Fibrocystic mastopathy grade 3. Forms and signs of fibrocystic mastopathy. Decoctions and infusions

Update: December 2018

It is known that most women suffer from this pathology, and the peak incidence is observed during childbearing age (about 30–45 years). Fibrocystic mastopathy is considered one of the most common diseases in women, and its incidence is 30–40%; in the case of concomitant gynecological diseases in the fairer sex, this pathology reaches 58%.

Definition of the term

Fibrocystic mastopathy or fibrocystic disease is a benign dishormonal pathology of the mammary glands, in which both proliferative and regressive changes are noted in their tissues, as a result of which a pathological relationship between the epithelial and connective tissue components is formed.

Structure and regulation of mammary glands

The mammary gland is a paired organ and is represented by three types of tissue. The main one is parenchyma or glandular tissue, in which ducts of various diameters pass; the glandular tissue is divided into lobules and lobes (there are about 15 - 20 of them). The lobules and lobes are separated by stroma or connective tissue, which makes up the framework of the mammary gland. And the third type of tissue is adipose tissue, it is in it that the lobules, lobes and stroma of the mammary gland are immersed. The percentage of parenchyma, stroma and adipose tissue is directly related to the physiological state (age) of the reproductive system.

During gestation, the mammary glands reach morphological maturity. Their size and weight increase, the number of lobules and ducts increases, and milk secretion begins in the alveoli (the morphomolecular unit of the mammary gland). After childbirth, due to the production of milk, the mammary glands increase even more (lacteal sinuses are formed in the ducts of the lobes, in which milk accumulates). And after the cessation of lactation, involution occurs in the mammary glands, and the stroma is replaced by adipose tissue. With age (after 40), the parenchyma is also replaced by adipose tissue.

Both the growth and development of the mammary glands are regulated by numerous hormones. The main ones are, and. A role in regulating the development of mammary glands and somatotropic hormone has also been proven. The main changes in the mammary glands under the influence of hormones are the parenchyma, and to a lesser extent the stroma is subject to hormonal influence. The condition of the mammary glands depends on the ratio of the content of these hormones. When the hormonal balance is disturbed, mammary gland mastopathy develops.

Forms of mastopathy

In modern medicine there are a large number of classifications of this disease. The following is considered the most convenient in clinical work:

Diffuse mastopathy

Nodular mastopathy

• lipoma;
• fibroadenoma;
• breast cyst;
• lipogranuloma;
• intraductal papilloma (roughly speaking, a wart in the milk duct);
• breast hematroma;
• angioma.

In the case of damage to both mammary glands, they speak of bilateral fibrocystic mastopathy, and if the process develops in one gland - about unilateral (for example, a cyst of the left mammary gland).

Depending on the severity of clinical manifestations, the disease can be mild, moderate or severe.

In addition, both diffuse and nodular mastopathy can be of proliferating and non-proliferating forms. Fibrocystic mastopathy (FCM) of the first form is prognostically unfavorable. In this case, proliferation of the epithelium of the milk ducts occurs, which leads to the formation of intraductal papillomas or proliferative changes in the epithelium of the internal walls of the cysts, which leads to the development of cystadenopapilloma.

All the described changes are fraught with malignant degeneration and are dangerous.

A special form of the mammary gland also appears at the end of the second phase of the cycle, which is called mastodynia or mastalgia. Mastodynia is caused by cyclic engorgement of the gland due to venous stagnation and stromal edema, which leads to a sharp increase and soreness of the mammary gland (more than 15%).

Causes

The etiological factors and the mechanism of development of the disease are caused by hormonal imbalance. The leading role in the formation of mastopathy is given to conditions in which there is progesterone deficiency, impaired ovarian function and/or absolute or relative hyperestrogenism. This is due to the fact that estrogens promote the proliferation of epithelium in the alveoli, milk ducts, and enhance the activity of fibroblasts, which causes proliferation of the stroma. Also in the mechanism of formation of the disease, hyperprolactinemia and excess prostaglandins are also important (causing mastodynia, and then mastopathy). For the development of hormonal imbalance, the action of provoking factors is necessary. But even with their existence, mastopathy does not develop immediately, since it requires their long-term influence (several years) and “layering” of one factor on top of another. Such provoking factors include:

• early menarche (early puberty, up to 12 years, leads to rapid hormonal changes, which also affects the condition of the mammary glands);
• late menopause (cessation of menstruation after 55 years is also unfavorable for the mammary glands due to prolonged hormonal effects on their tissue);
• termination of pregnancy (a sharp hormonal decline after an abortion or miscarriage leads to hormonal disorders and the development of mastopathy);
• there were no pregnancies or childbirths at all;
• short period of lactation or categorical refusal to breastfeed;
• heredity (benign and malignant breast diseases in women on the maternal side);
• age (over 35);
• stress as a cause of endocrine pathology;
• bad habits;
• injuries to the mammary glands, compression of the chest by a tight and uncomfortable bra;
• inflammatory processes of the mammary glands;
• hormonal-dependent gynecological diseases (cycle disorders, anovulation and fibroids, endometriosis);
• iodine deficiency;
• pathology of the liver, thyroid gland;
• obesity (adipose tissue acts as an estrogen depot, and their excess leads to hormonal disorders);
• tumors of the hypothalamus and/or pituitary gland (failures in the production of FSH and LH lead to hyperestrogenism);
• irregular sex life or dissatisfaction with sex, which contributes to stagnation of blood in the pelvic organs and, as a result, causes dysfunction of the ovaries and hormonal imbalance.

Symptoms

With mastopathy, the symptoms and their severity depend not only on the form of the disease, but also on the emotional state and character of the woman and on existing concomitant pathologies. In the mastopathy clinic, the following symptoms predominate:

• Mastodynia or breast tenderness

Pain syndrome can be of varying nature and intensity. In the initial stage of the disease, chest pain appears on the eve of menstruation, which many women regard as premenstrual syndrome. The pain can be dull, aching, or so sharp that it is impossible to touch the chest. The pain syndrome is caused by stagnation of blood in the veins and tissue swelling and is described by patients as breast engorgement. Women also note an increase in the volume of the mammary glands (edema). After menstruation, the pain disappears, but as the pathology progresses, the pain becomes constant, only its intensity changes depending on the phase of the cycle. Severe pain also negatively affects the psycho-emotional state of a woman. In addition to sleep disturbances, mental lability is noted, irritability, aggressiveness and tearfulness appear.

• Nipple discharge and breast lumps/lumps

Discharge from the nipples is a characteristic, but not obligatory symptom of mastopathy. The severity and color of the discharge also varies. The discharge may be insignificant and appear only when the nipple is compressed, or it may occur independently, as evidenced by stains on the underwear. The color of the discharge may be whitish or transparent, or greenish, which indicates a secondary infection. The appearance of discharge from the breast indicates involvement of the milk ducts in the process. An unfavorable prognostic sign is the appearance of brown or bloody discharge, which is characteristic of malignant tumors.

Diffuse mastopathy

It is more often diagnosed in young women, and palpation reveals enlarged and painful mammary glands with rough heaviness and pronounced lobulation, as well as fine granularity.

Nodular mastopathy

Nodular is the next stage in the development of the disease, which occurs in the absence of treatment for the diffuse form of the pathology. Palpation of the mammary glands allows you to feel with your fingers individual or individual areas of the lump or cyst. Foci of compaction are palpated as dense nodes without obvious boundaries with pronounced lobulation. The nodes can reach impressive sizes (up to 6–7 cm). In the case of the formation of a mammary gland cyst, round or oval elastic formations with obvious boundaries that are not connected with the surrounding tissues are palpated.

Diagnostics

Diagnosis of the disease begins with collecting anamnesis and complaints. After the survey, the patient’s doctor examines and palpates the mammary glands. During the examination, the contours of the breast, the presence/absence of asymmetry of the mammary glands, skin tone and venous pattern, the position of the nipples and whether there is any deformation are clarified.

Next, the mammary glands are palpated (necessarily in the first phase of the cycle) in two positions: standing and lying, since some formations may not be palpable in one position. In addition, the doctor squeezes the nipples and determines the presence/absence of discharge from them, and also palpates the regional lymph nodes (axillary, sub- and supraclavicular).

Instrumental methods for diagnosing mastopathy include:

• Mammography

The essence of this method is an X-ray examination of the chest. Mammography is indicated for women at significant risk for breast cancer, as well as all women 35 years of age and older during medical examination. inspection. X-rays of the mammary glands are performed in the first half of the cycle (days 7–10) and always in 2 projections (frontal and lateral). The advantages of mammography include high information content (up to 97%) and the ability to detect non-palpable formations.

• Ultrasound of the mammary glands

This examination is indicated for women under 35 years of age, as well as for pregnant and breastfeeding women. The advantages of the method are harmlessness and safety, high resolution, the ability to examine breast implants or in case of existing trauma and/or inflammation of the breast, and the ability to examine regional lymph nodes. Among the disadvantages of the method: it is impossible to examine the mammary gland as a whole, but only a “slice”, little information content in case of fatty degeneration of the breast, subjective assessment of the images (depending on the qualifications and experience of the doctor).

