Fibrocystic mastopathy of the mammary gland - symptoms and treatment, drugs. What is proliferative fibrocystic mastopathy? What forms of this disease are there? Proliferative mastopathy of the breast

FCM is a proliferative form. Fibroadenomas. What to do?

Asked by: Elena

Female gender

Age: 27

Chronic diseases: Fibrocystic breast disease, proliferative form.

Hello! What to do, please advise.

In 2011 there was an operation to remove fibroadenoma.
Histological examination for 2011:
Three sections of gray-yellow fabric, tightly elastic consistency, dimensions: 1.7× 1.5× 0.7 cm 2.0× 1.3× 0.7 cm 2.8× 1.7× 0.7 cm
Conclusion:
Fibrocystic breast disease, proliferative form.
Ductal and intraductal hyperplasia without atypia of the ductal epithelium. Pericanalicular fabroadenoma of the breast.

After the operation, not a single doctor told me that such a diagnosis as fibrocystic disease, a proliferative form, needed to be treated. Only one doctor said that you need to apply a cabbage leaf.
I know that there are 3 degrees, judging by the histological examination, I have 2 degrees of FCM - the proliferative form. The diagnosis was made in 2011, and now it’s 2014 and it still hasn’t been treated.
A) mastopathy without proliferation (I degree);
B) fibrocystic disease with epithelial proliferation (II degree);
B) mastopathy with atypical epithelial proliferation (III degree);
The last two forms are considered as obligate precancer.

Today I have many nodular formations - cysts from 0.5 to 1.3 cm, painful, with clear contours, mobile, in both mammary glands and a recurrence of fibroadenoma at the site of the previous operation. Cytological examination of fibroadenoma for 2014:
The studied material was represented by erythrocytes, cell structures of hyperplastic cuboidal epithelium, and stromal fragments.
Clinical diagnosis:
Fibroadenoma of the left breast. (Same size as the previously removed one) Now a new fibroadenoma is forming in the right mammary gland.

I visited the doctor and they said the fibroadenoma needs to be cut out along with the surrounding tissues. I have a small breast volume of approximately 0.5, the doctor did not guarantee that a relapse would not occur again or a new one would not appear in another place. I understand perfectly well that after 2-3 such operations, what will be left of my breast.
1. Could you decipher the cytological examination 2014?
2. Why didn’t any doctor talk about treatment? 3. What to do in such a situation. 4. Can extreme measures be taken? What options are there? I don’t want to be under threat all my life, worry, stress and undergo endless treatments and operations. I am extremely determined and knowledgeable.
Thank you for your attention.

Is it necessary to have surgery for the proliferative form of fibrocystic disease? Based on a biopsy, I was diagnosed with a proliferative form of fibrocystic disease. Microscopic picture - In the material of the right mammary gland there are red blood cells up to the whole size; a significant amount of fat droplets; scraps of subcutaneous fat; single accumulations of emithelial cells with severe dystrophy. No AKs were found. In the conclusion it is written: An area of ​​fibrosis in the right mammary gland in a square of up to 13 mm. The SCT showed that in the right mammary gland there was an irregularly shaped area of ​​compaction 0.9*1.5*1.2. The doctor says that we need to have an operation. Is it so? Thanks for the answer

Focal fibrocystic mastopathy with positive tumor marker results Dear doctor, I have several questions for you, but first I will describe the situation. 27 - 27 years ago, after a breast injury, I was diagnosed with fibrocystic mastopathy of the right breast. The doctor recommended the birth of a second child and breastfeeding. After the birth of the child, feeding continued for 2 years. Periodically, gradually increasing pain occurred. Before menstruation, for 10 days, the pain intensified so that the contact of the mammary gland with clothing was painful. During self-examination, I began to notice a slight change in the shape of the breast - a platform appeared. During the entire time there were several more injuries (accidental blows to the breast while rearranging furniture and gardening work). An ultrasound of the breast in the conclusion says: diffuse - fibrous - cystic mastopathy, etc. of the breast. with the presence of focal formations. Education size 3x4.8. There is a genetic predisposition to oncology: my mother died, as doctors said, from transient uterine cancer; a month and a half ago, my older sister reported about breast cancer. Since the end of May, my voice disappeared, I couldn’t speak at all for 10 days, then whispered speech appeared (after the fifth intralaryngeal injection based on hydrocortisone and peach oil). I have a nodular goiter. I was tested for tumor markers CA 15-3. Result 63.7. I decided to consult a therapist. He said that he did not know what kind of analysis it was and even if the readings were increased by 2 times, there was nothing wrong with that! I asked for a referral to the district cancer center. The doctor, smiling, went to consult a young specialist, also a therapist, who advised him to write me a referral. I feel guilty. Maybe he’s right and I don’t need to force things? Sorry for wasting your time! Thank you in advance and all the best to you!

