Plunges many women into horror, however, such a pathology, especially when detected on early stages, is quite amenable to therapy.
There are several varieties of this disease, one of which is the mixed diffuse cystic fibrous form.
In general, the course of the mastopathy process is determined by individual characteristics female body, according to which the necessary therapy is prescribed.
What is diffuse fibrocystic mastopathy?
Diffuse fibrocystic mastopathy of the mammary glands involves pathological tissue proliferation with the formation of not only fibrous tissue, but also cystic compactions, the elimination of which may require surgical assistance.
This type of mastopathy refers to benign oncological processes, occurring in 35-68% of women of reproductive age.
This form of the disease often acts as a background against which pathological processes of a malignant nature develop. The likelihood of malignancy in diffuse fibrocystic mastopathy is determined by the severity of tissue proliferation processes.
If the growth is pronounced, then the probability of breast cancer formation is almost 32%. With minor tissue growths, the risk of malignant oncology does not exceed 1%.
Causes
However, it is known for sure that such a disease is inextricably linked with hormonal imbalance, because breast development depends on the level of ovarian, adrenal, pituitary and hypothalamic hormones.
For breast pathology of this form, the presence of estrogen deficiency, as well as insufficiency of the progesterone hormone, is typical. But prolactin in fibrocystic diffuse mastopathy, on the contrary, increases.
Hormonal levels are influenced by many factors:
- Abortion;
- Too early attack puberty;
- No history of pregnancy with natural birth;
- Age after 35;
- Late onset of menopause (over 55 years of age);
- Short lactation or a woman has completely given up breastfeeding;
- Presence of bad habits;
- The presence of blood relatives with pathologies of mammary glandular tissue, in other words, a hereditary predisposition;
- Endocrine pathologies against the background of deep stress;
- Inflammation in breast tissue;
- Iodine deficiency state;
- Breast injuries, uncomfortable or tight underwear, squeezing and causing discomfort;
- Gynecological pathologies of a hormonal-dependent nature such as infertility, endometriosis, cycle disruptions or fibroids, anovulation, etc.;
- Thyroid and liver pathologies;
- Pituitary or hypothalamic tumor-like formations;
- Obesity;
- Abuse of hormonal contraceptives and other steroid drugs;
- Lack of regularity in sexual life, lack of orgasms, dissatisfaction with sexual life - all this provokes pelvic congestion, which leads to malfunction of the ovaries and hormonal imbalance.
Species
In terms of prognosis, fibrocystic diffuse mastopathy is classified into non-proliferative and proliferative.
The first type of diffuse mastopathy is characterized by a favorable prognosis, because malignancy of the pathology in this case occurs no more often than in 1% of cases. In the proliferative form, pronounced tissue proliferation is observed, so the prognosis is less favorable and a third of patients have mastopathy.
In addition, diffuse mastopathy is divided into types according to the morphology of the formations:
- The interstitial component predominates;
- Predominantly glandular tissues;
- With a predominance of cystic components.
Signs
Until recently, the mastopathy cystic fibrous diffuse form was considered an absolutely benign pathological process that does not cause malignancy, however, studies in recent years have proven that such a mastopathy form should be considered as a precancerous lesion of mammary glandular tissue.
In other words, diffuse cystic fibrosis, under the influence of certain circumstances, can transform into a malignant tumor.
If a woman, along with fibrocystic mastopathy, has adenosis, multiple cystic formations, hyperplastic changes, as well as extensive growths of mammary glandular tissue, then the likelihood of malignancy of the mastopathy increases fourfold.
In general, this mastopathy form refers to pathological conditions of a benign nature, and it acts as a provocateur of cancer only in certain clinical cases. That is why, even after treatment of such a pathology for preventive purposes, a woman needs to be systematically observed by a mammologist.
The main signs of fibrocystic diffuse mastopathy are:
- Painful symptoms. They may appear unexpectedly or upon palpation. Pain can manifest itself in the form of minor discomfort or severe pain. Often, painful symptoms are accompanied by a feeling of tightness, puffiness or heaviness in the chest and can radiate to the armpit or shoulder area;
- Against the background of the mastopathy process, a secretion may begin to be released from the nipple, similar to colostrum or having a greenish-yellowish tint. Sometimes the secretion takes on a brown tint, similar to blood - this is a dangerous manifestation that requires immediate intervention;
- A palpable examination of the mammary glands reveals distinct lumps.
