Breast adenosis is a benign tumor that refers to the form fibrocystic mastopathy and is associated with the proliferation of glandular breast tissue. This disease is characterized by the formation of dense nodules inside the breast and discharge from the nipple, and pain is often present.
It occurs very often in women after 35–40 years of age, and in girls aged 12–14 years. The cause of the pathology is related to the restructuring of the body. In the International Classification of Diseases, the disease was coded D24.
It is diagnosed by palpation and ultrasound, after which conservative therapy is prescribed. In severe cases, with focal forms of the tumor, surgical intervention is used.
If the disease is not treated, complications will arise that will provoke it, then the neoplasm becomes malignant and metastasizes. Treatment of mammary adenosis is prescribed only by a doctor.
Etiology
The condition of the mammary gland is closely intertwined with a woman’s hormonal background. Disturbances in hormonal levels are observed in girls when the menstrual cycle is just beginning to establish, in women at the beginning of pregnancy, and in women after 40 years of age.
With hormonal imbalance, there is a lack of progesterone and excessive production of estrogen. The main reasons causing hormonal imbalances that contribute to the occurrence of neoplasms in the mammary gland are:
- excess weight - body fat promote the synthesis of estrogen, during which it increases;
- termination of pregnancy in late stages (up to 22 weeks) provokes a sharp hormonal change in the body;
- late pregnancy - in women after 35 years of age, the ovaries begin to lose their functionality, and when pregnancy occurs, they become more active and their work is stimulated, which causes a failure in the production of hormones;
- refusal to breastfeed – leads to stagnation of milk and dilation of the ducts, which causes a change in structure and the formation of a cyst;
- unreasonable use of hormonal drugs leads to failure and disrupts the balance of hormones.
Additional causes of hormonal imbalances are:
- ovarian tumors;
- immune diseases;
- pancreatic diseases;
- liver diseases;
- constant ;
- poor environment;
- nutrition with genetically modified products;
- smoking.
The mammary gland contains three types of tissue: glandular, fibrous, and fatty. leads to the proliferation of one of the tissues.
Breast adenosis is a type of fibrocystic mastopathy when the cells of the milk lobules are affected, which occurs due to strong compression of them by overgrown connective tissue. Epithelial cells enlarge abnormally, increasing the size of the lobules.
Classification
Systematization existing varieties adenous neoplasms occur according to the degree of growth and structural features of the structure.
Based on the prevalence of pathological formations, the disease is divided into two forms:
- Focal adenosis of the mammary gland - develops in the ducts of the breast. A large tumor in the shape of a ball or disk appears in the gland. This nodular tumor consists of lobules contained in a capsule.
- Diffuse adenosis of the mammary gland. It is characterized by the formation of several areas of compaction, without clear boundaries, grows unevenly and covers the entire breast, and subsequently nodules and cysts form.
Based on the type of overgrown epithelial cells, they are distinguished:
- apocrine adenosis - develops in the form of nodules that follow the shape of the breast;
- ductal adenosis - affects the milk ducts, expanding them with the help of epithelial cells with columnar metaplasia;
- sclerosing adenosis of the mammary gland - has a nodular shape, can be easily felt and moved, causes heaviness and pain in the chest, may be accompanied by an enlargement of the nearest lymph nodes;
- microglandular - the rarest among adenoses, associated with the proliferation of the smallest ducts, the tissues are not compressed or sclerosed;
- adenomyoepithelial – rare, manifests itself acutely, is focal;
- fibrous fibrosing adenosis – associated with the development connective tissue in the lobes and ducts, muscle and epithelial elements are subject to changes; this form often degenerates into cancer, and when it is detected, a biopsy of pathological tissue is performed.
The tumor can be located in one place without affecting surrounding areas. In its structure it takes only lobules that are separated by epithelium, its outlines are well defined. This type of disease is called localized adenosis.
Symptoms
The symptoms of the disease will depend on the type of tumor, the degree of growth and the strength of the inflammatory process.
Common features are:
- painful sensations in the chest;
- feeling of heaviness;
- enlarged glands;
- increased sensitivity;
- nipple discharge;
- the appearance of compactions or nodules;
- skin deformation;
- enlarged lymph nodes under the arms;
- worse before menstruation.
Treatment of mammary adenosis should be immediate, since the pathology of a benign tumor can transform into a malignant one. When the neoplasm turns into a cancerous tumor, the consequences will be irreversible: there is a high risk of death.
Diagnostics
When contacting the clinic, the patient is sent for a consultation with a mammologist, who talks with the woman, studies the medical history, listens to complaints, and finds out the presence of parallel gynecological ailments. Then the breast is examined. The patient may be sent for additional examination to a gynecologist, endocrinologist, oncologist, or immunologist.
