the distinctive features of the mammary gland is that its normal structure is characterized by great variability depending on age, the state of the reproductive system and the period of the menstrual cycle. In this regard, even doctors sometimes find it difficult to distinguish physiological changes in tissue from pathological ones, as well as determine the type of pathology. Mastopathy has many faces. In fact, we can rather talk about a group of diseases - dishormonal dysplasia (developmental disorders) of the mammary gland - which have a complex clinical and histological picture and are united by the general term mastopathy . Hence the many classifications of mastopathy.

Mastopathy is always associated with a hormonal imbalance in the body. Breast tissue is sensitive to the so-called “hormonal swing” that starts in a woman’s body with the onset of puberty and stops some time after menopause. These swings, in turn, are significantly influenced by many external and internal risk factors, of which there are many.

Menstrual cycle and hormones

The menstrual cycle is regulated by two types of reproductive (steroid) hormones produced by the ovary: from the first day to the middle of the cycle, hormones called estrogens are produced, and from the middle of the cycle, when ovulation occurs, gestagens (progesterone), the level of which in the body reaches a maximum before menstruation. In addition, the mammary gland is constantly influenced by hormones from the adrenal glands, thyroid gland and pituitary gland, which are under the control of the cerebral cortex.

Thus, normally, under the influence of hormones, the mammary gland undergoes monthly cyclic changes in the form of engorgement before menstruation and subsidence after menstruation. If, under the influence of some unfavorable factors, the hormonal balance is disturbed, the production of insufficient or, on the contrary, excessive amounts of hormones provokes pathological proliferation of the ducts, connective (fibrous) and glandular tissues of the breast. At the same time, lumps in the mammary gland, characteristic of the premenstrual period, persist after menstruation.

Some researchers associate pathological changes in breast tissue with an excess of estrogen in a woman’s body, the level of which, under unfavorable conditions, does not decrease to almost zero by the end of the cycle, but remains elevated. The cause of the disease may also be an excess production of the hormone prolactin by the pituitary gland, which stimulates the development of the mammary glands, milk production and forms the maternal instinct.

How mastopathy develops

The disease begins with the proliferation of connective tissue, with the formation of small nodules. This is a diffuse form of mastopathy. Its main manifestation is mastalgia - soreness of the mammary gland, which occurs before menstruation and subsides when it occurs, as well as periodically appearing spherical seals in the upper part of the chest. Often women ignore these symptoms without seeing a doctor for years. And they make a dangerous mistake, since it is at an early stage that mastopathy responds well to conservative treatment.

With further development of the disease, dense nodes ranging in size from a pea to a walnut form in the breast tissue. This form of mastopathy is called nodular . Chest pain becomes more intense and can radiate to the shoulder or armpit. The slightest touch to the chest becomes painful. Colostrum, a bloody or clear fluid, may be discharged from the nipple. When feeling the breast, the lobulation or granularity of the tissue is easily determined. At this stage of the disease, pain and changes in the gland do not disappear with the onset of menstruation. Here you can’t hesitate anymore and you need to urgently go to a mammologist.

Main risk factors

Mastopathy is a multi-cause disease associated with both genetic factors and environmental factors and lifestyle factors of patients.

Heredity The hereditary factor is of primary importance. First of all, this is the presence of benign and malignant diseases in maternal relatives. One of the most common unfavorable factors is inflammation of the uterine appendages, because as a result of inflammation, the production of sex hormones is disorganized.

Abortion One of the first factors that can provoke the development of mastopathy is abortion - a gross intervention in the hormonal system of the female body. As soon as a woman becomes pregnant, the entire body begins to prepare for childbirth. The entire hormonal background is completely restructured. The mammary glands begin to prepare for milk production literally from the first days of pregnancy. And suddenly there is a violent reversal of this process. In this case, it does not matter at all how professionally the abortion was performed. In any case, the body does not forgive such jokes.

Diseases of the thyroid gland Most patients with various forms of mastopathy have pathology of the thyroid gland. Hypofunction of the thyroid gland increases the risk of mastopathy by 3.8 times.

Liver diseases An important reason contributing to the occurrence of mastopathy are various diseases of the liver, bile ducts and gall bladder. The liver plays a very important role in breaking down excess estrogen produced. With her illnesses, this ability is reduced and even lost, as a result of which the hormone content increases.

Obesity Obesity , especially when combined with diabetes and hypertension, may play a role.