Diagnosis of mammary glands
The presence of such a disease can be detected through self-examination by palpating the mammary gland.
In addition, ultrasound diagnostics is used, which usually confirms the presence of pathology.
It is also highly informative, which is based on X-ray examination.
To clarify the form of mastopathy, an MRI may be additionally prescribed from the extracted biomaterial. A laboratory blood test for hormonal composition is also carried out.
Principles of treatment
The basis is the elimination of hormonal imbalance. The choice of prescribed drugs depends on the characteristics of the hormonal background. In accordance with the test results on the level of estradiol, progesterone, estrogen, prolactin, the doctor makes a conclusion about the choice of specific drugs that correct hormonal levels.
Cystic formations in mammary glandular tissues are often treated by puncture. First, the contents are pumped out of them, then sclerosing solutions are injected into them, however, such therapy is appropriate only for mastopathy that does not have signs of malignancy.
In especially severe cases, surgical intervention is necessary to perform sectoral removal of the formations. In the future, the removed tissues must be sent for histology. A cystectomy (husking) can also be performed.
Drug treatment involves taking several groups of medications:
- Hormonal drugs;
- Estrogen inhibitors;
- Contraceptives for oral administration.
If a woman is bothered by intense pain, then additional medications are prescribed to relieve pain symptoms.
Forecast
A timely visit to specialists at the slightest suspicion of the development of mastopathy significantly increases the favorable prognosis.
When the pathological process is neglected, there is a high probability of malignancy of fibrocystic formations in the breast. In the initial stages of mastopathy, treatment may be limited to minor adjustments in life, diet and the prescription of certain medications.
Therefore, it is better to regularly conduct preventive self-examination and, if suspicious lumps are detected, to visit a specialist, rather than to start mastopathy and lead it to breast cancer.
Prevention
As a preventative technique, experts recommend regularly performing a self-examination procedure. It is better to do this in the days after the end of menstruation.
Considering that the absence of pregnancy and childbirth provokes pathology, the conclusion suggests itself - such conditions will help avoid the development of mastopathy. And after childbirth, it is recommended to breastfeed the baby until one and a half years.
It is extremely important to give up bad habits, abortion, unhealthy food and a sedentary life. Don't limit sexual relations, sex life should be regular.
Only when a woman is satisfied with her life, relationships and social aspects, will she be able to avoid many health problems, including mastopathy.
Video about breast self-examination:
Fibrous-glandular mastopathy is a pathological process of proliferation of breast tissue with a predominance of the glandular component. The main reason The development of this disease is caused by hormonal imbalances in the body.
Despite the fact that mastopathy is quite easy to treat, it is important not only to adhere to all the recommendations of the attending physician, but also to identify emerging problems in a timely manner. After all, pathological processes in the chest often lead to more serious diseases in the body.
Causes
Fibrous-glandular mastopathy or adenosis is a disease of the mammary glands, which is accompanied by the appearance of specific compactions.
They can occur in one breast or in both at once. In addition, during diagnosis their number and size are determined. Therefore, in medical practice, a distinction is made between a single formation and multiple compactions.
During their functioning, the mammary glands constantly produce certain hormones - estrogen and progesterone. A deficiency or excess of one of them disrupts the entire hormonal balance, which subsequently leads to the proliferation of connective and glandular tissue.
Most often, mastopathy affects the mammary glands of women after 35 years of age. This is largely due to natural changes in the body. But besides this, irritating factors that provoke hormonal imbalance are:
- frequent stress;
- treatment with hormonal drugs;
- irregular sex life;
- abortions;
- miscarriages or infertility;
- impaired metabolism;
- problems with the thyroid gland;
- late pregnancy;
- injuries received.
Doctor's recommendation: In order to prevent serious complications and detect lumps in time, experts recommend that all women regularly conduct self-examination of their breasts. But besides this, it would not be superfluous to systematically visit a mammologist to conduct an examination of the mammary glands in a hospital.