• Needle biopsy

If a suspicious area (compaction or cavity formation) is identified, a fine-needle puncture of the pathological focus is performed, followed by a histological examination of the contents.

• Hormonal status study

First of all, the level of estrogen and progesterone is determined; if hyperprolactinemia is suspected, the level of prolactin is determined, and if necessary, adrenal and thyroid hormones are examined.

• Ultrasound of the pelvic organs

It is carried out to exclude diseases of the ovaries and uterus.

• Blood chemistry

Liver enzymes, blood sugar and other indicators are examined to exclude concomitant extragenital diseases.

In addition, additional methods for examining the mammary glands include (if necessary) ductography (examination of the milk ducts), pneumocystography (examination of cavity formation), laser and digital mammography, thermography, and magnetic resonance imaging.

Treatment

When mastopathy is detected, treatment must be carried out without fail and its tactics depend on a number of factors: the age of the patient, the form of the disease, the presence of concomitant pathology, interest in pregnancy or contraception. Fibrocystic mastopathy involves treatment both conservatively and surgically.

Conservative treatment Patients are treated only with a diagnosed form of diffuse mastopathy, and after consultation with a mammologist-oncologist. Conservative therapy is carried out with non-hormonal and hormonal drugs.

Non-hormonal treatments

• Vitamins

Vitamin A is prescribed, which has an anti-estrogenic effect, vitamin E, which enhances the effect of progesterone, vitamin B6, which reduces the content of prolactin, vitamins PP, P and ascorbic acid, which strengthen the vascular wall, normalize microcirculation and reduce swelling of the mammary glands. In addition, all of these vitamin preparations improve liver function, where estrogens are inactivated and generally have a beneficial effect on mammary gland tissue.

• Iodine preparations

Iodomarin and iodine active are used, which normalize the functioning of the thyroid gland and participate in the formation of its hormones (see).

• Sedatives and biostimulants (adaptogens)

Prescription (motherwort, valerian, peony tincture) normalizes the patient’s psycho-emotional state, improves sleep and increases resistance to stress. Adaptogens (eleutherococcus, radiola rosea) stimulate the immune system, normalize metabolic processes in the body, improve liver and brain function.

• Herbal remedies

Mastodinone, cyclodinone or remens are used, which have a beneficial effect on hormonal balance, eliminate pathological processes in the mammary glands, and reduce the concentration of prolactin.

The prescription of drugs such as indomethacin, nise, or not only reduces pain by suppressing the synthesis of prostaglandins, the “causative agents” of pain, but also relieves swelling and engorgement of the mammary glands.

• Diuretics

Diuretics (Lasix or: lingonberry leaf, kidney tea,) help reduce swelling in the mammary glands and reduce pain.

Hormone therapy

This is the main link of conservative treatment, it consists of prescribing the following groups of drugs:

• Gestagens

Taking utrozhestan, duphaston, norkolut, pregnin and other drugs in the second phase of the cycle reduces the synthesis of estrogen and normalizes progesterone levels, which has a beneficial effect on the course of mastopathy. The duration of taking progestin agents is at least 4 months. Local use of gestagens (progestogen) is also possible - applying the gel to the surface of the mammary glands twice a day for at least 3 to 4 months, which promotes the absorption of 90% of progesterone by mammary tissue and eliminates side effects.

• Prolactin production inhibitors

Parlodel suppresses the secretion of prolactin and is prescribed for detected hyperprolactinemia.

• Androgens

Treatment with androgens (methyltestosterone, danazol, testobromlecid) is carried out for women after 45 years of age for 4 to 6 months continuously. Androgens inhibit the release of FSH and LH by the pituitary gland, suppress their effect on the ovaries and inhibit the production of hormones by the ovaries.

• Antiestrogens

Tamoxifen and other drugs in this group are taken continuously for 3 months.

• Combined oral contraceptives

Taking Marvelon, Rigevidon and other contraceptive drugs is indicated for patients under 35 years of age with anovulation and disruption of the second phase of the cycle.

Surgery indicated for the detection of nodular mastopathy (fibroadenoma or cyst) and consists of either sectoral resection of the mammary gland (removal of the pathological focus along with the breast sector) or enucleation (husking) of the tumor/cyst. Indications for surgery are: suspicion of cancer according to histological examination of the puncture, rapid growth of fibroadenoma, recurrence of the cyst after a previous puncture.

Question answer

Is pregnancy allowed with mastopathy?

Pregnancy has a beneficial effect on the course of mastopathy, since the change (increased secretion of progesterone) during gestation not only stops the disease, but promotes complete recovery.

Is it possible to breastfeed with mastopathy?

Not only is it possible, but it is also necessary. Lactation is the prevention of breast diseases, and in the case of mastopathy, it helps to normalize processes in the tissues of the mammary glands (the growth of the epithelium of the glandular tissue increases, which suppresses the proliferation of pathological cells).

Is it possible to use alternative treatment for mastopathy?

Yes, it is possible to use traditional treatment methods for this disease, but only when combined with drug treatment and after consulting a doctor.

What traditional treatment methods are used for mastopathy?

One of the effective methods of traditional therapy is the use of fresh cabbage. You can apply a fresh cabbage leaf with cut veins to your chest overnight, wrapping it in a towel, or you can twist the cabbage and pumpkin (1:1) through a meat grinder, distribute the resulting mass evenly over the mammary glands, wrap it in plastic, and then with gauze and leave the compress for 2 hours. . Such treatment relieves pain and inflammation, reduces swelling in the mammary glands and is carried out in courses of 7 to 14 days.

Why is mastopathy dangerous?

Complications of mastopathy include relapse of the disease after drug treatment, which is possible with undiagnosed hormonal disorders, suppuration and rupture of a breast cyst and the degeneration of fibroadenoma into cancer (less than 1% in the non-proliferating form and reaches 32% in the case of pronounced proliferation of fibroadenoma). Therefore, nodular mastopathy must be treated surgically without delay.

Is it possible to sunbathe with mastopathy?

Sunbathing, as well as other thermal procedures (visiting a bathhouse or sauna) is prohibited for this disease. It should be remembered that with any form of mastopathy, a woman is at high risk for breast cancer, and insolation and any other type of “heating” of the breast contributes to the transition of diffuse mastopathy to nodular or malignancy of a benign breast tumor.

Is it necessary to follow a diet?

Yes, for mastopathy, you should adhere to the principles of therapeutic nutrition, which excludes the intake of chocolate, coffee, tea and cocoa due to their high content of methylxanthines, which not only increase the pain syndrome, but also contribute to the progression of the disease. The diet should be rich in fresh vegetables and fruits (sources of vitamins and coarse fiber, which improves intestinal function), grains and bran products, fermented milk and seafood (sources of calcium and iodine), vegetable oils (vitamin E).

How to prevent the disease?

To prevent the development of mastopathy, it is necessary to adhere to several principles:

• to refuse from bad habits;
• wearing comfortable, appropriately sized underwear;
• refusal of abortion;
• avoid stress (if possible);
• adhere to the principles of breastfeeding;
• be regularly checked by a doctor;
• avoid chest injuries;
• maintain regular sex life.

The female breast is not only a source of pride for the fair sex, but also a subject of concern, and one of the main indicators of failures and improper functioning of the reproductive system, as well as a kind of litmus test for the state of a woman’s hormonal background.

This article highlights the main points and nuances of a common disease – fibrocystic mastopathy. This disease occurs in almost every second middle-aged woman, and is a borderline pathology, which, if neglected, has a risk of degeneration into cancer.

What is mastopathy?

Mastopathy is a pathological condition directly related to the hormonal state of the female body. Despite the seemingly remoteness from the reproductive organs, the female breast and its painful conditions are directly related to the condition of the uterus and ovaries.

Mastopathy affects the proliferation of glandular tissue in the female breast. The danger of this disease is that with initially sluggish symptoms, breast cancer may subsequently occur.

The structure of the mammary glands

Breasts of an adult woman- this is a collection of connective, glandular and adipose tissues, conditionally divided into so-called “lobes”.

The mammary gland consists of about 16-20 lobes, and is an organ responsible for many processes in the female body, of course, the main one of which is breastfeeding.

As for the structure of the female breast, they consist of:

1. chest;
2. pectoral muscle;
3. lobes of the mammary gland;
4. areolas;
5. mammary ducts;
6. fatty tissue;
7. skin.

Types of mastopathy

Experts have identified more than fifty subtypes of mastopathy at the present stage, however, from a clinical point of view, mastopathy is usually divided into three types:

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What is fibrocystic mastopathy?

This disease is a set of pathological changes in the mammary gland in the form of neoplasms, nodules and other benign changes.

However, despite its benign nature, experts consider fibrocystic disease to be a precancerous condition.

Causes

As mentioned earlier in this article, one of the main causes of mastopathy is in a woman’s body.

The work of the ovaries plays a huge role in this case. They produce most of the so-called female hormones.

They are mainly involved in the production of estrogen, androgen and progesterone. The slightest disruption in the production of these hormones affects the entire female body, and directly causes various diseases of the mammary glands, and mastopathy, which is the most common in women.