If a disease such as mammary adenosis is suspected, the following studies are prescribed:
- mammography - it helps determine the location of the tumor, its boundaries and extent of spread, the x-ray shows multiple darkened areas;
- ultrasound diagnostics - helps to identify the condition of the tumor, its structure, density, boundaries, size, ducts and lymph nodes are checked;
- hormonal studies - aimed at clarifying the quantity of sex hormones in the body, checking the concentration of thyroid and adrenal hormones;
- histological and cytological procedures - smears of fluid from the nipples and tissue biopsy are taken.
In addition to hardware studies, the following is prescribed:
- general blood test;
- general urinalysis;
- biochemical blood test.
This is done in order to exclude other somatic pathologies. The disease is differentiated in relation to adenoma, fibroadenoma and malignant tumor.
Treatment
Treatment of mammary adenosis is carried out using complex methods and will depend on the shape of the tumor. Diffuse neoplasms are amenable to drug therapy, while focal ones are treated only with surgical procedures.
Drug therapy will consist of the following measures:
- hormone therapy;
- ointments with anti-inflammatory and analgesic effects;
- herbal remedies.
Depending on the reasons that gave rise to the formation of pathology, diet, sedatives, immunomodulatory, antibacterial and anti-inflammatory drugs may be prescribed.
Therapy takes for a long time– from 3 to 6 months.
Surgical procedures are aimed at excision of the tumor node. If the malignant nature of the formation is revealed, the surgical procedure is secured with chemotherapy. A diet and vitamin-mineral complexes are prescribed.
Possible complications
Late diagnosis and untimely treatment can lead to the following complications:
- inflammatory diseases of the breast;
- formation of cysts in the mammary gland;
Scientists have proven the connection between the disease and the appearance of cancer: in such cases, the risk of malignancy increases five times; according to statistics, it occurs in 32% of patients.
Prevention
The best prevention is early diagnosis and timely treatment. You shouldn’t let the resulting disease get worse.
- do not have abortions;
- use hormonal treatment wisely;
- treat gynecological and endocrine diseases in a timely manner;
- Be sure to breastfeed your baby until 6 months;
- lead a healthy lifestyle;
- stick to a diet and don’t overeat;
- watch your weight.
Pregnancy should be planned and visited by specialists every year to prevent the development of a disease such as mammary adenosis.
Is everything in the article correct from a medical point of view?
Answer only if you have proven medical knowledge
Breast disease that occurs as a result of hormonal imbalance is called adenomatosis. This is one of the forms of mastopathy. Depending on the nature of changes in the structure of the breast, as well as the assessment of the attending physician, diffuse and localized forms of this disease are distinguished.
Adenomatosis of the breast is also called Reclus' disease (in honor of the doctor who first described this disease). The course of the disease is characterized by the formation of multiple small formations in the breast tissue.
Throughout the entire reproductive period, monthly changes occur in the breast tissue of a healthy woman caused by the influence of sex hormones (estrogens and progesterone).
If, for some reason, hormonal metabolism is disrupted in the breast tissue, pathological changes begin to occur, which can lead over time to the development of first diffuse and then nodular adenomatosis.
In some cases, sclerosing adenosis of the mammary gland develops, which is caused by excessive synthesis of the pituitary hormone prolactin. Normally, the production of this hormone increases during pregnancy and lactation, since prolactin affects the production breast milk. If increased production of prolactin is observed outside of these periods, sclerosing adenosis may develop.
Risk factors that can lead to disruption of hormonal metabolism and the development of diseases such as mammary adenosis:
- constant stress and nervous tension;
- bad habits (especially smoking);
- abortions;
- heredity;
- metabolic disorders due to hypothyroidism, diabetes mellitus, obesity and a number of other pathological conditions;
- chest injuries (deformation, bruises);
- late onset of menopause;
- short or long lactation period;
- disease of the reproductive system;
- intestinal dysbiosis;
- early onset of menstruation;
- uncontrolled use of oral contraceptives.
Species
Breast adenosis can be diffuse or localized. Diffuse is divided into fibrous (when only connective tissue grows) and fibrocystic adenosis of the mammary gland (when cysts form in the breast in addition to connective tissue).
Localized adenosis of the mammary gland is distinguished by the fact that pathological changes are observed in a limited area of the gland. If this form of the disease is detected, a biopsy is indicated to exclude breast cancer.
Types of adenosis
Symptoms
The main clinical signs of adenomatosis are a feeling of discomfort and heaviness in the mammary gland, when the patient feels as if the breasts are “expanding.” In addition, chest pain is observed, which usually appears a few days before the onset of menstruation and disappears with the onset of menstruation.