Diffuse changes in the parenchyma of the mammary glands according to the type of fibrocystic mastopathy During an examination by a gynecologist, mastopathy was determined. They advised me to undergo an ultrasound of the mammary glands, the results are in the appendix. Based on the results, they sent me to a mammologist, but the question is that in our city there is only one mammologist in the whole city, and you can only get to him after 2 months. Tell me what to do and how to behave. There was no pregnancy, childbirth, or abortion. According to gynecology, there is erosion of the cervix, on the advice of a gynecologist, I observe that it is not increasing or decreasing. Cytology type 1. There is no discomfort. The pain doesn't bother me. The pain is not great and appears only the day before the start of menstruation.

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Hello! According to your cytology conclusion, nothing really has been written about fibroadenoma, except that the cells are hyperplastic - an increased number, this happens due to hormonal imbalance (dysplasia). Regarding “cancer,” yours is not obligate (caused by genetic or congenital factors), but facultative (rarely turns into true “cancer,” but the longer the condition exists, the higher the risk that it will transform). I can’t give you an exact answer to the question “why didn’t any doctor talk about treatment?” I can’t read their thoughts and many doctors believe that they are smarter than everyone else. I’m not sure that you have fibroadenoma, I would even argue on this point, I would say that according to the ultrasound data I saw exactly: a proliferative form without atypia, fibrocystic mastopathy, but not a fibroadenoma (fibroadenoma does not grow, at most up to 2-3 cm - can only be treated surgically (enucleation). Surgery for mastopathy is done as a last resort, if conservative treatment does not help. I did not see the word “proliferation” anywhere in the cytology, only in the conclusion, on what basis did they do this conclusion? And why didn’t you mention histology after the operation or didn’t you do it? Ask the doctor this question, they should have sent the sample for histology. Let’s return to mastopathy - one of the common causes is hormonal imbalance. Do you have children? Go to laboratory and take tests for hormones (thyroid gland (TSH, T3, T4), estrogen, progesterone). After the operation in this case, you should have been sent to take these tests and be prescribed hormonal treatment (oral contraceptives, hormonal creams, etc. ). For mastopathy, surgery is performed, but only if the formation is large, up to 5 cm, and growing quickly.

Diffuse fibrocystic mastopathy is a benign oncological process that affects breast tissue. With the development of mastopathy, the relationship between the epithelial and interstitial components is disrupted, as the phenomena of proliferation and regression take place.

The relevance of this disease is due to the fact that it should be considered as a background against which malignant processes can develop. The frequency of degeneration into a malignant form depends on the severity of the proliferative process in mastopathy. Thus, with pronounced proliferation, the risk of developing breast cancer is 32%, and with mild proliferation – only 1%

What it is?

Fibrocystic mastopathy is a violation of the ratio of the connective and epithelial components of breast tissue, accompanied by changes of a proliferative and regressive nature.

It is customary to distinguish two forms of the disease:

1. Non-proliferative form. With this form of the disease, cysts of different sizes form inside the breast: from a few millimeters to several centimeters. At the initial stage of development of the disease, the formation of structures resembling bunches of grapes occurs. As the pathology progresses, the process of increased collagen production begins, which leads to the compaction of connective tissue, its proliferation and the formation of scars. As a result, the lobules that represent the mammary gland stretch and cysts form inside them. The non-proliferative form of the disease does not carry a high risk of malignancy of the pathological process. It is no more than 0.86%.
2. The proliferative form is characterized by the launch of the proliferation process, that is, the growth of epithelial and connective tissue through cell division. With proliferation of moderate severity, the risk of degeneration of the pathological process into malignant is 2.34%. With a pronounced degree of proliferation, these values ​​increase to 31.4%.

If we look at the statistics of the disease in general, there is a tendency towards an increase in pathology among women all over the world. During reproductive age, the disease affects on average up to 40% of women. If you have a history of multiple gynecological diseases, then the risk of encountering mastopathy ranges from 70 to 98%.

The high-risk group includes women who suffer from hyperplastic pathologies of the genital organs. During menopause, diffuse fibrocystic mastopathy is less common. Up to 20% of women suffer from it. After menopause occurs, new cystic formations most often do not appear. This statistical fact is also further evidence of the direct involvement of hormones in the development of the disease.

Causes of mastopathy

The main cause of mastopathy is considered to be a hormonal imbalance, consisting in increased production of the hormone estrogen.

Hormonal imbalances can also be caused by the following factors:

1. Multiple abortions, the consequence of which is always severe hormonal disruption of the entire endocrine system of the body;
2. Gynecological diseases, both inflammatory (endometritis, adnexitis) and tumors (uterine fibroids, ovarian cysts, endometriosis);
3. No pregnancies before age 30;
4. The likelihood of mastopathy increases in the presence of endocrine diseases (thyroid dysfunction, diabetes mellitus), as well as diseases of the liver and biliary tract (hepatitis, cholecystitis, etc.)
5. Refusal to breastfeed or its duration is too short (less than 6 months). If a woman breastfeeds her child for more than 6 months, this reduces the risk of developing mastopathy by 2 times.

Other contributing factors:

1. Injuries to the mammary glands (impacts, severe compression);
2. Psycho-emotional factors (depression, neuroses, stress, chronic fatigue syndrome);
3. Hereditary predisposition;
4. Bad habits (smoking, alcohol abuse, tanning fashion).

Clinically, there are two main forms of mastopathy: diffuse and nodular.