In addition to this reason, it should be especially noted that mastopathy can occur as a result of failures in the normal functioning of the kidneys and adrenal glands, improper functioning of the liver, and improper functioning of the pituitary gland, which is responsible for the production of prolactin in women.

Many factors are to blame for the fact that over the past hundred years the number of women suffering from mastopathy has increased significantly:

Until the 20th century, a healthy woman of fertile age was either pregnant or breastfeeding, which, according to many experts, had a beneficial effect on the natural hormonal background of the female body. The invention of various chemical and pharmaceutical agents, abortion at various stages, as well as other interventions in the reproductive system, had a sharply negative impact on hormonal levels, and continue to affect each individual female organ.

Diffuse fibrocystic mastopathy

The most common type of fibrocystic mastopathy is its diffuse subtype. This form is characterized by an increase in the amount of glandular tissue and the formation of edema.

According to the symptoms and characteristic course of the disease, it is considered the simplest form of diffuse mastopathy:

Nodular fibrocystic mastopathy

The nodular form of fibrocystic disease is much less favorable.

In this case, in addition to the disorders described above that are characteristic of the diffuse form of mastopathy, the presence in the mammary gland of one or several nodes, which most often represent a fibroadenoma or adenoma, is added.

It is a fairly common benign tumor, which affects mainly women of reproductive age, less often adolescents.

This neoplasm can have different sizes, from a pea in diameter to a tumor reaching up to 15 cm.

Fibroadenoma rarely develops into a malignant tumor; according to medical analysts, this occurs in only two percent of cases.

The situation is much worse with the nodular form of nodular fibrocystic mastopathy, represented by nodes with the proliferation of glandular tissue. Atypical hyperplasia is the medical name for nodes of this type. In cases of manifestation of nodes of this nature, mastopathy turns into oncology in every fifth woman

Mixed fibrocystic mastopathy is a collection of nodes, cysts and compactions. Most often occurs in women under 35 years of age. The early stage is very difficult to determine due to the absence of any discomfort in the area of ​​the mammary glands, and can most often be determined only during an annual examination by a mammologist.

Over time, all formations begin to grow, which leads to compression of the nerve endings, pain, a feeling of heaviness and fullness in the chest area.

Features of bilateral fibrocystic mastopathy

As the name of this form of mastopathy suggests, its main feature is that the disease occurs in both mammary glands.

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A completely natural point is that with a bilateral course there can be the same different forms of the disease as with a unilateral course, but still more often women encounter bilateral mastopathy with a diffuse nature of mastopathy in the initial stage.

This is due to the fact that the form with the formation of nodes is characterized by the formation of single or multiple cysts or nodes in one breast.

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Symptoms

Initially, the symptoms of mastopathy are very mild: the pain is mild, neoplasms may not be noticeable on palpation, and detection of mastopathy at the very beginning of the disease is possible only with regular mammological examinations.

The main symptoms may be aching, with possible milk discharge from the breast.

These disruptions in milk secretion are called galactorrhea.

Galactorrhea with mastopathy can be of varying intensity:

• from meager and spontaneous,
• to discharge at the slightest touch to the breast,
• up to the presence of blood impurities in these secretions.

Which doctor should I contact?

Visits to a mammologist for consultations and for preventive purposes, in principle, should be carried out annually to identify any pathologies, and in general to identify the disease at the earliest stages.

If you experience any discomfort or suspicion of mastopathy during self-examination, an urgent visit to a mammologist is necessary.

If suspicions are confirmed, the scheme for contacting further doctors and the general selection of treatment is determined strictly individually.

The attending physician independently determines the consultations and examination of which doctors are necessary in this case of the course of the disease.

Most often, in addition to mammological examinations, the patient will need to see a gynecologist, endocrinologist, neurologist and therapist. This will help establish all the information about the woman’s health, the causes of the disease, and determine further actions for the patient’s speedy recovery.

In advanced cases, or if characteristic signs are detected, the patient will need to be examined by an oncologist and undergo all the necessary tests

Treatment

The methods and intensity of treatment largely depend on the time of detection of mastopathy and the degree to which the disease is located in a particular case. It is worth noting that surgical treatment of this disease is the most extreme method, which also does not eradicate the cause and source of its occurrence.

The first step in the treatment of mastopathy is considered to be the normalization of the functions of organs that affect the course of the disease, as well as the normalization of the patient’s hormonal levels.

The most common method of treating mastopathy is conservative observation with periodic examinations to monitor the development of the disease, and the prescription of a list of drugs that promote a speedy recovery.

Main purposes in the treatment of mastopathy:

Drugs

Frequently prescribed drugs for the treatment of various types of mastopathy include::

1. anti-inflammatory drugs;
2. drugs that stimulate the outflow of venous blood;
3. antioxidant drugs;
4. preparations with natural extracts that regulate prolactin balance and improve the hormonal balance of the female body.

The treatment regimen is always strictly individual and can be described in detail and calculated exclusively by the attending mammologist or mammologist-oncologist.

In cases of a very advanced stage of mastopathy, the mammary glands undergo surgical intervention.

With any disease, the body does not receive enough of the minerals and vitamins it needs, which is why complex treatment of fibrocystic mastopathy, in addition to taking medications, involves taking vitamin-mineral complexes. When choosing vitamins, you should avoid self-medication and consult your doctor.

The selected vitamin complex must meet the following criteria:

Vitamin complexes must necessarily contain vitamins of groups A, E, C, D and B.

Also, in addition to taking vitamin-mineral complexes, the body of a woman suffering from mastopathy should receive foods, fruits and vegetables enriched with natural, non-synthetic vitamins of these groups. Such as apricots, carrots, cheese, Brussels sprouts, sweet peppers, currants, rose hips, various types of fish, nuts and meat.

Massage

For quite a long time, scientists considered mastopathy a complete contraindication for massage not only of the chest area, but also of the back, but after conducting a series of studies it turned out that massage not only does not harm the health of patients, but can also improve the clinical picture of the disease.

It can also slow down the transformation of benign tumors into cancer. However, the decision on preventive massage for mastopathy should be made by a mammologist.

The goals of massage for diseases of the mammary glands are:

However, there are a number of clear contraindications for massage for mastopathy:

1. Suspicion of malignancy of neoplasms;
2. The presence of damage to the skin of the mammary glands, both traumatic and damage associated with various inflammatory processes;
3. The presence of allergic rashes on the chest;
4. The patient's temperature is elevated.

It is important to know that massage of the mammary glands should exclude the use of any force, and should be carried out exclusively with soft kneading movements, by a specialist who knows the technique and features of massage for mastopathy.

Massage is most effective for the cystic form of the disease.

There are also various self-massage techniques that allow you to identify the disease yourself even in the earliest stages. However, when performing a massage at home, a woman must strictly follow all the rules so as not to harm the mammary glands, and also have a clear understanding of palpation.

Mastopathy as a disease requires certain changes in a woman’s diet and the introduction of a certain diet.

So, cocoa, chocolate and coffee should be excluded from the patient’s diet.

The principles of therapeutic nutrition must be introduced, and it is also necessary to exclude all products that in one way or another contain methylxanthines.

The diet of a woman with mastopathy should be rich in vegetables and fruits, which are the main sources of fiber and vitamins.

It is also worth adding fermented milk products, grains, products including bran and seafood to the menu as a source of vitamin E.

Removal of fibrocystic mastopathy

Medical removal of fibrocystic mastopathy- This is an extreme, radical way to eliminate the disease.

Mastopathy– the disease is diverse, and has many manifestations and forms of development, so there is no clear answer to the question of whether surgical intervention is necessary in the treatment of mastopathy.

Surgical removal of mastopathy is necessary only in cases where the presence of nodes and glandular tissues, as well as the size of neoplasms and the degree of neglect are a direct indication for removal of lesions.

Many doctors consider pregnancy the best way to cure fibrocystic mastopathy, and even recommend that women become pregnant to recover from breast diseases.

The thing is that during pregnancy, a woman’s body releases a lot of water, which helps treat the disease and restore hormonal balance in the female body.

An important factor is also that while carrying a child, the female body receives a kind of impetus to renew cells and improve the functioning of all vital systems.

Statistical studies show that more than 80 percent of women after pregnancy are completely cured of mastopathy. Long-term lactation also promotes healing.

This is explained by the fact that during breastfeeding, the process of renewal of mammary gland tissue accelerates, and fibrosis and compactions resolve on their own.

After the birth of a child, a woman with a history of mastopathy must have a preventive consultation with the attending mammologist, since the risk of lactostasis and congestion in the diseased breast is very high, and can cause further development of the disease.

Mastopathy and menopause

There is no specific age interval at which a woman may begin to develop mastopathy, just as there is no specific moment at which a woman may develop mastopathy.

However, doctors note that the signs of mastopathy in women during menopause appear much more clearly.

During menopause, they can no longer be confused with signs of pregnancy or premenstrual syndrome.

During menopause, women experience enormous hormonal changes, which can cause the formation of mastopathy, and the risk of this disease increases several times.

Treatment of mastopathy during menopause is developed exclusively on an individual basis, and most often represents a combination of various drugs, hormonal and non-hormonal in nature. To treat the mammary glands, courses of antioxidants, vitamin A or beta-carotene, and homeopathic remedies with proven effectiveness can also be prescribed.