At the initial stages, when only the glandular tissue of the mammary gland grows, compactions are formed that have clear boundaries and can be easily felt during palpation.
When, after some time, the connective tissue begins to grow, palpation reveals multiple compactions, which are a sign that sclerosing adenosis is observed.
In the fibrocystic form of the disease in the mammary gland, in addition to tissue proliferation and the formation of compactions, the formation of cysts is observed, which look like oval or round nodules filled with fluid.
Diagnostics
The main research methods used to diagnose mammary adenomatosis are:
- mammography (is one of the most informative methods for diagnosing breast diseases; it allows identifying small lumps that are not visible when examining the mammary glands and cannot be felt when palpating them);
- Breast ultrasound.
If indicated, the doctor may prescribe additional tests such as:
- biopsy of affected tissues followed by histological examination (carried out to exclude breast cancer);
- ductography (milk ducts are examined);
- blood and urine tests;
- thermography;
- examination of nearby lymph nodes;
- CT or MRI of the breast.
Such a complete diagnosis helps the doctor make the correct diagnosis and develop an adequate treatment regimen for the disease.
Treatment
Breast adenosis is treated by normalizing the hormonal levels in the patient’s body. In order for the treatment to be adequate and effective, it is necessary that it be developed by a specialist (this could be a gynecologist, endocrinologist, or mammologist).
If the cause of adenomatosis is increased production of estrogen, the prescription of drugs that reduce the effect of these hormones on the mammary gland (Fareston, Tamoxifen) is indicated.
To normalize the cycle, oral contraceptives are prescribed (which are chosen depending on the hormonal status).
To treat adenomatosis, which is caused by a dysfunction of the thyroid gland, drugs are used that normalize the production of thyroid hormones.
In addition to hormonal drugs for the treatment of adenomatosis, the use of vitamin complexes, which contribute to the normalization of metabolic processes in the patient’s body.
Together with system medicines use progesterone preparations that have a local effect on breast tissue, as well as homeopathic preparations.
If breast cancer is suspected, or if conservative treatment adenomatosis does not produce results, surgical intervention is indicated, which consists of partial or complete resection of the affected gland.
Prevention
In order to reduce the likelihood of developing adenomatosis to a minimum, the following rules and recommendations must be followed:
- eat right;
- observe the work and rest schedule;
- give up bad habits;
- Avoid stress and nervous tension if possible;
- prevent abortions;
- give birth to your first child in a timely manner (before 30 years of age);
- after the birth of the baby, breastfeed him for at least six months, and do not transfer him to artificial nutrition;
- have regular sex life;
- Perform breast self-examination on a regular basis;
- If possible, avoid exposure to adverse environmental factors;
- promptly treat all diseases of the reproductive system;
- be regularly examined by a mammologist if there is a history of breast cancer in the family.
In conclusion, I would like to remind you once again that if you detect any changes in the functioning of the mammary glands, you must immediately consult a doctor, because with timely diagnosis, even such a serious disease as breast cancer can be treated.
The anatomical and functional basis of the mammary glands are lobules that are capable of producing a special secretion for feeding a newborn baby: in the postpartum period, glandular tissue in the breast ensures milk production. Breast adenosis is a condition in which the tissue structure is dominated by an increased number (hyperplasia) of glandular lobules in the absence of lactation. The disease most often occurs in young women who delay childbearing and refuse breastfeeding.
Diffuse mastopathy with a predominance of the glandular component
Any variant of the hyperplastic process can become the basis for precancer. , in which adenosis occurs in the breast (an increase in the glandular part of the tissue), is a risk factor for diffuse forms of neoplasia of the mammary glands.
Any of the variants of mammary gland adenosis is a borderline state between normal and pathological, occurring in young women (age from 16 to 30 years). It is important to detect the problem in a timely manner in order to prevent the development of dangerous conditions in the chest: best prevention adenosis and – pregnancy and prolonged breastfeeding.
Area of adenosis in the mammary gland - what is it?
Mastopathy with a predominance of adenosis is in most cases a hormone-dependent condition: hyperplasia of the milk lobules occurs against the background of prolonged action of estrogen hormones. Pathology in the breast can be local: a node in the mammary gland in a young woman is a limited area of overgrown lobules.
Adenosis can be focal, which can become the basis for nodular mastopathy. Many small foci-nodules belong to, but can become a cause for the formation of a tumor large size. Diffuse variants increase the risk of developing cancer, but only in the absence of treatment and refusal to bear children.
Variants of mammary adenosis
Hyperplasia of glandular tissue can occur at any age and manifests itself in various forms of pathology. The following types of mastopathy with a predominance of adenosis are distinguished:
- diffuse;
- sclerosing;
- fibrosing;
- focal;
- local;
- small-knotted.