Regardless of what factors provoked the development of mastopathy, it is necessary to seek help from a specialist in time. Indeed, in some cases, the spread of the disease can cause the development of cancer cells in the formed compactions.
Clinical picture
The main symptom of fibroglandular mastopathy is swelling of the tissues and the formation of specific compactions in them.
In many cases, pain intensifies during menstruation. Dependencies on menstrual cycle The mammary glands swell, and touching the breast causes severe pain.
Also, during the development of the disease, a woman develops specific discharge from the nipples. They are usually yellowish in color and have a consistency similar to the colostrum that women experience after giving birth.
But spotting may already indicate the development of mastopathy into breast cancer. Swelling of the tissues causes a feeling of heaviness and discomfort. And depending on the type of fibroglandular mastopathy, the main symptoms of the disease may vary slightly.
In medical practice, the following types of mastopathy are distinguished:
- ductal;
- apocrine;
- adenomyoepithelial;
- sclerosing;
- microglandular.
In medical practice, two forms of disease development are also distinguished: local and diffuse. In the first case, mastopathy is the proliferation of tissue in specific locations of the tumor.
For this reason, the breasts change not only in size, but also in shape. Most often, patients with this diagnosis have severe breast asymmetry.
Good to know: in addition to official methods of treating fibroglandular mastopathy, many women resort to using prescriptions traditional medicine. Although such medications have proven themselves quite well during therapy, they should be used in your own experience only after consulting your doctor.
Manifestations are characterized by uniform growth of glandular tissue with the formation of one or more compactions. Such tumors can appear both in tissues and in the ducts themselves.
Diagnosis and treatment
The main procedure for determining the means and methods of treating fibroglandular mastopathy is a complete diagnosis. It includes:
- external examination and palpation of the breast;
- mammography;
- tissue biopsy;
- studies of nipple discharge;
- laboratory tests of blood and urine.
All these procedures allow the specialist to see the full clinical picture of the disease and determine methods for eliminating its main symptoms. In the first stages of pathology development, doctors use conservative treatment.
It includes taking medications such as:
- Hormonal drugs help restore the hormonal levels of the female body.
- Anti-inflammatory drugs relieve inflammation, reduce swelling, and also eliminate pain.
- Sedatives have a calming effect. Thanks to this, the functioning of the nervous system is restored.
- Modulators of the immune system normalize its functioning, promote rapid recovery, and prevent the likelihood of relapses of the disease.
- Diuretics are used more as auxiliary methods of complex therapy that reduce tissue swelling.
It is also quite important to carry out vitamin therapy, which will help replenish our body with all the necessary nutrients. Another way to treat mastopathy is diet.
In this case, it is an aid in the fight against the disease. Thanks to proper nutrition all processes in the body are restored, the functioning of many organs is improved, and the immune system itself is strengthened.
Experts recommend that women adhere not only during treatment, but also after it for the purpose of prevention. Therefore, it is advised to eat a lot of vegetables, fruits, drink more fluids ( green tea, compote), and also reduce the consumption of sweets and flour products. It is completely necessary to exclude the consumption of fatty, spicy, salty and smoked foods from the diet.
Why mastopathy is dangerous, see the doctor’s answer in the following video:
In recent decades, there has been a steady increase in the number of women visiting medical institutions for benign breast diseases. Such pathological conditions, one of which is diffuse mastopathy, are united by the general term “mastopathy” and differ from each other in anatomical and histological features, clinical manifestations and the degree of danger of degeneration into cancer. All these factors determine the high relevance of the problem.
The principle of the formation of pathological changes
Mastopathy, or fibrocystic disease (as defined by the World Health Organization) is a complex of hyperplastic (proliferation) processes in the mammary glands caused by an imbalance of hormones in the body.
In clinical practice, mastopathy is divided into forms:
- diffuse;
- nodal;
- mixed.
The need for such a division is explained primarily by the question of how to treat diffuse mastopathy, that is, with the choice of one or another treatment tactic. Diffuse mastopathy is observed by surgeons, gynecologists, therapists, oncologists and is treated using complex therapeutic agents, nodular mastopathy is treated primarily surgical methods in oncology centers with subsequent drug therapy and is observed only by oncologists.