Irregular sex life Sometimes even a break in sexual activity can trigger the development of mastopathy. Women's loneliness, lack of stable family relationships - all this contributes to the development of pathological processes in the breast. So, as a preventive measure for the disease, we can recommend improving your personal life, and even better, pregnancy and breastfeeding.

Stress A woman is at greater risk of getting sick when she is stressed, neurosed, or depressed. Prolonged mental stress is one of the leading causative factors in the occurrence of mastopathy.

Bad habits Indirect risk factors are addiction to alcohol and smoking. A direct connection has been identified between the quantity and quality of alcoholic beverages and cigarettes consumed and hormonal imbalance, which is the starting point in the development of mastopathy.

Injuries to the mammary gland Even microtraumas are dangerous when in the subway, on a bus you are pressed, squeezed, or accidentally hit in the chest with an elbow or a bag. In general, you need to develop the habit of protecting your breasts. In addition, underwear plays an important role. Under no circumstances should you wear underwear that tightens, squeezes, rubs or pricks. The skin of the chest is almost twice as thin as that on the face, and therefore requires careful treatment. The bra must be exactly the right size—the underwear should never be too small. Avoid push-ups with metal wires. Tight underwear with metal underwires, although very seductive, tightens the breasts and leads to microtraumas.

It turns out that the development of mastopathy is influenced by a woman’s high socio-economic level (diet, career-related stress, ecology of metropolises, late birth of the first child, etc.). The risk of mastopathy and breast cancer increases under the influence of such unfavorable factors as lack of pregnancy or late first pregnancy, lack of breastfeeding or its short period. Almost all researchers focus on the age at which the first and subsequent births occurred. In particular, women who give birth to two children before the age of 25 have a three times lower risk of developing breast disease compared to those who have only one child. Age is also an important risk factor for cancer. Typically, the incidence of breast cancer increases progressively with age and reaches 30-50% by age 75.

Often all these different factors are in a complex relationship, forming an overall unfavorable background. This is what dictates the need for regular comprehensive examination of the mammary glands (self-examination, mammography, regular consultations with a mammologist) for almost every woman.

Symptoms of mastopathy

— Pain in the chest, shoulder or axillary area — Feeling of fullness, swelling, heaviness in the mammary glands — Dull and aching pain in the mammary glands — Discharge from the nipple (colostrum, serous, sometimes bloody) — Appearance of cracks in the nipples, retraction of the skin or nipple — Hardening, thickening of the mammary glands - Tumor in the mammary gland

— The appearance of “nodes” in the mammary glands — Enlarged lymph nodes in the armpits

Painful sensations can be spontaneous or occur only with pressure, ranging from a feeling of slight pain to distinct tenderness caused by even the touch of clothing to the chest. The pain can be aching, stabbing, radiating to the neck and shoulder.

Also, you should be wary of irregular menstruation, pain before menstruation, discharge from the nipples and any changes in the structure and shape of the mammary glands.

Often women ignore these symptoms, mistakenly believing that pain and swelling before menstruation is the norm. This is wrong. Normally, your breasts should not hurt under any circumstances.

If you find any of the above signs, contact your doctor immediately. Because it is at an early stage that mastopathy responds well to conservative treatment.

Diagnosis and treatment

The main diagnostic methods that provide the most complete picture of the condition of the mammary glands are ultrasound and mammography. To finally confirm the clinical diagnosis and clarify the extent of the process in the mammary gland, the doctor may prescribe additional examinations (blood tests for hormones, cytological and histological examination, etc.). Their necessity in each specific case is determined individually by the mammologist.

Only after a thorough examination, the doctor determines treatment tactics. To effectively treat mastopathy, it is first necessary to identify the form and type of mastopathy, and the causes of its occurrence. That is why proper treatment of mastopathy begins with identifying the cause.

To do this, you need to undergo a standard list of examinations:

- examination by a mammologist - ultrasound of the mammary glands, axillary and clavicular areas on the 5-7th day from the start of menstruation, - blood test for thyroid hormones (T3, T4, TSH), ovarian hormones (progesterone, estradiol, FSH), preferably tumor markers - cytological examination of nipple discharge (if any) - ultrasound of the pelvic organs (uterus, appendages) - consultation with a gynecologist

Only after receiving the results of the examination can you determine the method and amount of necessary treatment that is suitable for you, taking into account your hormonal characteristics and the presence of concomitant diseases.