Mastopathy and IVF

The opinions of specialists regarding in vitro fertilization for fibrocystic mastopathy are sharply different.

From the opinion that this step can serve to degenerate benign neoplasms into cancer, to the opinion that pregnancy achieved through IVF will serve to normalize the hormonal state of the female body and contribute to a complete cure for the disease.

The danger of performing in vitro fertilization for mastopathy is that during preparatory procedures for artificial insemination, a woman is prescribed strong stimulating hormonal therapy, which can cause both the emergence of new pathologies in the mammary glands and an increase in existing tumors.

Why is it dangerous?

Mastopathy of any type and at any stage can serve as a favorable environment for the development of cancer, and as you know, breast cancer is the most common and leading disease among women in terms of deaths.

Therefore, you should be attentive to your health and conduct annual examinations for diseases of the mammary glands, as well as conduct an independent breast examination.

Fibrocystic mastopathy (FCM), a benign lesion of the mammary gland, is characterized by a spectrum of proliferative and regressive tissue changes with a violation of the ratio of epithelial and connective tissue components. In recent years, there has been a steady increase in this pathology throughout the world (A. G. Egorova, 1998; V. I. Kulakov et al., 2003). Mastopathy occurs in 30-70% of women of reproductive age; with gynecological diseases, its frequency increases to 70-98% (A. V. Antonova et al., 1996).

In premenopausal women it occurs in 20% of women. After menopause, new cysts and nodes, as a rule, do not appear, which proves the participation of ovarian hormones in the occurrence of the disease.

It is currently known that they occur 3-5 times more often in the background and in 30% of cases with nodular forms of mastopathy with proliferation phenomena. Therefore, in the anticancer fight, along with early diagnosis of malignant tumors, timely detection and treatment of precancerous diseases is no less important.

There are non-proliferative and proliferative forms of FCM. At the same time, the risk of malignancy in the non-proliferative form is 0.86%, with moderate proliferation - 2.34%, with pronounced proliferation - 31.4% (S. S. Chistyakov et al., 2003).

The main role in the occurrence of FCM is assigned to dishormonal disorders in a woman’s body. It is known that the development of the mammary glands, regular cyclical changes in them during puberty, as well as changes in their function during pregnancy and lactation occur under the influence of a whole complex of hormones: gonadotropin-releasing hormone (GnRH) of the hypothalamus, gonadotropins (luteinizing and follicle-stimulating hormones), prolactin, human chorionic gonadotropin, thyroid-stimulating hormone, androgens, corticosteroids, insulin, estrogens and progesterone. Any imbalance of hormones is accompanied by dysplastic changes in mammary gland tissue. The etiology and pathogenesis of FCM have not yet been definitively established, although more than a hundred years have passed since the description of this symptom complex. An important role in the pathogenesis of FCM is played by relative or absolute hyperestrogenism and progesterone deficiency. Estrogens cause proliferation of the ductal alveolar epithelium and stroma, and progesterone counteracts these processes, ensures differentiation of the epithelium and cessation of mitotic activity. Progesterone has the ability to reduce the expression of estrogen receptors and reduce the local level of active estrogens, thereby limiting the stimulation of breast tissue proliferation.

Hormonal imbalance in breast tissue towards progesterone deficiency is accompanied by edema and hypertrophy of intralobular connective tissue, and proliferation of ductal epithelium leads to the formation of cysts.

In the development of FCM, an important role is played by the level of prolactin in the blood, which has a diverse effect on the tissue of the mammary glands, stimulating metabolic processes in the epithelium of the mammary glands throughout a woman’s life. Hyperprolactinemia outside of pregnancy is accompanied by swelling, engorgement, pain and swelling in the mammary glands, more pronounced in the second phase of the menstrual cycle.

The most common causes of mastopathy are hypothalamic-pituitary diseases, thyroid dysfunction, obesity, lipid metabolism disorders, etc.

The cause of dyshormonal disorders of the mammary glands can be gynecological diseases; , hereditary predisposition, pathological processes in the liver and biliary tract, pregnancy and childbirth, stressful situations. FCM often develops during menarche or menopause. In adolescence and young women, the diffuse type of mastopathy with minor clinical manifestations, characterized by moderate pain in the upper outer quadrant of the mammary gland, is most often detected.

At 30-40 years of age, multiple small cysts with a predominance of the glandular component are most often detected; the pain syndrome is usually severe. Single large cysts are most typical for patients aged 35 years and older (A. L. Tikhomirov, D. M. Lubnin, 2003).

FCMs also occur in women with a regular two-phase menstrual cycle (L. M. Burdina, N. T. Naumkina, 2000).

Diffuse FCM can be:

• with a predominance of the ferrous component;
• with a predominance of the fibrous component;
• with a predominance of the cystic component.

Diagnosis of breast diseases is based on examination of the mammary glands, palpation, mammography, ultrasound, puncture of nodules, suspicious areas and cytological examination of punctate.

Examination of the mammary glands of reproductive age must be carried out in the first phase of the menstrual cycle (2-3 days after the end of menstruation), since in the second phase, due to engorgement of the glands, there is a high probability of diagnostic errors (S. S. Chistyakov et al., 2003) .

When examining the mammary glands, the appearance of the glands is assessed, paying attention to all manifestations of asymmetry (contours, skin color, position of the nipples). Then the examination is repeated with the patient's hands raised. After the examination, the mammary glands are palpated, first with the patient standing and then lying on her back. At the same time, the axillary, subclavian and supraclavicular lymph nodes are palpated. If any changes are detected in the mammary glands, mammography and ultrasound are performed.

Ultrasound of the mammary glands is becoming increasingly popular. This method is harmless, which allows the study to be repeated many times if necessary. In terms of information content, it is superior to mammography in the study of dense mammary glands in young women, as well as in identifying cysts, including small ones (up to 2-3 mm in diameter), while without additional interventions it makes it possible to judge the condition of the epithelium lining the cyst and carry out differential diagnosis between cysts and fibroadenomas. In addition, when examining lymph nodes and mammary glands with diffuse changes, ultrasound is the leading one. At the same time, with fatty involution of mammary gland tissue, ultrasound is significantly inferior in information content to mammography.

Mammography - radiography of the mammary glands without the use of contrast agents, performed in two projections - is currently the most common method of instrumental examination of the mammary glands. Its reliability is very high. So, for breast cancer it reaches 95%, and this method allows you to diagnose non-palpable (less than 1 cm in diameter) tumors. However, this method is limited in application. Thus, mammography is contraindicated for women under 35 years of age, during pregnancy and lactation. In addition, the information content of this method is insufficient when studying dense mammary glands in young women.

Despite the universally recognized connection between diseases of the mammary glands and genitals, Russia has not developed the concept of an integrated approach to the diagnosis and treatment of diseases of the mammary glands and organs of the reproductive system. A comparison of changes in the mammary glands with and showed that the frequency of pathological changes in the mammary glands with uterine fibroids reaches 90%, nodular forms of mastopathy more often occur when uterine fibroids are combined with adenomyosis (V. E. Radzinsky, I. M. Ordiyants, 2003). Based on these data and the fact that more than half of women with benign breast diseases suffer from uterine fibroids and endometrial hyperplasia, the authors classify women with these diseases as a high-risk group for breast diseases.

In inflammatory diseases of the female genital organs, the frequency of benign diseases of the mammary glands was significantly lower - only in every fourth; nodular forms were not identified.

Consequently, inflammatory diseases of the genitals are not the cause of the development of FCM, but may be accompanied by hormonal disorders.

A mammological study of women of reproductive age with various gynecological diseases revealed a diffuse form of mastopathy in every third patient, and a third of women had a mixed form of FCM. The nodular form of mastopathy was determined in patients with a combination of uterine fibroids, genital endometriosis and endometrial hyperplasia.

Treatment of patients with nodular forms of benign diseases of the mammary glands begins with puncture with fine-needle aspiration. If cells with dysplasia in a nodular formation or cancer cells are detected during a cytological examination, surgical treatment is performed (sectoral resection, mastectomy) with urgent histological examination of the removed tissue.

Depending on the results of the examination, treatment of gynecological pathology, mastopathy, and correction of concomitant diseases is carried out.

Diet is important in the treatment and prevention of breast diseases: the nature of nutrition can affect the metabolism of steroids. An increased amount of fat and meat products is accompanied by a decrease in androgen levels and an increase in estrogen levels in the blood plasma. In addition, special importance is attached to a sufficient content of vitamins in the diet, as well as coarse fiber, since its anti-carcinogenic properties have been proven.

In recent years, the frequency of use of herbal medicines in the treatment of benign diseases of the mammary glands has increased.

Many studies are devoted to the treatment of this pathology, but the problem remains relevant today (L. N. Sidorenko, 1991; T. T. Tagieva, 2000).

To treat mastopathy associated with mastalgia, various groups of drugs are used: analgesics, bromocriptine, night primrose oil, homeopathic drugs (mastodinone), vitamins, potassium iodide, oral contraceptives, herbal remedies, danazol, tamoxifen, as well as natural progesterone for transdermal use. The effectiveness of these remedies varies. Pathogenetically, the most substantiated method of treatment is the use of progesterone preparations.

