Mastopathy: symptoms and treatment
Mastopathy is a benign (in the vast majority of cases) disease of the mammary glands that occurs against the background of hormonal imbalance in the female body. Mastopathy, the symptoms of which are found in women of the reproductive age group (within 18-45 years), is characterized by the development of pathological processes in the tissues of glands in the form of proliferation.
As we already noted, mastopathy occurs in women in the age range of reproductive age, that is, at the age of 18-45, with a peak incidence observed in the period of 30-45 years. When considering the physiological features peculiar to the female body, the essence of the development of this disease is quite easy to explain, we will try to do it.
To begin with, consider what the mammary gland consists of, and it consists of a glandular tissue, which is based on a significant number of tubules with cells that promote the release of milk. This glandular tissue in each gland is divided into lobes (in the amount of 15-20), they also, during lactation (actually breastfeeding) provide the allocation of milk, which is accompanied by the opening located at the top of the nipple ducts. In the interlobar regions of the mammary glands, a sufficiently dense connective tissue is elicited, by means of which it is ensured that the lobes are maintained while forming a unique capsule in the mammary gland with it. This capsule looks like a dense shell that fixes the mammary glands in relation to those tissues that surround it. In addition, the mammary glands also have adipose tissue, through which the roundness of the shape of the breast is created. When considering healthy women, it can be noted that the ratio of connective tissue (providing maintenance) and glandular tissue (in other words, working) is determined by constant and clearly defined limits in the mammary glands, which ensures their normal structure and normal functioning.
Every month the body of a woman undergoes cyclic changes that occur against the background of hormonal effects on the part of progesterone and estrogen. These hormones not only provide regulation of the two-phase menstrual cycle, but also directly affect the tissues of the mammary glands.
If we consider the processes of similar hormonal effects in normal, then in this case the effect of estrogens formed within the period of the first phase of the menstrual cycle (before ovulation) leads to the development of proliferative processes in the mammary glands, which implies the proliferation of cells (proliferation) . In turn, progesterone, formed during the period of the second phase of the menstrual cycle (respectively, after ovulation, prior to the onset of menstruation), leads to a restriction of the action produced by the estrogen, thereby ensuring the inhibition of cell proliferation. Progesterone is a hormone of pregnancy, because its effect leads to an increase in the volume of the mammary glands, and their preparation for breast-feeding takes place. The effect of estrogen leads to swelling of the mammary gland tissue. The mammary glands are enlarged by the second half of the cycle, the increase is insignificant, but quite distinctly by the overwhelming majority of women, which is described by them in the variant of increased tension and sensitivity of the breast.
In the absence of pregnancy, the level of estrogen rises, resulting in mammary glands undergoing changes that lead to the opposite state, that is, to a decrease in their size and compliance with their previous indices. If pregnancy occurs, prolactin in the blood increases in terms, which, respectively, indicates its subsequent impact on the processes of milk production in the mammary glands.
As for the deviations from the norm with respect to the processes under consideration, the picture is as follows. Due to the influence of a number of unfavorable factors there is a disruption of the normal hormonal balance, as a result of which estrogens are formed in excess, but progesterone, preventing this, is formed in an amount insufficient for the normalization of processes. Thus, excessive multiplication of cells in the tissues of the mammary glands occurs, resulting in the development of mastopathy.
In some cases, the development of this disease contributes to the excess production of another hormone — prolactin, it is produced by the pituitary gland. Consideration of the normal situation with the production of this hormone indicates an increased volume of its production during pregnancy and lactation (which is necessary for the appearance and production of milk for feeding the child). In the pathological variant of treating its production, excess is noted outside the factor of pregnancy accompanying this process, respectively, this variant is not just a pathology, but also a condition for the development of mastopathy.
Causes of mastopathy
In addition to the basic conditions identified above, based on hormonal disorders, as a result of which mastopathy develops, there are other causes of this disease. The following factors are related to them:
- tumor formation in the ovaries, their inflammation (salpingoophoritis, adnexitis), uterine myoma, endometriosis — these factors contribute to the violation of the development of sex hormones in the body of a woman, which, accordingly, leads to mastopathy
- adrenal disease;
- diseases associated with thyroid function (diabetes, hypothyroidism, metabolic syndrome with concomitant obesity and increased blood pressure)
- irregular sexual life
- liver disease;
- the presence of urgent psychological problems (neurosis, stress, depression, etc.)