Symptoms

According to experts, the diffuse form of the disease is its initial stage. That is why the symptoms of the disease in some patients are quite blurred, as a result of which women may not pay due attention to their condition for a long time. However, without treatment, the disease progresses.

There are certain signs that allow one to suspect diffuse fibrocystic mastopathy in a patient:

1. Swelling of the mammary glands and an increase in their volume.
2. Chest pain. It has a dull, aching character and disappears after the onset of menstruation. Over time, the pain becomes more intense and lasting; it can be localized not only in the chest, but also radiate to the arm, shoulder or armpit. In some patients, even a light touch to the affected gland can cause pain. With further development of the disease, the pain becomes less significant.
3. Enlarged lymph nodes located in the armpits.
4. Loss of sleep, feelings of fear and anxiety.
5. The appearance of discharge from the nipples. They can be very different: abundant or scanty, bloody or colorless.
6. Changes in the skin of the nipples: cracks, retraction of the nipple or skin.
7. The appearance of formations in tissues. They can be either multiple (resembling a bunch of grapes) or single. Such formations do not have clear boundaries and can be found in different places of the mammary glands.

The degree of manifestation of symptoms of diffuse mastopathy depends on the phase of the menstrual cycle: they make themselves felt most strongly in the second half of the cycle, and after the start of the critical days, the symptoms smooth out. For many women in later stages of the disease, pain and lumps remain regardless of the phase of the cycle.

Why is mastopathy dangerous?

Diffuse fibrocystic pathology (FCM) is a benign process that is characterized by abnormal development of mammary gland tissue. Some types of cells actively multiply (that is, proliferation occurs), others regress - as a result, the ratio of the connective tissue component and the actual active secretory tissue changes.

Despite the declared benignity of fibrocystic changes, mastopathy is a favorable background for the development of malignant oncological diseases, and therefore is classified as a precancerous condition. With active proliferation of cells in the affected gland, the risk of cancer reaches 32%. With less activity of the pathological process, the risk is reduced to 1%, but this indicator cannot be neglected.

The vast majority of cases of diagnosis of fibrocystic pathology occur in women of childbearing age whose mammary glands are active. During perimenopause, significantly fewer such pathologies are observed. Women pay almost no attention to the primary signs of the disease, since they are not expressed by serious pain and are perceived as temporary discomfort. However, with age, the disease progresses and can lead to dangerous consequences.

Diagnostics

Considering the technical capabilities of diagnostic medicine, identifying diffuse cystic mastopathy is not difficult. All middle-aged women must undergo screening or preventive examination. From the age of 35, breast ultrasound is performed once a year; from the age of 40, X-ray mammography is prescribed once a year.

If a woman has signs of diffuse fibrocystic mastopathy, then diagnostic testing methods are prescribed by the doctor. Possible options:

1. Consultation with an endocrinologist and oncologist.
2. Anamnesis collection ─ general data, complaints, family history.
3. Breast examination, palpation.
4. Examination for gynecological diseases, taking smears.
5. Ductography is an X-ray examination of the milk ducts using a contrast agent.
6. Ultrasound examination, which evaluates benign and malignant formations with high accuracy.
7. Biopsy of a lump or cyst ─ histological examination of the tissues of the formation.
8. X-ray mammography is a study with a low radiation dose and minimal stress on the body.
9. MRI (magnetic resonance imaging) with contrast.
10. Blood tests for hormones: TSH, fT4, LH, FSH, prolactin, estradiol, progesterone.
11. Ultrasound of the thyroid gland and adrenal glands.
12. Microscopic examination of nipple discharge

There is no degeneration of diffuse fibrocystic mastopathy into cancer. The danger is that the disease prevents timely recognition of the presence of a malignant process in the breast.

Treatment

The chosen treatment method for fibrocystic mastopathy depends on the stage of the disease. Basically, it is complex, that is, it is accompanied by taking medications, eliminating diseases that became the precursors of this disease, as well as following a diet and using folk remedies.

Treatment of diffuse fibrocystic mastopathy of the mammary glands is carried out using non-hormonal medications.

These include the following:

• Treatment for FCM does not take place without taking vitamin-containing medications. In this case, you will need to take vitamins for a fairly long period of time. Particular attention is paid to vitamins of groups A, B, E and C.
• Preparations that contain a lot of iodine. These are “Iodine-active”, “Iodomarin”, “Klamin”. They help restore normal functioning of the thyroid gland. However, prescribing them to yourself is strictly prohibited.
• In case of severe pain due to breast disease, treatment is carried out using painkillers. For example, Diclofenac.
• Homeopathic remedies will help reduce the production of prolactin. “Mastodinon”, “Remens”, “Cyclodinone” have positive reviews. For the desired effect, it is necessary to take medications for at least six months.
• To reduce nervous tension, the patient may need sedatives and sedatives. Tinctures based on motherwort, valerian and other medicinal plants help very well.