Since the late 80s. last century, injectable (Depo-Provera) and implanted (Norplant) progestogens are widely used for therapeutic and contraceptive purposes (A. G. Khomasuridze, R. A. Manusharova, 1998; R. A. Manusharova et al., 1994). Long-acting injectable drugs include medroxyprogesterone acetate in the form of Depo-Provera and norethindrone enanthate. The mechanism of action of these drugs is similar to that of the progestin components of combined oral contraceptives. Depo-Provera is administered intramuscularly at 3-month intervals. The most common complications resulting from the use of Depo-Provera are prolonged amenorrhea and intermenstrual bleeding. Our research data showed that the drug does not have a negative effect on normal tissue of the mammary glands and uterus, while at the same time it has a therapeutic effect in hyperplastic processes in them (R. A. Manusharova et al., 1993). Long-acting drugs also include the implantable drug Norplant, which provides contraceptive and therapeutic effects for 5 years. For many years, it was believed that hormonal drugs should not be prescribed to patients with FCM from the time the disease is diagnosed until the indication for surgical treatment. At best, symptomatic therapy was carried out, consisting of prescribing a collection of herbs, iodine preparations, and vitamins.

In recent years, as a result of research, the need for active therapy, in which hormones play a leading role, has become obvious. With the accumulation of clinical experience in the use of Norplant, reports appeared about its positive effect on diffuse hyperplastic processes in the mammary glands, since under the influence of the progestin component in the hyperplastic epithelium, not only inhibition of proliferative activity consistently occurs, but also the development of decidual-like transformation of the epithelium, as well as atrophic changes in the epithelium of the glands and stroma. In this regard, the use of gestagens is effective in 70% of women with hyperplastic processes in the mammary glands. A study of the effect of Norplant (R. A. Manusharova et al., 2001) on the condition of the mammary glands in 37 women with a diffuse form of FCM showed a decrease or cessation of pain and tension in the mammary glands. During a control study after 1 year, ultrasound or mammography showed a decrease in the density of the glandular and fibrous components due to a decrease in areas of hyperplastic tissue, which was interpreted as regression of hyperplastic processes in the mammary glands. In 12 women, the condition of the mammary glands remained the same. Despite the disappearance of mastodynia, the structural tissue of the mammary glands did not undergo any changes. The most common side effect of Norplant, like Depo-Provera, is menstrual irregularity in the form of amenorrhea and intermenstrual bleeding. The use of oral gestagens for intermenstrual bleeding and combined contraceptives for amenorrhea (for 1 - 2 cycles) leads to the restoration of the menstrual cycle in the vast majority of patients.

Currently, oral (tablet) gestagens are also used to treat FCM. Among these drugs, duphaston and utrozhestan are the most widely used. Duphaston is an analogue of natural progesterone, completely devoid of androgenic and anabolic effects, safe for long-term use and has a progestogenic effect.

Utrozhestan is a natural micronized progesterone for oral and vaginal use. Unlike synthetic analogues, it has beneficial advantages, which consist primarily in the fact that the micronized progesterone included in its composition is completely identical to the natural one, which leads to an almost complete absence of side effects.

Micronized utrogestan is prescribed 100 mg 2 times a day, duphaston 10 mg 2 times a day. Treatment is carried out from the 14th day of the menstrual cycle for 14 days, 3-6 cycles.

Combined oral contraceptives are prescribed to block ovulation and eliminate cyclical fluctuations in the levels of sex hormones.

Danazol is prescribed 200 mg for 3 months.

GnRH agonists (diferelin, zoladex, buserelin) cause temporary reversible menopause. Treatment of mastopathy with GnRH agonists has been carried out since 1990.

The first course of treatment is usually prescribed for 3 months. Treatment with GnRH agonists inhibits ovulation and ovarian function, promotes the development of hypogonadotropic amenorrhea and the reversal of mastopathy symptoms.

For cyclic hyperprolactinemia, dopamine agonists (parlodel, dostinex) are prescribed. These drugs are prescribed in the second phase of the cycle (from the 14th to 16th day of the cycle) before the onset of menstruation.

In recent years, various herbal remedies that have anti-inflammatory analgesic and immunomodulatory effects have become widespread. The fees are prescribed in the second phase of the menstrual cycle and are used for a long time.

One of the most effective means of treating mastopathy is a combined homeopathic drug - mastodinone, which is a 15% alcohol solution with extracts of medicinal herbs cyclamen, chilibuja iris, tiger lily. The drug is available in bottles of 50 and 100 ml. Mastodinon is prescribed 30 drops 2 times a day (morning and evening) or 1 tablet 2 times a day for 3 months. Duration of treatment is not limited

Mastodinone, due to its dopaminergic effect, leads to a decrease in elevated levels of prolactin, which contributes to the narrowing of the ducts, a decrease in the activity of proliferative processes, and a decrease in the formation of the connective tissue component. The drug significantly reduces blood flow and swelling of the mammary glands, helps reduce pain, and reverse the development of changes in the tissue of the mammary glands.

In the treatment of diffuse forms of mastopathy, the drug Klamin, which is a plant adaptogen with antioxidant, immunocorrective, hepatoprotective activity, has an enterosorbent and mild laxative effect, has become widespread. One of the most important characteristics of Klamin is the presence of iodine in its composition (1 tablet contains 50 mcg of iodine), which in areas with iodine deficiency completely covers its deficiency.

The drug phytolon, which is an alcohol solution of the lipid fraction of brown algae, has a high antioxidant and immunostimulating effect. The active principle is copper derivatives of chlorophyll and trace elements. The drug is prescribed orally in the form of drops or externally. Together with a complex of herbs it has a good absorbing effect.

If there are concomitant diseases, it is necessary to treat them. When diffuse FCM is combined with uterine fibroids, endometrial hyperplasia, adenomyosis, it is necessary to additionally add pure gestagens (utrogestan, duphaston) to the therapy.

We observed 139 women who complained of aching pain, a feeling of fullness and heaviness in the mammary glands, intensifying in the premenstrual days, sometimes starting in the second half of the menstrual cycle. The age of the patients ranged from 18 to 44 years. All patients underwent examination and palpation of the mammary glands, and attention was paid to the condition of the skin, nipple, shape and size of the mammary glands, and the presence or absence of discharge from the nipples. In the presence of discharge from the nipples, a cytological examination of the discharge was performed.

All women underwent ultrasound of the mammary glands, and in the presence of nodes, ultrasound and non-contrast mammography; according to indications, a puncture of the formation was performed, followed by a cytological examination of the obtained material. Using ultrasound of the mammary glands, the diagnosis of the diffuse form of FCM was confirmed in 136 cases.

The menstrual cycle was disrupted by the type of oligomenorrhea in 84 women, 7 of the observed patients had polymenorrhea, and in 37 patients the cycle was apparently preserved, but functional diagnostic tests revealed anovulation. In 11 women, the menstrual cycle was not disrupted, but they had pronounced symptoms of premenstrual syndrome, which were observed in every menstrual cycle and affected the patient’s quality of life.

In 29 patients, mastopathy was combined with hyperplastic processes in the uterus (uterine fibroids, endometrial hyperplasia), in 17 - with adenomyosis, in 27 patients, along with mastopathy, there were inflammatory diseases of the genitals, in 9 women pathology of the thyroid gland was detected. Those examined often had extragenital pathology, and 11 close relatives had benign and malignant diseases of the genitals and mammary glands.

Based on the examination results, gynecological pathology, mastopathy and other concomitant diseases were treated. For the treatment of mastopathy in 89 patients, progestogel, gel, 1% - natural micronized local progesterone of plant origin was used. The drug was prescribed in a dose of 2.5 g of gel on the surface of each mammary gland 1-2 times a day, including during menstruation. The drug does not affect the level of progesterone in the blood plasma and has only a local effect. The use of progestogen was continued for 3 to 4 months. If necessary, patients were prescribed a course of maintenance therapy: vitamins E, B, C, A, PP. In addition, sedatives (tincture of valerian, lemon balm, motherwort) and adaptogens (Eleutherococcus, ginseng) were prescribed.

In 50 women, mastopathy was treated with mastodynon, which was prescribed 1 tablet 2 times a day in two courses, 3 months each, with an interval between courses of 1 month. The main active component of the drug Mastodinon is Agnus castus extract, which acts on dopamine D2 receptors of the hypothalamus and reduces the secretion of prolactin. A decrease in prolactin secretion leads to regression of pathological processes in the mammary glands and relieves pain. Cyclic secretion of gonadotropic hormones with normal prolactin levels restores the second phase of the menstrual cycle. At the same time, the imbalance between the levels of estradiol and progesterone is eliminated, which has a positive effect on the condition of the mammary glands.

Ultrasound was performed 6-12 months after the start of treatment. Positive dynamics were considered to be a decrease in the diameter of the ducts, the number and diameter of cysts, as well as their disappearance.

After the treatment (for 4-6 months), all 139 women showed positive dynamics within 1 month, which was expressed in a decrease and/or cessation of pain and a feeling of tension in the mammary glands.