The disease can be bilateral, when changes occur in both glands. It is not always that a woman detects changes on her own: typical signs of the disease are similar to the usual manifestations of a premenstrual state.
Hello. I was diagnosed with adenosis type. Should you be afraid of breast cancer? Alevtina, 28 years old.
Hello, Alevtina. FCM with a glandular component (adenosis) is a common disease in young women. With timely detection and treatment, the risk of cancer is minimal. The optimal form of breast cancer prevention is pregnancy, birth and long-term breastfeeding.
Detection of pathology - signs and diagnosis according to ICD-10
Every woman should have her breasts assessed monthly, in the first days after the end of menstruation. It is important to notice the initial signs of pathology:
- painful engorgement of the mammary glands, occurring 7-10 days before the expected period;
- change in breast sensitivity – touch causes discomfort or pain;
- aching or nagging pain 2-5 days before the onset of menstruation;
- heaviness and increase in the size of the glands;
- palpation identification of small nodular lesions;
- liquid discharge from the nipples when pressing on the chest.
Some women perceive these symptoms as manifestations of a premenstrual state, refusing to visit a doctor. The presence of typical signs of pathology requires the following studies:
- ultrasound scanning of the mammary glands (young women under 35 years old);
- (X-rays are performed after the age of 35);
- tomography (CT or MRI) at the slightest suspicion of cancer;
- aspiration biopsy (if a node is present).
The mammologist will prescribe diagnostic tests, on the basis of which the specialist will make a diagnosis in the form of an ICD-10 code. Possible conclusions could be:
- N1 diffuse form of mastopathy
- N2 fibroadenosis of glandular tissue
- N3 fibrosclerosis in the chest
- N9 unspecified form of benign mastopathy
For any type of benign changes in the mammary glands, it is important to strictly and consistently follow the doctor’s instructions. Best option treatment of diffuse forms of mastopathy with adenosis - conception of the desired baby, pregnancy and birth of a child with long-term lactation for at least 1 year.
Diffuse adenosis
Hyperplasia of the glandular tissue of the milk lobules in all parts of the breast is a standard form of the disease. Features of this form of the disease include:
- diffuse distribution in both glands;
- absence of clearly demarcated nodes (both on palpation and on ultrasound);
- connection with menstruation - an increase in pain and engorgement before critical days.
Diffuse adenosis is typical for young women who, for various reasons, postpone the birth of a child, and manifests itself with typical premenstrual symptoms. Lack of treatment or complete refusal of pregnancy can cause precancerous conditions to develop in the glandular tissue of the breast.
Sclerosing adenosis
Fibrosclerosis is typical for women over 35 years of age. The main reason is hormonal imbalances caused by age-related changes. Sclerosis is an increase in the thickness of interlobular fibrous tissue in the presence of hyperplasia of the glandular structures of the milk lobules. Symptoms of the disease include:
- nagging or aching pain in the chest, associated or unrelated to the menstrual cycle;
- palpation of small seals without identifying clearly demarcated nodes;
- no nipple discharge.
Sclerosing adenosis is one of the variants of age-related restructuring of the mammary glands, against the background of which it is necessary to constantly monitor the condition of the breast so as not to miss the occurrence of a tumor.
Hello. How dangerous is sclerosing adenosis of the mammary glands during menopause? Is it possible to develop into cancer? Irina, 51 years old.
Hello, Irina. With the advent of menopause, an age-related restructuring occurs in the mammary glands, during which the number of glandular lobules decreases and adipose tissue increases. Adenosis refers to unfavorable variants of diseases in menopause, but sclerosing and fibrosing types, being a benign pathology, rarely become malignant. It is necessary to be observed by a mammologist to prevent the situation from worsening.
Fibrosing adenosis
The replacement of glandular and muscle tissue with fibrous tissue is typical for older women. Fibrosing adenosis is a typical situation during menopause: the need for glandular lobules disappears, which leads to. Age-related changes are manifested by the following signs:
- local and intermittent chest pain;
- detection of a soft-elastic lesion in the mammary gland of small size;
- palpation of small nodules in the thickness of both glands.
A typical ultrasound picture (minimal amount of glandular tissue, predominance of fibrous strands and islets against a background of adipose tissue) indicates standard benign changes. Apart from observation by a doctor, no therapeutic action is required.
Focal adenosis
Growths of glandular tissue can be in the form of nodes - single or multiple. Having discovered a tumor-like formation, you need to consult a doctor and conduct a full examination to confirm the benign nature of the process. It is advisable to remove a large adenous lesion, proven by a biopsy, because the node can become the basis for malignant degeneration. Mastopathy with a focal form of hyperplasia of glandular tissue includes:
- localized adenosis;
- small nodular adenosis.