If previously various forms occurred in 30-70% of women, mainly aged 30-50 years, and among women with gynecological diseases this figure was 75-98%, then in recent years it often occurs even in teenage girls and women in the involutionary period .
Development mechanism
Effective, especially for mastodynia, is a hormonal preparation for external use - 1% Progestogel gel, containing progesterone, identical to endogenous (synthesized in the body). It must be rubbed into the skin of the glands every day for 3 to 4 months. A total of 2 courses are conducted per year for two years.
Danger of the disease
Can diffuse mastopathy develop into cancer?
Directly - no. Mastopathy as such is not considered a precancerous disease. However, their main characteristic feature is the common causative risk factors and the presence of similar hormonal and metabolic disorders. Significant similarities were also noted in morphological changes in nodular forms of mastopathy and malignant neoplasms.
These diseases are often combined. According to histological studies, cancerous tumors occur against the background of benign neoplasms in 46%, that is, on average, 5 times more often. At the same time, the risk of degeneration into a malignant tumor in non-proliferative forms of mastopathy is 0.86%, in moderately proliferative forms - 2.34%, in mastopathy with significant proliferation of the glandular epithelium - 31.4%.
Can diffuse mastopathy develop into nodular mastopathy?
If the risk factors that caused the disease remain, this is possible. The nodular form essentially represents the next stage in the development of mastopathy. It is characterized by the formation in both or one of the mammary glands of one or multiple permanent limited seals (nodes), changes in which no longer depend on the menstrual cycles.
Considering these factors, women with detected mastopathy in any form are subject to appropriate treatment and should be under constant dynamic monitoring.
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Diffuse fibrocystic mastopathy of the mammary glands is a benign tumor disease in which a change in the histological characteristics of the tissue occurs.
The pathology develops mainly in women of reproductive age, and doctors diagnose bilateral diffuse mastopathy.
It is necessary to consider the main causes of this disease, its main symptoms, methods of treatment and prevention.
Classification of pathology
The following types of disease differ depending on the clinical manifestations:
- Diffuse mastopathy with a predominance of the cystic component is characterized by a predominance of cysts in the affected mammary glands. They are clearly visualized during ultrasound examination.
- Diffuse mastopathy with a predominance of the fibrous component - characterized by predominant proliferation connective tissue in the organ. Often such mastopathy leads to the appearance of nodules in the mammary gland.
- Diffuse mastopathy with a predominance of the glandular component is characterized by proliferation. As in the previous case, a large number of compactions and nodules appear in the affected mammary gland.
- Nodular mastopathy is characterized by glandular tissue in certain places, and not in the whole gland.
- Fibrous-fatty mastopathy is characterized by the gradual replacement of healthy connective tissue with adipose tissue. Such changes can occur in the body during the postmenopausal period. This phenomenon is usually not related to pathology. However, the woman’s condition must be constantly checked using mammography.
Why does such mastopathy develop?
Diffuse form Mastopathy most often develops in women due to hormonal imbalance.
All patients in whom these disorders have lasted for more than 2 years are at risk.
In addition, diffuse breast fibrosis develops due to the presence of such predisposing factors:
Modern ideas about the nature of this disease claim that the most significant factor in its occurrence is considered to be excess estrogen and lack of progesterone.
Signs of fibrosis also occur as a result of increased production of the hormone prolactin.
Sometimes the onset of pregnancy can eliminate the formed breast lumps in the gland.
However, if a woman plans to give birth to a child in this condition, she needs to undergo a full clinical examination of the mammary glands: this way, even the slightest degree of tissue change can be detected.
Consultation with the attending physician in such cases is mandatory.
Pathogenesis of mastopathy
Diffuse cystic mastopathy is characterized, as already indicated, by hyperestrogenism and insufficient levels of the hormone progesterone in the body.
In support of the connection between hormonal disorders, it is necessary to consider an example: it has been proven that in women who used hormonal contraceptives at one time, diffuse cystic mastopathy and its other forms are observed much less frequently.