The lack of a uniform standard for the treatment of mastopathy is explained by the multifactorial nature of the occurrence and development of the disease. Taking this into account, treatment should be individualized depending on your age, the nature of the menstrual cycle, ovarian function, concomitant gynecological diseases (endometriosis, uterine fibroids, endometrial hyperplasia, polycystic ovary syndrome), as well as psycho-emotional status and hypovitaminosis.

Don't self-medicate!

You will not be able to independently determine the type and form of the disease, or identify the cause of its occurrence - only a specialist can do this. This means that you will not be able to choose the necessary and correct treatment, even if you “prescribe” yourself medications for the treatment of mastopathy, which are widely advertised in the media. By self-medicating, you will only delay time, possibly getting rid of the symptoms of the disease for a short time. But since the cause will remain, pain and lumps in the mammary gland will bother you again and again. Only long-term complex treatment under the supervision of a doctor will give the desired result and lead to relief from mastopathy.

By contacting our clinic, you can always get advice from a professional mammologist who is always ready to help you in the diagnosis and professional treatment of mastopathy. Be healthy!

Why does the disease occur?

There are a large number of provoking factors that contribute to the development of mastopathy:

1. Stress experienced. There are emotional outbursts in the life of every woman. This is dissatisfaction in family life, dissatisfaction with one’s position in society, various domestic conflicts, and troubles in the professional sphere. With any stress, functional disorders occur in the neuroendocrine system.
2. Fertility. Number of pregnancies, births, abortions, age at birth, duration of breastfeeding, menarche and menopause.
3. Diseases of a gynecological nature, in particular diseases of the pelvic organs, which are chronic inflammatory in nature.
4. Disturbances in the endocrine system. Thyroid dysfunction, metabolic disturbances, polycystic ovary syndrome, diabetes mellitus.
5. Diseases of the liver and bile ducts.
6. A predisposition that is inherited.
7. Lactation period is too short or long. Refusal of breastfeeding.
8. Lack of iodine in the body.
9. Breast injuries.
10. Obesity.
11. Bad habits – smoking, alcohol abuse.
12. Tumor in the pituitary gland or hypothalamus.

What does an increase in temperature indicate?

An increase in temperature during mastopathy is an alarming signal that cannot be ignored. If the thermometer rises above 37º, this indicates the presence of abnormalities in the tissues of the mammary glands or organs of the reproductive system. Some women immediately begin to panic, regarding a high temperature as an “alarm bell” for the progression of the disease, but such conclusions are erroneous. With mastopathy, diffuse abnormalities and proliferative changes occur, which are never accompanied by fever. An increase in temperature can be a consequence of some complications:

• inflammation (in the gland itself or outside it);
• infections;
• damage;
• necrosis (death) of part of the tissue.

In rare cases, temperature can be the result of physiological changes in which the glandular tissue is subjected to stress and a hormonal imbalance appears in the body. Against the background of such changes, the thermometer readings increase.

How does mastopathy manifest?

Most often, patients complain of the following clinical manifestations of the disease:

• pain in the mammary glands, regardless of whether they are touched or not;
• increase in gland volume;
• swelling and puffiness;
• discharge from the nipples that resembles colostrum.

Pain can be felt in the armpits, shoulders and shoulder blades. Most often, the symptoms of fibrocystic changes and premenstrual syndrome are combined. These conditions are manifested by the following symptoms:

• migraine-like headaches;
• swelling of the face, arms and legs;
• attacks of nausea, sometimes vomiting;
• bloating, indigestion.

If the neuropsychic form of premenstrual syndrome develops, it is manifested by irritability, depression, weakness, anxiety, tearfulness, and aggressiveness. It is not always possible to quickly determine the cause of pain, since not only pathological changes in the mammary glands are accompanied by such symptoms. Painful sensations accompany the development of cervicothoracic osteochondrosis, radiculopathy, and intercostal neuralgia. In such cases, appropriate therapy is needed, thanks to which it is possible to relieve unpleasant symptoms.

Mechanism of temperature rise

Fever is the body’s protective reaction to damage. An increase in thermometer values ​​above normal occurs due to the influence of special substances - inflammatory mediators, called pyrogens. These are particles of dead body cells or fragments of destroyed microbes that warn the thermoregulation center of possible danger.

Mastopathy is not characterized by fever; the disease proceeds latently for a long time and begins to worry when the seals reach medium size and begin to compress the vessels, nerves and milk ducts. Fibrous mastopathy is a common form of the disease. Let us consider the pathogenesis of increased temperature using this form as an example.