Diffuse fibrotic disease of the mammary glands should include treatment that will be aimed at restoring the functioning of the hypothalamus-pituitary gland-ovaries. Most often, it is recommended to use hormonal drugs for this. These include the following:

• Oral contraceptives "Marvelon" and "Janine". The peculiarity of their reception is strict adherence to the instructions.
• Medicines based on gestagens. These include Utrozhestan, Duphaston, Norethisterone. It is best to take them during the second phase of the menstrual cycle. Otherwise the effect will not be as strong.
• Women over 45 years of age should take androgens. Such drugs include Methyltestosterone, Fareston and Tamoxifen. The duration of treatment is determined individually depending on each case of the disease.
• In advanced cases of the disease, it is advisable to use inhibitors that stimulate the production of prolactin for treatment. This is the drug "Parlodel".

It is advisable to carry out therapy for fibrocystic mastopathy only after a thorough medical examination, which will establish the variety of forms of breast disease. When diagnosing the cystic variety of the disease, it will be necessary to conduct puncture and cytological examination of breast tissue. If the presence of a benign tumor is established, surgical intervention may be quite sufficient.

Treatment with folk remedies

Mastopathy is a disease known since ancient times, so there are a lot of folk recipes. But it is important to remember that this method can only cure the disease in the early stages of its development and taking into account the doctor’s recommendations.

Tinctures. Prepared using herbs that are infused with alcohol. You can prepare them yourself or buy them ready-made at the pharmacy:

• alcohol tincture of boron uterus;
• tincture of pine nut shells;
• propolis tincture.

Decoctions. They help normalize hormonal levels, cope with tumors and get rid of associated inflammatory diseases occurring in the body. The herbs are infused in boiling water and taken orally. For the treatment of diffuse fibrocystic mastopathy, it is recommended to drink herbal decoctions:

• burdock root;
• boron uterus;
• red brush to regulate the functioning of the thyroid gland;
• yarrow;
• chagi.

Lotions and compresses. Herbal compresses should be applied to the chest overnight for several weeks to achieve the following results:

• burdock leaf compress;
• cabbage compress with honey;
• flatbread made from rye flour;
• pumpkin compress;
• compress of grated beets and honey.

The use of traditional methods for the treatment of fibrocystic mastopathy should also be carried out under the supervision of the attending physician. Herbal medicine implies the ability to prepare decoctions from several herbs at once or use ready-made mixtures that can be purchased at a pharmacy.

Diet

The therapeutic diet should contain foods to stabilize hormonal levels. Food should be rich in fiber (greens, grains).

It is important to take natural estrogen (legumes, cabbage of all varieties). Vitamin therapy strengthens the immune system and gives the body strength (citrus fruits, raw vegetables and fruits). Natural iodine is a cure for mastopathy. Eating fish, seafood, liver and sour milk will replenish the body with phospholipids. It is necessary to drink 2 liters of plain water, this will help to quickly restore metabolic processes.

Most often, giving up your usual unhealthy lifestyle helps cure any illness. Fibrocystic mastopathy is easier to prevent, and this requires a timely visit to the doctor. At the initial stage of the disease, it is easier to defeat the disease.

Prevention and possible complications

Compliance with preventive measures reduces the risk of the disease and promotes a speedy recovery if it occurs. These include: giving up bad habits, avoiding stressful situations, choosing the right underwear, maintaining an active lifestyle, reducing salt consumption, timely treatment of diseases of the pelvic organs.

It is important to competently select hormonal contraceptives and regularly visit an oncologist and mammologist (at least once a year). Breastfeeding a child for more than 6 months reduces the risk of developing cancer by 2 times.

All women, including healthy ones, need to learn how to check their mammary glands on their own. This advice is especially relevant in the periclimacteric period (after the age of 45). This is done by visually examining the breast in the mirror and feeling it while lying down and standing. If any abnormal lump is detected, you should consult a doctor.

Despite the benign course, fibrocystic changes are a favorable background for the development of malignant diseases. With active proliferation (growth) of affected cells, the risk of cancer is 32%. With less activity of the pathological process, the risk decreases to 1%.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Non-proliferative form

Proliferative form

Considering that the breast is a hormone-sensitive organ, any changes in the level of hormones in the blood are reflected in the mammary gland. Manifested by swelling, pain, swelling of the mammary glands, this is especially clearly manifested in the second phase of the cycle. As a rule, against this background, a woman also experiences various autonomic disorders - migraine-type headaches, swelling of the extremities, bloating, mood swings, insomnia or weakness. All these symptoms were combined and called premenstrual syndrome. This is known to all of us PMS.

So why do some women suffer from this notorious PMS, while others do not?
There are many reasons causing dishormonal disorders, but we will highlight 7 main ones:
1. Stressful situations, in the literature they are called frustrating
2. Various sexual disorders.
3. Factors related to the female reproductive system
4. Gynecological diseases
5. Endocrine disorders
6. Pathological diseases of the liver and biliary tract
7. Hereditary predisposition

Let's look at each separately.
Stressful situations Of course, they exist in the life of every woman. There are many of these situations: dissatisfaction with work, family relationships, various conflicts with relatives, and work colleagues. Any type of stress can cause disruption of the endocrine system.
In healthy women, the body's adaptive capabilities are sufficient for independent recovery. In women suffering from fibrocystic disease of the mammary glands, excitation processes predominate over inhibition processes in the central nervous system. All this causes a malfunction of the organs of the endocrine system.