Postmenopausal women do not suffer from mastopathy: if they had a unilateral or bilateral form of this disease, then it usually disappears.
This observation suggests that estrogen levels play a role important role in the development of the disease.
Under the influence of estrogen deficiency, pathologies of other endocrine glands arise - the thyroid gland, pituitary gland, adrenal glands, etc.
They are also capable of causing mastopathy and diffuse fibroadenomatosis. Obesity and liver disease have the same effect on the occurrence of this disease.
Prolactin is produced in the pituitary gland. With mastopathy, the level of this biologically active substance is increased.
Pathological conditions of the pituitary gland precisely contribute to the occurrence of hyperprolactinemia. This substance activates proliferation processes in the mammary glands.
Glandular and cystic fibroadenomatosis of the mammary glands occurs because a large amount of connective tissue is formed, while the ducts of the organs dilate.
Interestingly, if during pregnancy and lactation the level of this substance in the blood increases, the risk of fibrotic changes and cancer, on the contrary, decreases.
Accordingly, you can get fibroadenoma when the body experiences pathological rather than physiological hyperprolactinemia.
Known symptoms of the pathology
The most common symptoms of diffuse mastopathy are the appearance of various types of compactions in the gland, which are clearly visible when palpating the organ.
In addition, such formations are also painful in the second half. monthly cycle.
And before menstruation, aching and pulling discomfort appears in the chest. The pain radiates to the shoulder blade or upper limb.
An examination by a mammologist and self-examination can detect signs of diffuse fibrous mastopathy such as nodes and lumps (single and multiple).
Sometimes they can take on the appearance of bunches of grapes: in this case, almost all parts of the gland are affected. Other symptoms of the disease are:
- moderate degree of breast enlargement;
- edema;
- discharge of clear or bloody fluid from the nipples (the amount may be insignificant or, conversely, scanty);
- enlarged lymph nodes in the axillary region.
However, in approximately 15% of cases, DFCM does not show any symptoms.
This is largely due to the different threshold of pain sensitivity in women and the peculiarities of the location of the nerves in the gland area.
Also, glandular mastopathy may not be detected during palpation. This is why it is so important to undergo a comprehensive diagnostic examination.
It is typical that before menstruation, an increase in such formations is possible.
After it ends, the compaction may decrease. Unlike cancer, fibroadenomatous nodes do not adhere to the skin.
Diagnosis of the disease
Diffuse changes in the mammary glands are subject to comprehensive diagnostics.
The following applies:
- palpation of the glands and lymph nodes, adjacent to them;
- mammography (it must be done in 2 projections);
- pneumocystography;
- ultrasound examination;
- radiothermometry;
- puncture fine-needle aspiration biopsy;
- detailed blood test;
- cytological examination.
The most accurate diagnosis can be made using ultrasound and mammography. The first is harmless to humans, so it can be repeated many times.
Some women do not know what it is and are afraid to undergo ultrasound diagnostics, citing the fact that ultrasound negatively affects the condition of the glands.
This is completely in vain: diagnostics gives a detailed answer to the question about the composition of the tissue and the trend of development of the tumor process.
In terms of information content, this technique for diagnosing mastopathy of the mammary glands is superior to mammography.
Mammography can be used more often in case of fatty tissue degeneration. The fact is that with this disease, echo signs are not so noticeable.
This diagnosis clearly shows the smallest nodes in the gland. Only with mammography can one notice diffuse fibrotic changes in the mammary glands with a diameter of less than 1 cm.
Currently, complex treatment of the disease is used. It mainly depends on the nature of the prevailing changes in the organ.
Thus, in the presence of chest pain, treatment of diffuse mastopathy is inextricably linked with the use of:
- analgesics;
- night primrose;
- homeopathic medicines;
- vitamins;
- herbal medicines.
Progestogen analogues are used for therapeutic and contraceptive purposes (they can be implanted or in the form of injections).
Medroxyprogesterone and norethindrone enanthate have shown their effectiveness. A drug based on medroxyprogesterone (Depo-Provera) is administered by injection (intramuscular) every 3 months.
Complications after such treatment are prolonged periods and the appearance of intermenstrual bleeding.