During control ultrasound 6-12 months after the end of treatment, a decrease in the density of the glandular and fibrous components was noted due to a decrease in areas of hyperplastic tissue, which was interpreted as regression of the hyperplastic process in the mammary glands. In 19 women with a diffuse form of FCM and in 3 with fibroadenoma, an objective examination and ultrasound revealed no changes in the condition of the mammary glands, however, all patients noted an improvement in their condition (pain, a feeling of tension and fullness in the mammary glands disappeared).

Side effects when using the drugs Mastodinone and Progestogel were not noted in any observation.

The use of these drugs is pathogenetically justified.

There is no treatment algorithm for the treatment of mastopathy. Conservative treatment is indicated for all patients with a diffuse form of mastopathy.

R. A. Manusharova, Doctor of Medical Sciences, Professor

E. I. Cherkezova, Candidate of Medical Sciences

RMAPO, Andrology Clinic, Moscow

Fibrocystic mastopathy (FCM) is a pathological condition of the mammary glands, accompanied by the appearance of lumps and cysts of various sizes and shapes. This is a fairly common disease among women of reproductive age, affecting at least half of the female population. The disease responds well to treatment in the early stages: it is better to undergo all therapeutic procedures in advance, without waiting for adverse consequences to develop.

ICD-10 code

N60.1 Diffuse cystic mastopathy

Causes of fibrocystic mastopathy

The main reason for the development of fibrocystic mastopathy is hormonal destabilization in the body: the hormones progesterone and estradiol play a dominant role in the process. Factors that determine hormone imbalance may include the following:

• early puberty. The rapid renewal of hormonal levels does not allow the body to quickly adapt to changes, which is reflected in the tissue structure of the mammary glands;
• late menopause. The long-term effect of hormones on gland tissue plays a decisive role;
• no history of pregnancy;
• frequent forced termination of pregnancies (more than twice) provokes a sharp rise and fall in hormonal activity;
• absence or extremely short lactation period;
• constant or frequently recurring stress;
• age period from 40 years;
• metabolic disorders - obesity, diabetes mellitus, endemic goiter;
• liver dysfunction;
• endocrine system disorders: hypo- or hyperthyroidism, thyrotoxicosis;
• genitourinary diseases, reproductive disorders;
• uncontrolled use of hormonal drugs, including contraceptives.

Symptoms of fibrocystic mastopathy

Initially, the fibrocystic form of mastopathy was not defined as a condition predisposing to breast cancer. However, recent scientific research has shown that mastopathy should be considered precisely as a precancerous condition, which under certain circumstances can transform into a malignant tumor.

The likelihood of developing breast cancer as a consequence of FCM depends on many factors, for example, the total duration of the disease, its stage, intensity and brightness of manifestations. A history of multiple and large cysts, fibroadenoma, adenosis, hyperplasia and proliferative mastopathy increases the risk of developing cancer by 2-4 times.

Although fibrocystic mastopathy is considered a benign disease, in some cases it is an intermediate process in the formation of a malignant formation. That is why medical examination of patients with treated FCM and long-term monitoring of their condition is an important link in the prevention of breast cancer.

The clinical symptoms of fibrocystic mastopathy are determined by painful sensations, thickening of the mammary gland and the appearance of discharge from the milk ducts. By palpation you can feel small- and coarse-grained formations, dense areas of breast tissue. Pain in this disease can appear spontaneously, or occur only when trying to touch: a feeling of slight discomfort can be replaced by sharp, severe pain even from a small touch.

Pain in the mammary gland may be accompanied by a feeling of heaviness, puffiness, squeezing, and sometimes radiates to the shoulder joint or to the axillary area.

Patients often note the appearance of secretion from the milk canals: the secreted liquid resembles colostrum, or may be slightly yellow or greenish.

The initial symptoms of fibrocystic mastopathy may be more pronounced with the onset of menstruation or PMS. As the disease progresses, the symptoms become more pronounced, the pain is more noticeable, and tissue compactions can be detected regardless of the frequency of the cycle.

Pain in fibrocystic mastopathy

The presence of pain in fibrocystic mastopathy is a fairly common, but very individual symptom. Dull, aching, shooting, twitching, it can have varying intensity and be accompanied by a feeling of pressure in the mammary glands.

The pain often intensifies before the onset of menstruation (at the same time the level of hormones increases), may be limited to local manifestations or radiate to the shoulder joint, subscapularis and axillary region.

Not all women feel pain with mastopathy: about 10% of patients usually do not observe signs of painful discomfort, and some feel pain only during their menstrual period. At the same time, the general symptoms of the disease may be absolutely the same. The reason for this phenomenon may be differences in pressure on nerve endings and differences in individual pain thresholds.

Also, soreness can be observed not only in the mammary glands, but also in nearby lymph nodes, which may be slightly enlarged and tense.

Discharge from fibrocystic mastopathy

Discharge from fibrocystic mastopathy may not be observed in all cases of the disease. This phenomenon is individual: there may be no liquid discharge at all, sometimes it can be very copious (often this sign allows one to independently detect the disease), or occur only when the peripapillary area is slightly compressed. The discharge usually does not have a specific odor, its color varies from transparent, light, whitish to yellowish and greenish. Sometimes their appearance resembles colostrum (the secretion of the mammary glands, secreted in the last days of pregnancy and in the first days after childbirth).

In some cases, the discharge may acquire a brownish or bloody tint: this is a rather serious symptom that requires mandatory medical examination. Bloody discharge from the milk ducts can be a sign of a malignant process in the mammary glands, destruction of the capillary blood supply system and damage to the walls of the ducts.

In principle, any detected nipple discharge requires consultation with a specialist, and this especially applies to discharge mixed with blood.

Pregnancy and fibrocystic mastopathy

Pregnancy with fibrocystic mastopathy is not only possible, but also desirable. Everyone knows that during the period of bearing a child, a significant restructuring of the hormonal status in a woman’s body occurs. This can serve as an impetus for further stabilization of hormone levels and stopping the development of the disease. For this reason, many gynecologists strongly recommend that women become pregnant, safely carry the child to term, and subsequently breastfeed the child.

By the way, the natural period of lactation often becomes the main medicine to combat the disease. You should not interrupt breastfeeding in advance: the period of breastfeeding often brings women relief and even complete recovery with the resorption of cystic formations and nodes.

If a woman was treated for FCM with hormonal drugs and became pregnant in the same cycle, treatment of the disease should be stopped immediately, since the use of hormones during pregnancy requires great caution. In this situation, consult your doctor; perhaps he will prescribe you other, non-hormonal drugs approved for use during pregnancy.

Lactation

The question of breastfeeding a child with fibrocystic mastopathy should be decided by a mammologist, since the degree of progression and severity of the disease is individual for all women.

The bottom line is that breastfeeding promotes certain physiological processes in a woman’s body: in particular, the growth and reproduction of epithelial cells of the mammary glands are activated, which tend to synthesize their own antibodies that can affect various neoplasms, including cysts and fibromatous nodes.

Long-term breastfeeding should be carried out with constant monitoring of the condition of the mammary glands, with periodic examination by a doctor and measures to prevent lactostasis. Taking medications during the lactation period must be agreed with the doctor.

Fibrocystic mastopathy and cancer

According to recent scientific research, fibrocystic mastopathy should be considered as a possible precancerous condition. This concept is morphological in nature, it can include intraductal atypical proliferation of the epithelium and manifestations of carcinoma.

If you notice the following signs and symptoms on your breasts, you should immediately seek advice from a specialist:

• nodular compaction in tissues or on the skin of glands, especially nodes welded to tissues and to each other;
• the appearance of ulcerative lesions on the skin, in the area around the nipple, or crusts on or around the nipple;
• localized or widespread swelling of the breast tissue;
• bloody, brown or black discharge from the milk ducts;
• the appearance of areas of redness on the skin;
• change in the shape of the breast, the appearance of tuberosity, disruption of the contours of the glands or the nipple area;
• the appearance of asymmetry in the location of the mammary glands;
• inability to displace the gland.

Forms

ICD-10 is a generally accepted international classification of diseases, among which there are all types of mastopathy. It is the primary information document used by healthcare professionals around the world. Standardization and unification of diseases has the right to be revised only once a decade.

This classification is designed to create the most comfortable conditions for determining the analytical data of world statistics regarding the level of disease cases and deaths that are periodically recorded and sent by various regions and countries of the world. Diagnostic indicators are described as an alphanumeric code, which is extremely convenient in the process of storing and retrieving the necessary information. Data received from all over the world is carefully structured and processed.

Diseases and pathological conditions of the mammary gland in the ICD 10 list are in the subsection of diseases of the genitourinary system, numbered N60-N64.

Diffuse fibrocystic mastopathy

Diffuse lesions of the mammary gland are characterized by excessive growth of connective tissue areas of various shapes. This condition can disrupt the structure of the canals and lobular structure of the glandular organ and contribute to the appearance of small cystic formations.

The diverse etiology of diffuse mastopathy can be associated with genetic predisposition, ecology, and multiple external factors. The determining causes are a disorder of neurohumoral processes, increased estrogen synthesis and progesterone deficiency.