Sexual factors
Sexual dissatisfaction is noted in the majority of women with fibrocystic diseases of the mammary glands. Sexual life is a delicate matter and we do not undertake to make comments here. But it should be remembered that sexual dissatisfaction leads to stagnation and neurotic reactions. Which leads to headaches, unmotivated mood swings, irritability, sleep disturbances, and possible aching pain in the lumbar region. Some women may experience irregularities in their menstrual cycle.
We do not call for spontaneous sexual intercourse, but we remind you that regular sex life improves not only a woman’s mood, but also the condition of her internal organs.

Reproductive system
In the occurrence of fibrocystic mastopathy in women, the age of the onset of the first menstruation, too early or, conversely, too late, the number of births, pregnancies, abortions ( 3 or more abortions are unfavorable factors), the birth of a large fetus, the duration of lactation, early or late onset of menopause, all these factors lead to dishormonal processes in a woman’s body.

Gynecological diseases
There is a connection between the occurrence of fibrocystic mastopathy in women with uterine fibroids, endometriosis, as well as inflammatory diseases of the pelvic organs ( ovaries, uterine appendages).

Endocrine system diseases
The most common pathology associated with fibrocystic mastopathy is hypothyroidism. The thyroid gland is an organ that has a huge impact on the functioning of a woman’s reproductive system. Pathology of the thyroid gland can cause the development of various diseases in a woman: these can be irregularities in the menstrual cycle, even its absence, infertility and the release of colostrum in women who are not in the lactation period ( galactorrhea).

The next important condition associated with endocrine disorders is metabolic syndrome. This symptom complex includes the following conditions: obesity, insulin resistance, hyperglyceridemia, arterial hypertension, compensatory hyperinsulinemia, type 2 diabetes mellitus.

Insulin resistance and hyperglyceridemia conditions are risk factors for the development of dysplastic breast diseases. These conditions are characterized by an increase in insulin-like growth factors, which leads to the development of dysplastic changes in the mammary gland. Type 2 diabetes mellitus is one of the forms of this disease in which insulin resistance is observed, accompanied by hyperinsulinemia. Which leads to an increase in the amount of insulin-like growth factors. Insulin-like growth factors directly interact with receptors located in the mammary gland and this interaction leads to proliferation processes. The result of all these complex processes is fibrocystic mastopathy.

Clinic and diagnostics

Women with fibrocystic mastopathy have certain psycho-emotional characteristics: a tendency to depression, cancerophobia ( fear of cancer), various anxiety states.
An important point in the diagnosis of fibrocystic mastopathy is examination and palpation of the mammary glands. The value of this method is clear, and the peculiarity is that this examination is carried out on the 7th - 10th day of the menstrual cycle. This rule should be followed in order to eliminate diagnostic errors. The second rule is that the examination should be carried out in two positions, standing and lying down.
Whatever palpation technique your doctor uses, be sure to examine the axillary, subclavian and supraclavicular lymph nodes.

To clarify the diagnosis, the following diagnostic methods are used:
1. X-ray mammography is currently the leading method in the diagnosis of breast diseases, competing with ultrasound. It is carried out in two projections. It is highly informative, allowing you to identify even small tumor-like formations. Makes it possible to assess the dynamics of the disease with or without treatment. The disadvantage is: low information content among young women ( up to 35 years old), in which the mammary gland has a dense consistency and cannot be used during pregnancy and lactation.

2. Ultrasound echography is safe, allowing this method to be used repeatedly, even over a short period of time. The possibility of using this method in pregnant women and women during breastfeeding. High diagnostic capabilities, which is especially important for young women for whom mammography is not indicated due to age. But it should be noted that the use of this method is limited in women with large breasts, due to the large amount of adipose tissue. It is important to note that the diagnostic capabilities of this method are directly related to the qualifications of the doctor and the technical parameters of the ultrasound diagnostic device used.
Therefore, in difficult cases, it should be remembered that these two methods complement each other, allowing a more accurate diagnosis.

3. Doppler sonography of the mammary glands allows you to obtain a color image of the blood flow, which, in turn, allows you to more clearly differentiate various diseases of the mammary gland.

4. Puncture followed by cytological examination of the obtained material. Carry out in the presence of a tumor-like formation or other questionable formation in the mammary gland.

Taking into account the results of the cytological examination, individual treatment is carried out.

Treatment

• Identification and elimination of diseases leading to proliferative changes in the mammary gland.
• Restoring balance in the functioning of the endocrine system.
• Surgical removal of all nodular formations, including cysts, with mandatory cytological examination.

As you can see, this disease is quite complex in terms of identifying the causes that cause it, so if you find a lump in your breast, consult a doctor immediately. And remember your health is in your hands!!!

The issue of preserving a woman’s youth, beauty and health is always acute. Especially when it comes to the mammary gland. But, unfortunately, sometimes a woman puts her beauty and youth first, and forgets about her health until the problem begins to bother her, but sometimes it’s too late, and it’s impossible to turn back time!