Depo-Provera does not have any pathological effects on healthy breast and uterine tissue.
Norplant is an implantable drug. It is introduced into the body for 5 years. During this time, it provides the necessary hormonal and therapeutic support.
Recently, information has appeared about the effectiveness of active hormone therapy.
After all, very often diffuse mastopathy of the mammary glands develops precisely because of hormonal changes.
Active use of gestagens is effective in 70% of cases of hyperplastic processes in the mammary gland.
A control examination a year after the therapy shows that glandular mastopathy is regressing, as the density of the glandular and fibrous components decreases. The structure of the tissues has a normal appearance.
The most commonly used oral gestagens are Utrozhestan and Duphaston. The second is a drug analogue of natural progestogen.
Utrozhestan is a progesterone: its form of administration is mixed, that is, the medication can be taken orally and intravaginally. The dosage of these drugs is purely individual.
Women over 45 years of age may also be prescribed certain medications based on male sex hormones.
Among them, Methyltestosterone is highly effective. Testobromlecid contains soothing components that have a beneficial effect on the nervous system and relieve stress.
About non-hormonal treatment
Non-hormonal therapy for seals is an important component of an integrated approach. Here are some recommendations for non-hormonal treatment of fibroadenomas:
- Diet is extremely important. It is necessary to exclude tea, coffee, and chocolate from the diet. At the same time, it is recommended to increase the amount of fruits and fresh vegetables in the daily diet. Animal fats are limited.
- Smoking and drinking alcohol is strictly prohibited.
- It is recommended to exercise, normalize sex life, and eliminate stressful situations.
- It is important to take medications that primarily affect the nervous system. These include sedatives, antipsychotic drugs and tranquilizers. They are prescribed only by a specialist.
- It is important to consume iodine tincture. This is necessary to normalize the functioning of the thyroid gland.
- It is necessary to strengthen the immune system. To do this, take tincture of eleutherococcus and ginseng.
- Non-steroidal anti-inflammatory drugs are prescribed only by a doctor. Their independent use, despite the fact that they have a positive effect and relieve pain, is prohibited.
- Fibrous mastopathy can also be treated with physiotherapy. Electrophoresis, magnetic therapy, acupuncture are indicated.
- Local or Novocaine is recommended if, for example, the patient is diagnosed with fibrous or cystic mastopathy with a predominant pain syndrome. For this purpose, various biologically active food additives are also used.
A number of studies indicate that the treatment of diffuse fibrocystic mastopathy with medicinal herbs quite effective. For this use:
- yarrow;
- horsetail grass;
- tricolor violet flowers;
- rose hips;
- nettle;
- bearberry;
- wormwood grass;
- celandine;
- eucalyptus leaves.
Based on large quantity medicinal plants and microelements, homeopathic preparations have been created to reduce the intensity of the development of FCM and bring the condition of the gland tissue back to normal.
Disease prevention
Prevention of fibrocystic mastopathy comes down to the following measures:
- timely detection and treatment of any disturbances in a woman’s monthly cycle;
- timely diagnosis and treatment of gynecological pathologies;
- rational family planning and childbirth, since diffuse fibrous mastopathy often develops in nulliparous women;
- prevention of abortions, treatment of conditions that threaten miscarriages;
- normalization breastfeeding(it is extremely important for a woman’s health that the period of breastfeeding be longer than 3 months);
- avoidance and correction of traumatic conditions and stress;
- treatment of all pathologies of the endocrine system (such as thyroid diseases, diabetes, pathologies of other internal secretion organs);
- prevention and effective treatment of obesity;
- timely diagnosis of any breast diseases in women at risk (and, above all, in those who have an unfavorable family background);
- combating smoking and drinking alcohol;
- rational use of hormone-containing contraceptives, taking into account the individual characteristics of the body and contraindications (for this you need to consult a doctor).
So, diffuse fibrous mastopathy of the mammary glands is a disease that requires great attention from the woman and timely and effective treatment.
This is why it is important not to neglect annual preventative medical examinations. This is very important for all women at risk to observe.
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This disease is highly treatable. However, it is worth remembering that most therapeutic measures will have to be carried out throughout life.