In both cases, a woman may be bothered by premenstrual pain, the presence of lumps and heaviness of the mammary glands. Treatment and observation by a mammologist will help prevent dangerous species diseases.
Treatment of mammary adenosis
Correction of breast pathology is selected individually for each woman. Adenosis of the mammary glands requires surgical intervention only in nodular forms of the disease, when there is a real risk of tumor formation. For diffuse forms, the mammologist will prescribe the following treatment measures:
- lifestyle changes with the obligatory abandonment of bad habits and diet correction;
- cyclic vitamin therapy (optimal for young girls under 20 years old) - taking vitamins determined by the doctor in different phases of the menstrual cycle;
- hormone therapy (correction of endocrine imbalance that provokes changes in glandular tissue) using herbal or synthetic drugs;
- long-term use of sedative herbal preparations.
After consulting with your doctor, you can use folk remedies, of which good therapeutic effect provide the following infusions:
- from horse chestnut;
- from walnut partitions;
- based on boron uterus;
- from burdock roots.
Hello. Is it possible to see adenosis of the mammary glands on an ultrasound? Or is it better to do? Inna, 35 years old.
Hello, Inna. Experienced doctor Ultrasound diagnostics will detect disease in the chest based on typical signs (increased thickness of glandular tissue, dilation of ducts, appearance of small cysts in the chest). Ultrasound of the mammary glands is performed for women under 35 years of age in phase 1 of the cycle (from 7 to 11 days). Mammography helps to make an accurate diagnosis in patients over 35 years of age. It is better for you, Inna, to do an ultrasound scan, but if there is any doubt about the diagnosis, you can additionally perform a mammogram.
You can ask your question to our author:
– a form of fibrocystic mastopathy, accompanied by the proliferation of glandular breast tissue. It manifests itself as pain and engorgement of the breast, the formation of dense areas in it, and the appearance of discharge from the nipple. Diagnosis of adenosis is based on the collection of complaints and anamnesis, examination and palpation of the breast, additional research methods (ultrasound and radiography of the mammary glands, determination of hormone levels, cytological examination of nipple discharge and biopsy). Treatment of the disease depends on its form and includes conservative therapy (prescription of hormones) or surgery.
ICD-10
N60.2 Fibroadenosis of the mammary gland
General information
Adenosis refers to benign formations of the mammary glands of a hormonal-dependent nature, which is confirmed by the occurrence of symptoms in the second phase of the cycle. Synonyms for adenosis are “fibrosing adenosis”, “myoepithelial hyperplasia” or “lobular sclerosis”.
Adenosis affects women of reproductive age - the prevalence of the disease in the age group of 30–40 years is 30–70%. In women with gynecological diseases, the frequency of adenosis increases to 100%. This condition can develop in girls during the period of menstruation and in women in the first trimester of pregnancy, which is considered physiological, since all manifestations of adenosis disappear on their own after some time, after the hormonal levels have stabilized.
Causes of mammary adenosis
The main and only cause of the pathology is hormonal imbalance - lack of progesterone and excess estrogen. Etiological factors causing hormonal imbalance include:
- Obesity. Adipose tissue synthesizes estrogens. With excess weight, estrogen production increases, which leads to relative hyperestrogenism (progesterone levels remain normal).
- Spontaneous and induced abortions. Termination of pregnancy, especially at long terms (15–22 weeks), provokes a sharp hormonal change and disruption of compensatory mechanisms. The level of sex hormones does not immediately return to normal, which gives impetus to the development of endocrine problems, in particular adenosis.
- Late pregnancy. In women over 35 years of age, ovarian function declines. The onset of pregnancy activates the work of the ovaries, which causes a postpartum failure in the synthesis of estrogen and progesterone and hormonal disruption.
- Postpartum agalactia. Agalactia indicates a lack of progesterone, which is responsible for the development and differentiation of mammary gland parenchyma cells, and an excess of estrogen. With hyperestrogenism, the glandular stroma grows; a lack of progesterone leads to uncontrolled growth of the glandular epithelium.
- Refusal to breastfeed. An increase in prolactin concentration due to lack of breastfeeding causes stagnation of milk in the ducts. Their blockage and expansion occur, which leads to structural changes - the formation of cysts.
- Uncontrolled use of COCs. Taking hormonal pills without taking into account individual characteristics and adherence to the regimen causes hormonal imbalance and the development of dysplastic processes in the breast.
Adenosis of the mammary glands most often occurs in patients with gynecological pathologies (endometrial hyperplasia, ovarian tumors, uterine fibroids, endometriosis), which also develop against the background of hyperestrogenism. Triggers that trigger hormonal disorders can be somatic diseases (arterial hypertension, pancreatic and liver diseases), chronic stress, sexual disorders, disturbed ecology, smoking.