It goes through several stages:

• malnutrition of glandular tissue;
• cell degeneration and formation of connective tissue nodules;
• proliferation of pathological formations;
• damage to seals and release of pyrogens;
• the effect of mediators on the thermoregulation center, vasoconstriction and increased heat production by muscles.

In most cases, mastopathy occurs without fever. Inflammatory mediators appear only during complications or in the case of concomitant pathology.

Types of fibrocystic disease

In most cases, the nature of mastopathy is diffuse, this is manifested by the following changes:

1. The predominance of glandular structures – swelling, proliferation of glandular tissues. This form is the most favorable.
2. The predominance of fibrous structures: swelling occurs, interlobular connective tissue septa increase in size and begin to put pressure on the surrounding tissues, the lumen of the ducts narrows, sometimes it becomes completely overgrown.
3. The predominance of cystic changes: one or more elastic cavities appear, which are filled with liquid contents and clearly demarcated from the surrounding tissues.
4. Mixed form - the number of glandular lobules increases, the connective tissue interlobular septa grow and increase in size.

The nodular form of mastopathy is the most unfavorable among all. In addition to the changes noted above, one or more nodes appear. In this case, an adenoma or fibroadenoma is diagnosed. This is a benign breast tumor. It can appear at any age, with women at risk from 20 to 40 years old. Sometimes fibroadenoma can quickly increase in size and reach a diameter of more than 10 cm. This happens during puberty. Transformation of fibroadenoma cells into malignant ones occurs in 2% of women.

It is worth paying attention to such a symptom as bloody discharge from the nipples. Such clinical manifestations arise as a result of papilloma, which forms inside the ducts. It ulcerates and bleeds. This is a serious reason for concern and a visit to the doctor.

Prevention

A unified system for the prevention of mastopathy has not yet been developed. However, doctors recommend adhering to the principles of a healthy lifestyle, avoiding stress, and normalizing nutrition. Caffeine is known to have a negative effect on a woman's hormonal levels. Therefore, doctors recommend limiting coffee intake as much as possible. In addition, a significant factor in maintaining women's health and normalizing hormonal levels is regular sex life.

With timely diagnosis, correction of mastopathy is effective in most cases. However, even after completing the full course of treatment, relapses are possible, so medical experts recommend visiting a mammologist at least twice a year. “SM-Clinic” is open seven days a week, appointments are made around the clock.

Sources:

1. Gorin V.S. Principles of treatment of mastopathy / V.S. Gorin [and others] // Siberian Medical Review. — 2008.
2. Konstantinov V.K. Mastopathy: clinical picture, diagnosis and treatment / V.K. Konstantinov, I.P. Stepaeva // Health and education in the 21st century. - 2007. - No. 10. - P. 374-375.
3. Manusharova R.A. Treatment of fibrocystic mastopathy / R.A. Manusharova, E.I. Cherkezova // Medical Council. - 2008. - No. 3-4. — P. 20-26.

How to diagnose

When a woman turns to a mammologist with complaints or for a preventive examination, the doctor performs the following diagnostic procedures:

• examination, manual examination of the mammary glands, axillary, subclavian, regional lymph nodes;
• ultrasound examination of the mammary glands and lymph nodes;
• X-ray mammography is a mandatory test for all women after 40 years of age;
• laboratory blood tests - general analysis, biochemical parameters, hormone levels, tumor markers;
• if cysts are detected, their tissue is punctured and further cytological examination of the material is carried out;
• if nodular formations are detected, their contents and cells are collected, after which a cytological examination is performed.

Features of treatment

The temperature drops only when the threshold of 37.5º is exceeded - in other cases, bed rest and rest are prescribed. If there is a fever, the doctor, based on the examination, may prescribe:

• antipyretics (“Voltaren”, “Nurofen”) - to eliminate fever;
• analgesics (“Nise”, “Ketanov”) - to relieve pain;
• hormonal agents (“Gestagens”, prolactin inhibitors) – in the absence of contraindications;
• antibiotics - if there is an infection.

Therapy can also be supplemented with cool compresses and distraction procedures. It is strictly forbidden to heat the breasts and use rubs with spices.

Elimination of discomfort during mastopathy

If you are looking for a way to relieve mastopathy pain, try the following options:

1. First, you should contact a mammologist who will make a diagnosis and prescribe painkillers, hormonal drugs or anti-inflammatory drugs.
2. Normalize your diet by eliminating sweets and fatty foods, alcohol and coffee.
3. Drink at least 1.5 liters of water per day.