- absence of pregnancy and, accordingly, delivery until the age of 30
- the actual hereditary predisposition;
- Frequent abortions — in this case, the situation is considered by the changes in the functioning of the female body as a whole, which occurs from the very first days of pregnancy, is in the preparation for childbirth and the corresponding changes in the state of the mammary glands, in which abortions lead to hormonal failures And to mastopathy against their background;
- Breast trauma, which is also true when wearing tight and uncomfortable bras with metal bones in them (as a result, it is advisable to isolate the microtraumas to which the breast is exposed in this case)
- refusal to breast-feed a child, untimely interruption of such feeding;
- long-term treatment with hormones
- the presence of chronic gastrointestinal diseases;
- the presence of bad habits (alcohol and smoking);
- deficiency in iodine.
Mastopathy: forms (species)
The peculiarity of the diffusive forms of mastopathy is the actual series of changes that arise in the mammary gland tissue, we distinguish their varieties:
- Diffuse mastopathy, characterized by a predominance of a glandular component (adenosis of the mammary glands). For this form of mastopathy, as can be assumed from its initial definition, the overgrowth of the glandular tissue in the mammary glands is inherent, as a result of which the mammary glands that produce milk are increased.
- Diffuse fibrous-bone mastopathy, characterized by the predominance of the cystic component in the accompanying processes. In particular, this form of mastopathy is manifested by the formation of small cavities containing liquids (that is, bubbles with fluid) that are otherwise defined as cysts.
- Mastopathy is diffuse cystic fibrosis with a predominant fibrous component (mastopathy is fibrous). In this case, mastopathy is accompanied by a predominance of connective tissue in the mammary gland
- Fibrous-cystic mastopathy is mixed. For this form of mastopathy, the proliferation of connective tissue with the simultaneous appearance of cysts (cavities) in the mammary gland is characteristic.
In nodular forms of the disease, the mammary glands are locally affected (that is, the mammary gland is not completely affected, but only in certain segments). Taking into account the peculiarity of the lesion in nodal mastopathy, the compaction sites are of limited nature, and these seals develop after the previous diffusive form of mastopathy. The most common form of nodal mastopathy is fibroadenoma. This education has a rounded shape, it is quite dense and mobile. Most of the fibroadenoma is formed in women at a young age. Education is benign, its elimination is done mainly through surgical intervention.
Let’s summarize the main points concerning varieties of mastopathy. Nodal mastopathy — mastopathy, the symptoms of which are manifested against the background of single seals; Fibro-cystic mastopathy — symptoms manifest themselves against the background of the development of cysts, as well as fibroaden and papillomas (intra-flow); Cystic mastopathy — symptoms are manifested in the background of the formation of cysts; Diffuse mastopathy — the symptoms are manifested against the background of the appearance of many seals in the mammary glands. In general, fibrotic mastopathy is a mastopathy, the symptoms of which indicate the relevance of a benign process of nature, in which cysts, fibroses and dense nodules are formed in the mammary glands. Let us dwell in more detail on the symptoms of mastopathy, in which we distinguish some features inherent in each of the varieties of its forms.
The most common signs of mastopathy are the following manifestations of this disease:
- tenderness, marked in the mammary glands, which has a constant or periodic character of manifestation, and the intensification of this soreness often occurs at the beginning of menstruation, and the fading — to its completion
- allocation of nipples (reminiscent of colostrum, etc.)
- a feeling of appearance in the mammary gland of the compaction
- the appearance of nodules in the gland
Most often, the manifestations of the disease in question are the appearance of seals in the tissue of the gland, their character is tumorous (an actual feature of nodal mastopathy). Another form of the disease, diffuse mastopathy, is characterized by the fact that the touch with her breast tissue is painful and somewhat dense. Fibrous-cystic mastopathy combines the changes indicated in the previous variants. As a rule, the changes occurring in the gland are detected from the upper part of it.
The peculiarity of fibrocystic mastopathy is that its course, in contrast to, for example, a disease like breast cancer, consists in the defeat of both glands at once (in cancer, only one of the glands is affected). As can be determined directly from the definition of this form of mastopathy (fibrocystic mastopathy), the changes occurring in it have a fibrous character and a cystic character, with predominantly one of these components predominant.