After all, every year about a million women in the world learn about the terrible diagnosis of breast cancer, and these numbers are constantly and steadily growing. And few people know that when diagnosed at the first stage, the cure rate is 94%. The most important thing to remember is that breast cancer is most often preceded by mastopathy.

Let's take it in order - let's figure out what fibrocystic mastopathy is

This is a benign, hormone-dependent disease, which is characterized by a variety of changes in the mammary gland - from proliferation (increase) to regression (decrease) occurring in the tissues. In this case, the ratio in the gland changes - between its connective tissue and epithelial components, as a result of which either fibrous or cystic components predominate.

In women over the age of 18 years, fibrocystic mastopathy of the mammary glands occurs in 30-70%.

Reasons for the development of mastopathy in women

The dominant role in the development of this disease belongs to hormonal cyclic changes in a woman’s life. Under the influence of hormones, the mammary gland undergoes a number of changes - from the onset of puberty and gland growth to pregnancy and breastfeeding.

If any shift occurs in the control of these processes by hormones, dysfunction occurs in the mammary gland and a change in the tissues in one direction or another, which is manifested by fibrous or cystic changes.

In turn, an imbalance in a woman’s hormonal status is caused by factors such as overwork, stress, heredity, pregnancy and childbirth, sexual disorders, liver diseases, gynecological and endocrine diseases, and family history.

But the most important factor in the development of fibrocystic mastopathy is an increase in the level of the hormone estrogen (hyperestrogenism) and a decrease in progesterone in a woman’s body, often against the background of the above factors leading to the development of the disease. Thus, estrogen leads to growth and proliferation (increase) of the stroma and epithelium of the ducts, and progesterone, on the contrary, prevents this process from occurring and promotes differentiation of the epithelium.

When, for one reason or another, there is little progesterone in the body, swelling and an increase in connective tissue develop in the mammary gland, in turn, due to the proliferation of the ductal epithelium, cysts form in the gland. And a hormone such as prolactin (normally a lactation hormone), when it increases outside the period of breastfeeding and the second phase of the menstrual cycle, leads to engorgement, swelling and pain in the mammary gland, and even the possible release of colostrum.

Very often, diseases such as uterine fibroids, endometriosis, endometrial hyperplasia are combined with fibrocystic mastopathy, this is due to the fact that all of the listed diagnoses also manifest themselves against the background of hyperestrogenism. And, of course, with inflammatory diseases of the uterine appendages, where the process of hormone production mainly occurs, the hormonal balance is disrupted, which again leads to the development of disease in the mammary gland.

Factors contributing to the development of mastopathy:

• Late onset of menstruation
• Absence of pregnancy and childbirth
• Breastfeeding for less than a month and more than a year
• Abortion
• Late onset of first pregnancy
• Diseases of the female genital organs accompanied by hyperestrogenism
• Menstrual irregularities
• Liver and thyroid diseases
• Scleropolycystic ovarian disease

Classification of mastopathy

Depending on the predominance of the altered component (glandular, fibrous, cystic) and adipose tissue in the mammary gland, its severity and prevalence, it is customary to distinguish the following forms:

1. Diffuse form (distribution of the pathological process throughout the gland)
   • With a predominance of the cystic component (fibrocystic disease)
   • With a predominance of the glandular component (adenosis)
   • With a predominance of the fibrous component (fibroadenosis)
   • Mixed form (all components)
   • Sclerosing adenosis
2. Nodal form (single pathological foci)

The diffuse type of development is more typical for young girls, and at the age of 30 to 40 years, small multiple cysts with a predominance of the glandular component are more common.

They also distinguish proliferative and non-proliferative forms of mastopathy. The risk of developing breast cancer is high in the proliferative nodular form of the disease, and is 31.4%, in contrast to the non-proliferative form - 0.86%.

Diagnosis of fibrocystic breast disease

Breast examination: it should definitely be carried out in the first phase of the menstrual cycle (immediately after the cessation of menstruation), in order to avoid diagnostic errors, since before menstruation, the mammary gland, under the influence of hormones, swells, swells and is not indicative of diagnosis.

At the same time, they pay attention to the appearance, the symmetry of the location of both glands, evaluate the color of the skin, the contour and relief of the tissues, the location of the nipples, and their convexity. The examination is carried out with arms lowered and raised.

Feeling the mammary glands (palpation): Standing and lying on your back. The left mammary gland is palpated with the right hand and vice versa. Clockwise, starting from the nipple and to the periphery, with spiral movements in the radial direction, palpation of one and the second mammary glands is carried out.

Pay attention to lumpy, dense formations that are painful when palpated. And don’t forget about the lymph nodes in the armpits, above and below the collarbones. The axillary lymph nodes should normally be no more than 1 cm, painless, soft-elastic and move slightly with movement; sub- and supraclavicular lymph nodes are not palpable in healthy women.

Ultrasound diagnostics: Just like the examination, it is carried out in the first phase of the menstrual cycle. The method makes it possible to diagnose cysts from 3 mm in diameter, which cannot be determined by palpation, and to differentiate between cysts in the mammary gland and fibrosis. And also examine the lymph nodes in detail.