Pathogenesis
Cyclic changes occur in the mammary glands, which are regulated by hormones: hypothalamic releasing factors, FSH and LH, estrogens, prolactin, human chorionic gonadotropin, androgens, glucocorticoids, progesterone, thyroid and pancreatic hormones. Adenosis is accompanied by absolute and relative hyperestrogenism, which is combined with progesterone deficiency. Estrogens ensure the proliferation of the milk ducts due to excessive cell proliferation and stromal hyperplasia through the activation of fibroblasts. The functions of progesterone include reducing the number of estrogen receptors on cell membranes and reducing the effect of estrogens on target organs (breasts, uterus).
With a lack of progesterone, the differentiation of the glandular epithelium and collagen cells formed in a significant number is reduced, and the blocking of proliferative processes is inhibited. As a result, cell division becomes uncontrolled, and the process of inhibition of proliferation in glandular tissues is disrupted. This leads to structural and morphological changes: proliferation and swelling of intralobular connective tissue, activation of proliferation of glandular epithelium in the mammary ducts, which causes their blockage, expansion and formation of cysts.
Classification
In mammology, a unified classification of breast adenosis is used. Systematization of formations is carried out according to the area of gland tissue damage and the histological structure of adenosis. According to the prevalence of pathological formation, 2 forms are distinguished:
- Focal (local). A mobile large spherical or disc-shaped formation is formed in the gland. The node has a fibrous capsule and consists of lobules.
- Diffuse. Several areas of compaction appear in the mammary gland, the shape and boundaries of which are blurred. The formation grows unlimitedly and is located unevenly.
Based on the type of overgrown epithelial cells of the gland parenchyma, they are distinguished:
- Sclerosing adenosis. Accompanied by proliferation of acini (areas of gland lobules) while maintaining the integrity of their epithelial and myoepithelial layers. Despite the compression of the acini by fibrous tissue, their configuration is maintained.
- Apocrine adenosis. It is characterized by apocrine metaplasia of the epithelium (the transition of cuboidal epithelial cells to cylindrical ones with the appearance of apocrine secretion). In terms of histological structure, apocrine adenosis is similar to infiltrating cancer, but its nature is benign.
- Ductal adenosis. It is distinguished by dilated milk ducts, which are limited by epithelial cells with columnar metaplasia. Similar to sclerosing adenosis.
- Microglandular adenosis. Accompanied by diffuse and random proliferation of small ducts. There is no sclerosis or compression of glandular tissue.
- Adenomyoepithelial adenosis. This form is very rare and is combined with the formation of breast adenoepithelioma. It is focal adenosis.
Symptoms of breast adenosis
The symptoms of adenosis are similar to the clinical picture of mastopathy. Depending on the form of the disease, the severity of certain symptoms varies. Common symptoms of adenosis include mastodynia (pain, engorgement of the glands, their increased sensitivity), pain that intensifies on the eve of menstruation, the appearance of discharge from the nipples, and breast tenderness on palpation.
Local form
With a local form of pathology, a dense, movable compaction with a lobular structure is felt in the gland, not fused with the surrounding tissues and having clear boundaries. Pain during palpation, discharge of mucus/milk from the nipple, skin deformation and enlargement of the axillary lymph nodes are not observed.
Diffuse form
The diffuse form of the disease is characterized by diffuse pain in the gland (pain covers the entire gland), the breast swells before menstruation, and a yellowish or colorless discharge appears from the nipple. Diffuse adenosis is characterized by the formation of several nodules in the gland different sizes, which do not have clear boundaries and a certain shape. Nearby nodular formations merge, which creates the illusion of a tumor of considerable size. Palpation of the breast is painful, regional lymph nodes are not enlarged.
Complications
Late diagnosis and treatment of adenosis increases the risk of complications (inflammatory diseases of the breast, deformation of the gland, the formation of cysts in the breast tissue and papillomas in the milk ducts). According to the latest scientific data, a connection between the disease and breast cancer has been proven, the likelihood of which increases 5 times with adenosis. The incidence of malignancy of the neoplasm depends on the degree of proliferation of epithelial cells. Non-proliferative forms malignize in 0.86%; in the case of moderate proliferation, breast cancer develops in 2.5%; adenosis with a severe degree of cell proliferation transforms into a malignant tumor in 32% of cases.
Diagnostics
To diagnose adenosis, consultation with a mammologist is necessary. The doctor collects anamnesis and complaints, clarifies the presence of concomitant somatic and gynecological diseases, performs a physical examination and palpation of the breast. If necessary, a gynecologist, oncologist and endocrinologist are involved in examining a woman. If adenosis is suspected, instrumental and laboratory diagnostic methods are prescribed:
- Mammography. Allows you to determine the localization of the process, its prevalence and boundaries. The radiograph shows multiple shadows with blurred boundaries and irregular shapes, corresponding to areas of overgrown lobules.