When considering these components in particular, the following picture is formed. Thus, the predominant fibrous component is characterized by the appearance of compaction. If the cystic component predominates, the gland tissues in this case contain a number of cysts in the area of the milk ducts (i.e., the microcyst). The onset of the disease in this case is accompanied by so small their formations that they can not be recognized either by palpation (probing) or by ultrasound — the nature of the changes can be traced in this case except by using a microscope for this purpose.
Let’s proceed to a more detailed examination of the listed symptoms.
- Breast soreness
The pain that occurs with mastopathy can be described by nature as aching, in some cases — accompanied by a feeling of heaviness, concentrated, as is clear, in the mammary glands. The pain intensification occurs within the premenstrual period (which we already noted earlier in one of the two phases of the cycle, against the background of increased production of estrogen). When mastopathy pain is not only local, but often irradiates (spreads) to the scapula or to the arm, neck.
Pain is one of the main symptoms that indicate mastopathy, however, despite this, about 10-15% of patients do not experience it. In this case, palpation and examination determines the same changes that accompany the course of the disease in those women who have pain. Such a course of the disease can be explained, for example, by the difference in the threshold of pain sensitivity, individual for each patient individually.
Pain associated with mastopathy is related to the fact that the actual processes in the disease lead to compression of the cervical structures and connective tissue of the nerve endings, while simultaneously involving these nerve endings in the sclerosed tissue.
About 10% of patients face an increase in lymph nodes in mastopathy (they are affected in the axillary region), as well as with a certain degree of their soreness.
- Breast Augmentation in Volumes
This symptomatic manifestation is the periodic engorgement of the glands, which is connected, as we noted earlier, all with the same menstrual cycle. Such engorgement occurs due to venous stasis, as well as swelling, to which the connective tissue is exposed. On average, the increase in mammary glands occurs within the limits of 15%, which is also accompanied by increased sensitivity of the mammary glands (it consists in the characteristic discomfort noted during palpation), and, again, morbidity. In some cases, sensations are accompanied by discomfort in the abdomen and headaches, anxiety and general nervous irritation. Such a symptomatology generally determines the premenstrual syndrome.
- Pulling out of your nipples
By the nature of the discharge from the nipples with mastopathy can be very different. So, they are abundant (which is their independent manifestation) or situational (that is, appearing only when pressing on the nipple). Excretions from the chest can be either transparent or whitish, or brown. A special danger is the appearance of bloody discharge — a similar manifestation in mastopathy indicates the transition of the process into a malignant form of the flow. It is important to understand that regardless of the color, nature and consistency of discharge from the chest, you must immediately visit the appropriate specialist!
- Node / Node Appearance
In the case of nodal mastopathy, a node (or nodes) is identified, with clearly identifiable contours. As for the size of such a node, they can reach various limits. It is often difficult to determine what is relevant in a particular case, nodal mastopathy or breast cancer. Accordingly, for detailed specification of the nature of this tumor, additional measures of diagnosis are applied.
In diagnosing the disease, various methods are used, we will distinguish them below:
- Palpation (palpation) of glands. This method of research allows you to make a primary diagnosis yourself, which provides an opportunity for early detection of the disease. Palpation by itself implies, as noted, palpation, respectively, with its help you can determine the features of the structure of the mammary glands, as well as to determine whether there are densities in the chest, whether there is soreness. The doctor also performs palpation, which is done to establish a preliminary diagnosis and then focus on additional diagnostic measures.
- Mammography. It is a study in which an x-ray of the glands is done. Mammography allows you to determine even the presence in the glands of small-sized seals, the detection of which when palpation is not possible.
- Ultrasound. Using this procedure, it is possible to detect changes that are affected in a particular case by the mammary glands (diffuse, nodal changes). Combination of this method with the previous one, mammography, makes it possible to determine mastopathy with the greatest efficiency according to the diagnostic measures already considered.
- Puncture. Used to investigate nodal neoplasm. The use of this method allows us to determine the nature of the structure peculiar to the node with a sufficiently high degree of accuracy, and also to perform simultaneous differential diagnostics (isolating mastopathy from a number of other diseases relevant to the mammary glands, for example, this may concern breast cancer, etc.) . For a puncture a syringe is used, the introduction of the game is carried out in the breast node, which is done to remove its cells and for later study already under a microscope.
If there are some difficulties in diagnosing, then additional measures are applied, for example, doktografiya, doplerosonography, etc.