Mammography: Method of x-ray examination of the mammary glands. It is applicable to women after 40 years of age, due to the fact that glandular tissue is replaced by adipose tissue with age, and sometimes the ultrasound method when examining adipose tissue is not as informative as mammography.

It is carried out in the direct and lateral projection of the gland and makes it possible to visualize a tumor up to 1 cm in diameter. However, it is not applicable to pregnant women, but is widely used in breast cancer screening, when according to the program, a woman after forty years of age is required to undergo annual mammography of the mammary glands and sometimes in combination with ultrasound.

Fine needle biopsy lesion more than 1 cm and histological examination of the obtained material (the type of tissue, the degree of proliferation, the predominance of the component - cystic fibrous or glandular, and the presence of development of the oncological process are determined).

What are the symptoms of mastopathy

With diffuse form

• Painful sensations (mastalgia) in the mammary gland, intensifying on the eve of menstruation, of varying strength and character, sometimes radiating to the shoulder blade, armpit, shoulder. After menstruation the pain goes away.
• Sleep disturbance associated with chest pain.
• The age of women is often under 35 years.
• Edema and diffuse thickening of the gland tissue are determined by palpation. Sharp pain when touching the breast, sometimes dense areas without clear contours are identified (usually in the upper - outer parts of the gland). There may be discharge from the nipple in the form of droplets of milk.

With nodular form

• The woman's age is from 30 to 50 years.
• Upon palpation, clear round lumps in the mammary glands are determined, especially more clearly in a standing position.
• Nodules can be multiple or single, both in two and in one mammary gland.

Treatment of mastopathy

Treatment of different forms of mastopathy has different tactics. First of all, this is the elimination of the causes and factors that led to mastopathy (treatment of concomitant pathologies - inflammatory diseases of the genital organs, nervous system, endocrine disorders).

Non-hormonal treatments

• For mastalgia, analgesics, decongestants, non-steroidal anti-inflammatory drugs (meloxicam group) are used.
• Means that improve blood circulation (venous outflow, impaired by swelling of the breast tissue) are vitamins of group P, contained in rose hips, citrus fruits, black currants, cherries and raspberries
• Physiotherapy (electrophoresis with potassium iodide)
• Sedatives and sedatives – valerian, motherwort. As you know, stress leads to hormonal imbalances and, as a result, mastopathy.
• Retromammary blockades with novocaine
• Vitamin therapy B1, B6 and E, A (improving estrogen metabolism in the liver during hyperestrogenism, normalize hormonal balance, stabilize the growth of normal epithelial cells, have an antioxidant effect, improve the functioning of the nervous system, promote normal functioning of the thyroid gland and ovaries.
• Herbal medicine based on twig, meadowsweet, calamus - Oenothera Biennis, Sunara C.irdunculus, Vilex Agnus castus, Pueraria labata, Glycyrrhiza glabra, Angelica sinensis, Artemisia vulgais - (mastodinon, tazalok, vitokan)
• Comfortable underwear – bra. If the selection is not correct, deformation of the mammary gland, swelling and pain may occur. The shape of the underwear should be of a comfortable shape and the correct size. Not wearing a bra can lead to sagging breasts and overload of the ligaments, which leads to pain.

Hormone therapy

• Progestogens are more effective after 35 years of age; they use injectable forms in the form of preparations containing medroxyprogesterone acetate (Depo-Provera) and in the form of a patch (Norplant), which provides an effect for 5 years. As well as tableted gestagens (utrozhestan), which have antiandrogenic, antiestrogenic and decongestant effects. Progestogel in the form of a gel, which is applied to the skin of the mammary gland itself, has also found widespread use.
• Cyclic hormonal therapy is more common in women aged 18 to 35 years.
• Hormone therapy with combined oral contraceptives - more often in women from 18 to 35 years old, in order to eliminate fluctuations in hormones in the menstrual cycle.
• Antiestrogenic drugs (tamoxifen).
• Antiprolactin drugs - dopamine agonists - (bromcreptin, dostinex), which are more effective in the cystic form of mastopathy with proliferation.

Diet therapy for mastopathy

• Exclusion from the diet of pickles, canned and smoked foods.
• Avoid taking fats (saturated and unsaturated).
• Get into the habit of eating more often fresh vegetables rich in fiber (preferably Brussels sprouts), fruits, citrus fruits, and grains. There are studies that prove that with constipation and disturbances in the intestinal microflora, released estrogens are reabsorbed into the blood, leading to hyperestrogenism.
• A sufficient amount of fluid - up to 2 liters per day, as well as the use of herbal teas that have a diuretic and decongestant effect.
• Exclusion of methylxanthines - caffeine containing products (tea, chocolate, coffee), which contribute to the formation of fibrocystic disease in the mammary gland.
• Limit salt intake, as it contributes to the accumulation of fluid in the body and tissue swelling.
• Quitting smoking - nicotine impairs microcirculation in blood vessels, leading to blood stagnation and the formation of tissue edema.
• It has been proven that increased estrogen production is affected by excessive consumption of fatty and meat products.