Depending on the structure and nature of tissue damage, the following types of diffuse mastopathy are distinguished:

• pathology with dominance of the glandular component (adenosis);
• pathology with a dominance of the fibrous component (fibroadenomatosis);
• pathology with a dominance of the cystic component (cystosis);
• mixed course of FCM;
• sclerosing type of adenosis.

The intensity of the detected disorders makes it possible to divide diffuse mastopathy into minor, moderate and severe forms.

Nodular fibrocystic mastopathy

The term “focal fibrocystic mastopathy” is often also applied to nodular FCM. Nodular mastopathy can be characterized by the proliferation of connective tissue areas and the formation of cystic formations resembling single or multiple nodes.

With this disease, one or a group of nodules with clear, limited contours can be palpated in the mammary gland. Before the onset of menstruation, nodular formations may swell, enlarge, and become somewhat painful. At the end of menstruation, you can easily palpate low-painful nodules of various shapes, densely elastic consistency, having clear boundaries that are not fused with the surrounding tissues. It is noteworthy that in a horizontal position the nodules can be palpated extremely weakly, or even completely absent.

Peripheral nodes usually do not enlarge.

The pain may be insignificant or absent at all, and the presence of nodules in women is more often discovered completely by accident: thus, the manifestations of the disease can be very individual.

Nodular mastopathy is quite often a consequence of a diffuse disease.

Nonproliferative fibrocystic mastopathy

The medical term non-proliferative fibrocystic mastopathy refers to a disease of the mammary glands that does not have characteristic signs of proliferation, namely tissue proliferation of the glandular organ with the formation of a neoplasm and intensive cell division and multiplication. With this pathology, there is no increase in the number of structural elements of the tissue and the organ as a whole, and there is no excessive growth of tissue, as in many other pathological conditions. There may be significant or localized tissue swelling that cannot be described as the formation of new structures.

Proliferation is the process of cell reproduction, which in most cases turns out to be the final stage of any inflammation, in which a clear separation of the pathological focus from healthy nearby tissues can be observed.

The non-proliferative form of FCM has a more favorable course and prognosis, but requires no less careful medical monitoring and treatment.

Mixed fibrocystic mastopathy

With a mixed form of fibrocystic mastopathy, the characteristic symptoms of all forms of the disease are combined:

• signs of diffuse FCM with a predominant cystic component, when small cavity formations (capsules or cysts) with fluid form in the mammary gland;
• signs of fibrous mastopathy with a predominant fibrous component, in which connective tissue areas grow in the gland;
• manifestations of adenosis of the mammary glands (proliferation with a predominant glandular component) - excessive growth of glandular tissue, which is characterized by a significant increase in breast size;
• cystic formations, or nodes, affect the mammary gland both in the form of single manifestations and total multiple tumors that can be easily palpated in an upright position;
• the simultaneous development of fibroadenoma is possible - a round, mobile and dense formation of a benign nature in the mammary gland.

This form of the disease is a somewhat advanced version of the disease, is more difficult to treat and requires long-term therapeutic interventions.

Bilateral fibrocystic mastopathy

The name of this form of FCM speaks for itself - manifestations of fibrocystic disease with this pathology are present on two mammary glands simultaneously. The changes are expressed in hyperplasia of connective tissue, fibrous, glandular elements in both mammary glands, affecting the organs themselves and their milk canals, which contributes to the disruption of trophic processes and the formation of cystic formations.

Such bilateral damage to the mammary glands approximately doubles the risk of a malignant tumor, although FCM itself does not pose a life-threatening threat.

Bilateral fibrocystic mastopathy is a consequence of a persistent, long-term and serious imbalance in the hormonal balance in the body, therefore its treatment should be aimed primarily at restoring the normal natural level of hormones, identifying the cause of the imbalance (pathology of the ovaries, thyroid gland, adrenal glands, pituitary system, etc. .).

Fibrocystic mastopathy during menopause

Violation of the regularity of the appearance of menstruation and their complete disappearance for a woman of fifty years of age is considered a normal physiological state, moreover, it determines the positive dynamics of the current pathological processes of the reproductive system of the body, up to complete recovery.

The risk of acquiring additional or aggravating existing breast disease may increase if the onset of menopause occurs too early (before 45 years) or too late (after 55 years).

With the first symptoms of menopause, a significant change in hormonal balance occurs. During this time, the mammary glands may cause pain and a feeling of tension and pressure.

Typically, the signs of fibrocystic mastopathy weaken in this period. Cystic formations, cords and nodes in the mammary glands can significantly decrease or disappear altogether, pain and heaviness in the chest gradually fade away.

Simultaneously with the decrease in ovarian function, the glandular tissue in the mammary glands gradually atrophies and is replaced by connective tissue and lipid areas.

Fibrocystic mastopathy and IVF

In vitro fertilization (IVF) is the so-called “test tube conception”, sometimes the only way for childless couples to have their own child. Before preparing for artificial insemination, you should see many doctors to determine possible contraindications to the procedure. Often women are very worried about the presence of various forms of FCM: what will the doctor say, and is mastopathy a contraindication to IVF?

Honestly, their worries are not groundless: during artificial insemination, the method of hormonal stimulation is used, and this can significantly complicate the course of the disease and provoke a rapid increase in cystic formations.

However, many doctors understand the importance of this procedure for a woman. Also taken into account is the fact that FCM phenomena tend to regress during the period of breastfeeding. Therefore, reproductology and mammology often give permission to perform in vitro fertilization procedures even in the presence of fibrocystic mastopathy.

Complications and consequences

The most common consequences of FCM may be the following conditions:

• an increase in the size of the cystic formation with a visual change in the mammary gland;
• development of a background inflammatory process with subsequent infection and suppuration of the cystic formation;
• degeneration of a cystic formation into a malignant one;
• rupture, violation of the integrity of the cyst.

Fibrocystic mastopathy cannot pose any immediate danger to the patient’s life and is not the cause of significant discomfort and inability to live a full life (in the absence of advanced stages with huge cystic formations).

The severity of the pathological process is aggravated only with the background development of the inflammatory reaction, the entry of an infectious agent, and signs of suppuration of the nodes.

There are also cases of transformation of a cyst into a cancerous tumor, because it is known that the development of mastopathy significantly increases the risk of the formation of a malignant tumor.

Diagnosis of fibrocystic mastopathy

Cystic FCM can be detected by independently palpating the mammary glands. To confirm the diagnosis, ultrasound and mammography (x-ray of the mammary glands) are used.

The mammography method is quite informative and determines the size, contours and number of cystic formations.

The ultrasound method provides the opportunity for a detailed examination of formations with examination of the cystic wall.

Magnetic resonance imaging is used quite rarely; this method allows for a thorough examination of each layer of tissue and formations.

Aspiration biopsy of the breast determines the nature of the cystic formation; a similar result can be demonstrated by pneumocystography.

Histological examination of the material extracted during biopsy is mandatory: this method is necessary to study the cellular structure of the cyst and allows you to refute the malignant nature of the formations, determine the presence of intraductal papilloma, or clarify the presence of inflammatory and purulent processes in the cyst.

Also, standard diagnosis of mastopathy is impossible without palpation of the mammary glands and collection of anamnesis characteristic of this pathology. Sometimes blood tests may be ordered to determine the extent of hormonal imbalance.

Ultrasound

The ultrasound method allows you to measure the thickness of the layer of glandular tissue in each area of ​​the mammary glands from the periphery to the peripapillary zone, as well as evaluate tissue density in various zones of the organs.

The image obtained using ultrasound changes steadily depending on the patient’s age: over the years, the thickness of the glandular tissue layer decreases, and the density increases, reaching maximum values ​​by the age of 55.

The structure of the mammary glands varies significantly during adolescence, the reproductive period, menopause, as well as during pregnancy and breastfeeding.

With fibroadenomatosis and diffuse mastopathy, the picture may be different depending on the dominance of any sign of the disease: it can be glandular hyperplasia, cystic formations, fibrous changes or a mixed type of pathology. Very often, the cystic manifestation of FCM is combined with signs of fibrosis of glandular tissues.

The main ultrasound signs of fibrocystic mastopathy are:

• fibrous changes (fibrosis of areas of the milk canals and septa);
• discrepancy between the structure of the mammary glands and the patient’s age;
• lesions of the nipple and surrounding area;
• thickening of the glandular tissue layer more than 14 mm;
• dilation of the mammary ducts;
• detection of cystic formations.

Puncture

The puncture is usually performed by aspiration using a thin needle. The cystic capsule is punctured with a needle, which simultaneously aspirates the internal contents of the cyst. The procedure is not only diagnostic, but also therapeutic.

The cystic contents obtained during puncture usually have a yellowish-gray color, but if the cyst exists for a long time, the fluid may acquire a brown-black or greenish color. Cytological examination of the contents is rarely carried out due to its low information content.

A puncture for collecting cells from a tumor-like formation of the mammary gland is a fairly popular research procedure. The obtained cell samples are necessarily sent for histological and cytological examination. Sometimes, if the aspiration result is negative, a repeat cell biopsy may be prescribed.

Puncture of the mammary gland is a low-painful, but extremely informative procedure, which is extremely necessary in the differential diagnosis of fibrocystic FCM.