Breast examination is particularly important for women who have crossed the age threshold of 35 years, because it is from this time that the relevance of this type of hormonal changes, which subsequently develop quite dangerous diseases. In particular, it is necessary to pay special attention to their own health in this regard for those women who have previously been diagnosed with breast cancer (mother, aunt, sister) among the next of kin.
Primary self-examination for mastopathy is carried out after the end of menstruation — it is during this period that the signs of the development of breast diseases manifest themselves in the most pronounced form.
- Self-examination in lying position:
- mentally divides the breast into four parts (side, bottom, top)
- Each of the departments is examined in detail for the presence of seals or nodules in it.
- Self-examination in front of a mirror
- it is necessary to raise your hands up and evaluate the characteristics of the external contours of the chest, nipples: no hollows should appear on the chest, the nipples in shape should correspond to the right characteristics
- each nipple is carefully drawn one after the other, which makes it possible to verify the absence / presence of selections.
About the development of diseases of the mammary glands, evidenced by such signs as:
- appearance of wrinkles on the skin of the mammary glands
- probing the seals
- skin retraction detection
- the presence of pain, incl. With their spread to the scapula, arm or neck;
- changing the shape of the nipples, their color, highlighting them.
For an in-depth study of the independent conduct of an initial survey, see below.
The basic principles used in the treatment of the disease we are considering are the normalization of the hormonal background (that is, the normalization of the relationship in the blood of sex hormones), as well as in eliminating stresses while simultaneously increasing the body’s resistance to them. In addition, of course, local treatment of glandular tissues is also performed. As noted in the description above, nodal mastopathy (fibroadenoma) is primarily subject to surgical removal (similar surgical intervention is defined as sectoral resection).
Treatment of mastopathy should be complex, and its greatest effectiveness is achieved with the use of a number of endocrine drugs. For example, these are homeopathic preparations (on plant basis), in particular, the following types are used:
- Mastodinon. This drug is nonhormonal, its reception provides normalization of prolactin level in the blood, as well as a decrease in the severity of pain, prevention of the development of premenstrual syndrome. Used in the form of drops (twice a day for 30 drops, diluted in water) or in the form of tablets (reception: morning and evening for 1 pc.). The course of this treatment is 3 months.
- Cyclodinone. A non-hormonal drug that reduces the production of the hormone prolactin while simultaneously normalizing the menstrual cycle and reducing the concomitant soreness of the mammary glands. It is applied in the form of drops (every morning, 40 drops, diluted in water) or tablets (the time of reception is the same as taking drops, 1 tablet each). The duration of treatment in any form is 3 months.
- Mamakalm — non-hormonal herbal preparation based on kelp (seaweed). The drug is saturated with iodine, due to which there is a corresponding effect, aimed at ensuring the normalization of thyroid functions. In addition, the drug is also aimed at reducing the manifestations of soreness in the chest and pain accompanying menstruation. The drug Mamakalm is used in the form of tablets (1-2 tablespoons 2-3 rubles per day). Given that the drug contains iodine, it should be taken with extreme caution by patients with actual thyroid disorders. Admission of this drug, as well as the drugs listed earlier, must be agreed with the attending physician.
Diffuse mastopathy is cured by hormonal therapy in the case of a fairly late stage of the disease course, which is especially necessary in the presence of other forms of hormonal disorders of the body. Also used in the treatment of mastopathy are anti-estrogens, drugs that promote the absence of ovulation and preparations aimed at reducing prolactin levels (in addition to the previously noted mastodinone).
Expressed painful feelings require a restriction in the reception of coffee, tea, cocoa and chocolate. In addition, it is important to follow a certain diet, avoiding smoked products and fatty foods, including in the diet as many fruits and vegetables as possible. An important role in the treatment of the disease is also given to vitamin therapy, in which, in particular, attention should be paid to such vitamins that belong to group A and E. By taking vitamins, the inherent functions of the liver improve, this organ is extremely important from the side of providing them with metabolic hormonal processes.
If the disease is detected at an early stage, cure is possible in 99% of all cases. Treatment of mastopathy requires dispensary observation, which, depending on the specific form of mastopathy and other factors accompanying the course of the disease, is on the order of 3-6 months.
If you have symptoms that indicate mastopathy, you should contact a mammalogist or a treating gynecologist. In any case, the treatment of mastopathy should not be delayed or ignored as a necessity, nor should it be done on its own.