Treatment of mastopathy with folk remedies

It is very important to understand that fibrocystic disease is a precancerous disease and ignoring regular visits to the doctor, medical examinations, and, on the contrary, self-treatment with traditional methods, can lead to dangerous health conditions, including the development of late diagnosed breast cancer.

If the diagnosis is clarified and there is no risk, then the attending physician may recommend tried and tested folk recipes as an addition to the main treatment.

• Herbs that have an antitumor effect are burdock, immortelle, cabbage, wormwood, elderberry, celandine, thistle, birch, cinquefoil.
• Immunomodulatory effect - echinacea, aloe, propolis, elecampane.

Surgical treatment for nodular forms of mastopathy

It is used for nodular forms of mastopathy if atypical cells or proliferative changes in the mammary gland epithelium are detected in a punctate taken during aspiration biopsy. Sectoral resection (linear excision of tissue) and mastectomy (removal of a section of the gland) are used, followed by a study of the histology of the isolated tissue.

Timely diagnosis, detection and treatment of fibrocystic mastopathy is an important step in the prevention of breast cancer, because the risk of developing an oncological process in the gland tissues with fibrocystic mastopathy increases 3-5 times.

Mammary cancer

Throughout the world, breast cancer ranks first among malignant tumors in women. Every year, up to a million women join the ranks of this terrible disease. The saddest thing is that in recent years cancer has become younger, and girls of 20 years old are already suffering from it.

Breast cancer is a malignant tumor that affects breast tissue, often against the background of previous hormonal changes, such as mastopathy. Men also get breast cancer, but 100 times less often.

Pathogenesis of breast cancer

Unfortunately there is no exact reason. But there are risk factors leading to the development of a gland tumor:

• Abortion
• Early onset of menstruation and late menopause
• Late first birth
• Long-term, uncontrolled use of hormonal oral contraceptives
• Violation of a diet rich in fats (as a source of estrogens)
• Long history of infertility
• Tobacco smoking and alcoholism
• Dyshormonal diseases of the mammary glands (fibrocystic disease with proliferation)
• Colon, ovarian and uterine endometrial cancer
• Obesity
• Breast cancer in close relatives
• Woman's age over 50 years

How does breast cancer develop?

The stages of development of the oncological process have not been fully identified. But there is a theory that against the background of the above factors for the occurrence of cancer and an increased amount of estrogens, against the background of proliferation, uncontrolled division and reproduction of pathological cells occurs, and a tumor is formed.

Subsequently, it grows into the surrounding tissues, blood vessels, bones and lymphatic vessels, and then spreads along them and through the blood to other organs, leaving metastases there. Often metastases begin to develop in the lungs, liver, bones, and brain. When the body is contaminated with cancer foci and as they grow, organ function is impaired, toxins from these areas also enter the blood, immunity decreases and the person cannot cope with the disease and, unfortunately, dies.

Classification of malignant breast tumor

This refers to the size of the tumor, damage to the lymphatic vessels and metastasis.

And also by type of infiltration:

• Non-infiltrative cancer (intraductal and lobular)
• Infiltrative cancer (ductal, lobular)
• Rare forms (medullary, mucous, papillary, tubular, secretory, apocrine, with metaplasia and others)
• Nipple cancer (Paget's cancer)

Diagnosis of breast cancer

• History of the disease– time of appearance of the first signs of a tumor, enlargement of lymphatic vessels, whether there was any discharge from the nipple.
• Breast examination– deformation of the gland is revealed, nipple retractions are possible, changes in the color of the skin, swelling of the tissues; with slight compression of the skin area, the so-called “lemon peel” may appear - a prognostic sign of cancer.
• Tumor markers CA 153, confirming the diagnosis by laboratory means.
• Needle biopsy– confirming histologically cancer cells (the most reliable method).
• Ultrasound diagnostics– allows you to visualize the tumor process, germination into surrounding tissues, metastasis to the axillary supra- and subclavian lymph nodes. Doppler ultrasound shows increased blood flow around and in the tumor itself.
• Mammography– the sensitivity of the method is up to 95%, allowing you to accurately assess the size of the tumor and damage to the lymph nodes.
• Ductography– allows you to estimate the size of the tumor in the duct (in intraductal forms of cancer) and its distance to the nipple.

Breast cancer treatment methods

Treatment combines an integrated approach, including surgery and radiation, hormonal and chemotherapy, as well as symptomatic treatment in advanced cases. Which in some cases helps to achieve remission.

Radiation therapy is used in the sternum area, combining it with chemotherapy and the use of hormones (tamoxifen). Lymph nodes affected by metastases are also irradiated to prevent the spread of the tumor process.
Preoperative chemotherapy helps shrink the tumor, which can reduce the size of the surgery.

For surgical treatment, the following types of breast surgery are used:

• Areola-sparing mastectomy (removal of affected breast tissue while preserving the nipple for further breast reconstruction)
• Radical mastectomy without removal of the pectoral muscles (breast removal)
• Surgery with breast conservation and radiation therapy

To summarize, I would like to say that there is always time to look at yourself in the mirror once a month, conduct a breast self-examination, make an appointment with a doctor, smile and know that you are healthy! Good luck to you!