- Ultrasound of the mammary glands. Helps determine the location of the affected area of the gland, its boundaries, consistency and size. Ultrasound reveals an increased density of glands in young women, small cysts (up to 3 mm) formed when the ducts are blocked, and the condition of the regional lymph nodes is assessed.
- Hormonal studies. The content of sex hormones, prolactin, FSH, LH is determined. According to indications, the concentration of thyroid and adrenal hormones is examined.
- Histological, cytological examination. A cytogram of the discharge from the gland and a puncture biopsy of the suspicious area of the breast are performed. The presence/absence of atypical cells is determined in the smear, and the degree of cell proliferation of the formation is assessed in the biopsy material.
Clinical blood and urine tests, blood biochemistry (sugar, liver enzymes, etc.) are also prescribed to identify somatic pathologies. Differential diagnosis of adenosis is carried out with other dysplastic processes of the mammary gland (adenoma, fibroadenoma, cyst) and breast cancer.
Treatment of mammary adenosis
The treatment strategy for adenosis (conservative therapy or surgery) is determined by its form and the nature of the disease.
In case of a diffuse form of pathology, conservative treatment is prescribed, which includes taking sedatives, vitamins (A, E, ascorbic acid, P, group B), minerals and hormonal drugs. At mild form diseases, monophasic combined oral contraceptives are used for a course of 6 months. With severe symptoms of adenosis, taking gestagens for at least 3 months is indicated.
Patients are advised to reconsider their diet: limit animal fats, carbohydrates, increase the consumption of fresh vegetables and fruits. At sedentary In life, it is necessary to increase physical activity and normalize weight, and, if possible, avoid stressful situations.
In the case of a focal form of adenosis, a sectoral resection of the gland is performed - excision of the formation within healthy tissue with urgent histological examination of the node. For cosmetic purposes, a breast incision is made around the areola of the nipple; after the wound heals, an inconspicuous scar remains.
Prognosis and prevention
With early diagnosis and timely initiation of treatment, the prognosis for life and disease is favorable. Prevention of adenosis includes the prevention of abortions, competent selection of hormonal contraceptives, treatment of gynecological and endocrine diseases, preservation of the first pregnancy and lactation for at least 6 months, giving up bad habits and management healthy image life. You should also regularly conduct breast self-examinations, visit a gynecologist every six months, and adhere to proper nutrition, plan your first pregnancy before age 30.
Breast adenosis is a disease that belongs to one of the types of mastopathy and is characterized by fibrous and cystic transformation of breast tissue. The pathogenesis of the disease is associated with the development of an abnormal arrangement of cellular structures due to compression of them by growths of connective tissue and cystic cavities. In this article we will talk about mammary adenosis: what it is, how it develops, how life-threatening it is, and what are the treatment methods.
What is it
Causes and risk factors
The main etiological factor in the development of diseases is hormonal imbalance in female body. Pathological changes in the functional ability of the endocrine system lead to tumor degeneration of breast tissue. Changes in hormonal levels can be caused by severe and prolonged emotional distress, excessive physical activity, as well as diseases that reduce immunity.
Provoking factors for the development of mammary adenosis:
- previous abortions and surgical interventions in the form of cesarean section, traumatic childbirth;
- first pregnancy in women after 40 years of age;
- complete infertility of a woman;
- a woman's refusal to breastfeed her child naturally.
Risk factors for developing the disease:
- obesity or uniform excess body weight;
- inflammatory processes of the female reproductive organs;
- chronic pathologies of the pancreas;
- hypertension;
- immunodeficiency;
- long-term use of hormonal contraceptives;
- promiscuity;
- surgical operations on the pelvic organs; mental disorders.
Species
By structure
Classification of mammary gland adenosis depending on the structure of the pathological process:
- Apocrine form is a tumor that changes the structural appearance of the cells that make up the lobules of the mammary gland.
- Tubular form- this is a tumor that forms inclusions in the form of tubes in the tissues of the gland, as is correct, a lot of them form, they are easily palpable and visible during ultrasound examination.
- Microglandular adenosis- this is a type of pathology in which many round glandular cells appear in fibrous tissue.
- Focal adenosis mammary gland or sclerosing adenosis of the mammary gland are types of tumors that are characterized by the presence of their own excretory ducts.
By localization
Classification depending on location:
- Local adenosis breast cancer is a form of oncological pathology that is benign in nature. The tumor is a neoplasm with clear boundaries; its structure resembles lobules and has a fibrous capsule. The tumor is located in a specific area of the mammary gland and has a clearly defined, limited appearance.
- Diffuse adenosis mammary gland is a tumor that is characterized by the absence of clear boundaries of germination. Diffuse adenosis is a very severe pathology that leads to complete tissue destruction and, as a consequence, complete amputation of the mammary gland.
Features of sclerosing adenosis
Sclerosing adenosis of the mammary gland differs from other forms of the disease in that the proliferation of tumor cells is so compact that even with standard instrumental research methods the development of an oncological disease can be missed.
In the sclerosing form of the disease, tumor cells are located in the area of fibrous tissue; the progression of the proliferation of these cells leads to compression of the excretory ducts of the mammary glands. Due to the uniform distribution of fibrous tissue and tumor, compression by the duct occurs evenly on all sides.
Symptoms
Breast adenosis is a disease that develops gradually against the background of hormonal imbalance.
General symptoms manifest themselves as:
- soreness in the chest area, which intensifies before the onset of menstrual bleeding;
- enlargement and increase in gland density during menstruation;
- serous and purulent discharge from the nipples; presence of conglomerate when palpating the breast;
- tenderness of the gland on palpation.
At diffuse adenosis diffuse pain is noted throughout the gland. Symptomatic manifestations develop in connection with the change of phases in menstrual cycle. The pain can be cutting, stabbing and pressing, sometimes radiating to the neck, shoulder or back.
On palpation, sharp sensitivity of the nipple and the presence of purulent discharge when pressed are noted. When palpated, you can detect the presence of many small formations in the structure of the gland.
Local form
In the local form of the disease, the tumor is located in a specific area, it has clear boundaries and does not grow. When palpating the gland, a round, mobile and painful to the touch formation is discovered, which is not accompanied by the development of a local inflammatory process. Unlike the diffuse form, there is no discharge from the nipples, and there is no exacerbation of the disease during menstrual bleeding.
Diagnostics
In practice, the following methods are used to make a final diagnosis:
- General examination of patients and palpation of the affected area.
- X-ray examination methods (mammography) are carried out to detect dense tumor formations.
- Ultrasound examination is used to examine pathological structures and their consistency. Adenosis of the mammary glands on ultrasound manifests itself in the form of increased echogenicity of the affected area and cystic degeneration of glandular cells.
- Carrying out puncture and bacteriological culture from cystic cavities.
During an external examination of the patient, the following parameters are assessed:
- comparison appearance healthy and damaged gland;
- assessing the condition of the skin over the mammary glands;
- assessment of nipple condition;
- detection of the inflammatory process in regionally located lymph nodes.
Treatment
Treatment tactics differ depending on the form and severity of the disease. Adenosis of the mammary glands is successfully eliminated using conservative treatment methods, but with rapid progression and in an advanced state, patients are recommended to undergo surgical intervention.
Conservative
Conservative methods include the use of:
- Vitamin-containing medicines used for general strengthening of the body.
- A group of drugs with a sedative mechanism of action, used when a woman is depressed for a long time.
- Diuretic and diuretic drugs are used for severe swelling of the soft tissues of the lower extremities.
- Hormonal treatment is used as etiotropic therapy.
In cases where adenosis of the mammary glands has developed, treatment is carried out not only with the use of drug correction, but it is also recommended to adhere to special diet. Women are advised to limit the consumption of fatty and genetically modified foods, and eat more natural, environmentally friendly and vitamin-containing foods.
Folk remedies
Traditional methods of treatment involve the use of herbal preparations or environmentally friendly products. As traditional methods Compresses made from ground pumpkin seeds, chopped beets or fresh cabbage leaves are widely used.
These methods will not help get rid of the disease, but will significantly alleviate the patient’s general condition; they do not cause side effects and are absolutely harmless to use.
Surgical
Surgical intervention is performed in extremely advanced conditions and in the local form of the disease. Due to advances in modern medicine, operations have become less traumatic using plastic methods.
However, in case of massive damage to the glandular structures of the gland, surgical intervention with its complete removal is indicated.
Prevention
To prevent the disease, women are recommended to:
- closely monitor the regularity of the menstrual cycle;
- periodically attend consultations with gynecologists;
- adhere to a healthy lifestyle and promptly treat infectious diseases of the reproductive system;
- give up bad habits;
- avoid pregnancy and childbirth over 40 years of age.
Paying attention to your health will help you avoid many unpleasant diseases in the future.
Danger of disease
The prognosis for recovery depends on the degree of progression of the disease and how effectively conservative therapy was carried out. On early stages the disease is not particularly dangerous, but an advanced condition can threaten a woman with the development of malignant cancer.
Video
In our video, an oncologist will talk about breast diseases.