Treatment of fibrocystic mastopathy

The main measures in the treatment of fibrocystic mastopathy should be aimed at stabilizing the normal hormonal levels in the female body.

Therapeutic methods of influence are determined by a specialist based on the results of tests of hormones in the blood, in particular progesterone, estradiol and prolactin. In accordance with the results, medications are prescribed that can correct the imbalance of hormones.

Treatment of mastopathy may include a puncture method of aspiration of fluid from the cyst with further introduction into the cavity of special drugs that provoke obliteration of the walls of the cyst (sclerotherapy). This procedure is applicable to ordinary cystic formations without symptoms of malignancy of the process and symptoms of an intraductal tumor.

In severe situations, characterized by the appearance of multiple cystic formations, excessive tissue growth, as well as when malignant degeneration of cells is suspected, a sectoral resection of the mammary gland is used with mandatory histology of samples of removed tissue.

Traditional treatment

Traditional treatment of fibrocystic mastopathy is used for unstable and mild symptoms of the disease; with nodular FCM, a slight decrease in formations is noted, but relapses of pathological foci cannot be excluded.

Cabbage leaves are also effective in treating mastopathy. Usually, cabbage leaves are applied at night, or a compress is made: the mammary gland is lubricated with unsalted butter, a clean cloth is applied, and a mixture of ground cabbage and sour milk is applied. You can use this compress both day and night, after wrapping your chest in cellophane.

Using a mask of castor oil (100 g), honey (2 tablespoons), lemon juice (from 2 lemons) and ground burdock root (to the consistency of sour cream) will help with varying degrees of disease development. All ingredients are mixed and placed on a clean linen napkin. Constant use of the mask allows you to achieve recovery within a month after the start of treatment.

Also popular are products based on herbs and medicinal plant infusions.

Herbal treatment

• The Altai herb borovaya uterus is recognized as very effective for women's diseases. It is used for hormonal disorders in the body, to restore metabolism, the function of the endocrine system, and has a beneficial effect on the condition of the ovaries, bladder, and mammary glands. The tincture of this herb is prepared as follows: 0.5 liters of high-quality vodka, pour 50 g of boron uterus, leave for 2 weeks in a dark place (not in the refrigerator). Take a teaspoon three times a day before meals, duration of use is about six months, with interruption of treatment during menstruation.
• Red brush herb perfectly cleanses the genitourinary system and stabilizes the functioning of the endocrine system. The tincture of this herb is used three times a day, half a teaspoon in half a glass of water, taken with meals for a month, taking a break during menstruation.
• Burdock root can be poured into three glasses of boiling water (per 60 g of leaves), leave for 4 hours, strain and drink a glass three times a day before meals.
• Yarrow, motherwort and string - mix 2 tablespoons of raw materials and pour in a liter of boiling water. Take 1 glass before meals. An excellent remedy for diffuse mastopathy.
• Mix equal parts of honey, lemon juice, radish juice, carrot and beet juice with an equal share of Cahors wine, take 2 tablespoons of the mixture before meals until the symptoms of the disease completely disappear.

Operation

Surgical treatment is used for fibroadenoma or some large cystic formations.

For minor tumors and nodes, sometimes conservative therapy and periodic observation by a specialist are sufficient.

The following methods of surgical treatment of the disease are usually used:

• sectoral resection (the formation is removed simultaneously with a section of the mammary gland);
• enucleation of a cystic formation (husking and removal of the cyst itself).

The use of surgical treatment must be justified and used for the following indications:

• based on a histological examination confirming suspicion of malignancy of tumor cells;
• with intensive growth of formation (the tumor is observed for three months);
• with repeated recurrence of nodular FCM after conservative or sclerotherapeutic treatment of the disease.

Surgery is performed using general or local anesthesia; the operation lasts about 40 minutes.

Drug treatment

Therapeutic drugs used in the treatment of mastopathy should primarily be aimed at eliminating the causes of the disease, improving the body's immunity, and treating pathologies of the ovaries and thyroid gland.

• Hormonal agents: progesterone, duphaston, utrozhestan, etc.
• Contraceptives - used to regulate the menstrual cycle.
• Estrogen inhibitors.

For severe pain, analgesic drugs, diuretics (relieve swelling of the gland before menstruation), and homeopathic remedies are used.

Starting from the age of forty, steroid drugs methylandrostenediol, methyltestosterone, and testosterone injections may be prescribed.

If the function of the corpus luteum is insufficient, progesterone medications or injections are taken in the second phase of the cycle.

Iodine preparations may be prescribed for insufficient thyroid function.

The effectiveness of the listed funds is varied. However, the benefits of treatment are felt as a result of the complex effects of drugs: analgesics, bromocriptine, vitamins, homeopathy, potassium iodide, contraceptives, herbal remedies, tamoxifen, danazol, progestin agents, etc.

Mastodinon

The drug Mastodinon is a homeopathic remedy that is very popular among women who have problems with the menstrual cycle, pathology of the mammary glands, and PMS.

The drug is popular primarily for its effectiveness, as well as the natural origin of the composition of the product: the medicine is based exclusively on herbs.

Mastodinon eliminates various menstrual cycle disorders, helps with fibrocystic FCM, and relieves the accompanying symptoms of PMS.

The drug helps reduce the synthesis of prolactin by the posterior lobe of the pituitary gland, which allows it to influence the processes of pathological proliferation of mammary tissue.

Taking Mastodinon is extremely rarely accompanied by side effects due to the presence of exclusively natural components in the drug.

Mastodinon for fibrocystic mastopathy is used 30 drops or one tablet twice a day. Can be diluted with a small amount of liquid.

The drug should be taken for at least 90 days continuously, the visible effect appears already in the second month of use.

Mastodinon can be taken for quite a long period if there are proper medical indications for this.

Homeopathy

The use of an alternative method of treatment with homeopathy has long proven itself to be good: homeopathic remedies do not accumulate in the body, do not provoke allergic and adverse reactions, and are suitable for treating pregnant women and nursing mothers, the elderly and small children.

Homeopathy can cure the disease within 2-5 weeks, and relapses after taking medications are extremely rare.

During the inflammatory process in the tissues of the gland, drugs based on apis (apis mellifica) work well, and belladonna will relieve swelling and a burning sensation in the mammary glands.

Significant suppuration of the gland, accompanied by high temperatures and dull pain, is a reason to prescribe drugs prepared from bryonia and bufo plants. Pulsatilla extract can help cure breast disease caused by injury.

Despite the fact that homeopathic medicines have virtually no contraindications and precautions in use, the use of remedies should be discussed with a doctor. He will help you choose the right drug that will make treatment of the disease even more effective.

Vitamins

Drug therapy for fibrocystic FCM is often supplemented with vitamin complexes containing vitamin A, B1, B2, B6, PP and ascorbic acid, as well as vitamin E.

Vitamin E has a special role in therapeutic measures in the fight against the disease. This vitamin has antioxidant properties, enhances the action of progesterone, takes part in the regulation of fat metabolism, and softens the manifestations of premenstrual syndrome.

The antioxidant properties explain the anti-inflammatory and regenerative effects of the drug. However, for it to be effective, you must take vitamin E for at least three months.

B vitamins are also important in the treatment of mastopathy. They are responsible for the normal functioning of the nervous system and normalize energy metabolism. The performance of the immune system, cell division and growth are ensured by these vitamins. It is especially necessary to take vitamin supplements for people who are characterized by mental and emotional stress, stress, and chronic diseases.

You can improve the supply of vitamins to your body by taking vitamin complexes, or provide your diet with a sufficient amount of vegetables and fruits.

Nutrition and diet

The principles of changing nutrition for fibrocystic mastopathy are aimed at stabilizing the hormonal levels in the body.

It is recommended to include foods containing fiber in the diet - these are all types of cereals, parsley, dill, and various greens. It is important to consume natural estrogens - these are peas, beans, lentils, chickpeas, mung beans, cabbage (white cabbage, Brussels sprouts, Peking cabbage, broccoli, Savoy, cauliflower). Needless to say, the body needs vitamins and minerals contained in citrus fruits, dried fruits, and other fruits and vegetables.

Iodine, which is rich in seafood and fish, is also useful for the functioning of the endocrine system. The source of the necessary phospholipids will be liver dishes and fermented milk products.

It is recommended to limit the consumption of animal fats, fast carbohydrates, and monitor the caloric content of the diet: the presence of excess weight adversely affects the health of the mammary glands and the reproductive function of a woman.

The diet for fibrocystic mastopathy should be balanced, rich in vitamins and dietary fiber. Great importance should be paid to the drinking regime: a sufficient amount of liquid will allow you to quickly stabilize metabolic processes in the body. One and a half liters of clean water per day is the optimal amount of fluid for the normal functioning of the body.

In addition, for successful treatment of FCM, it is necessary to exclude foods containing methylxanthines from the diet - black tea, coffee, cocoa, Coca-Cola, chocolate.

What are the causes of fibrocystic mastopathy, what is it? This disease is characterized by a benign course. Fibrocystic mastopathy is accompanied by the appearance of lumps and cysts in the breast, which can have different shapes and sizes. Most often, this form of the disease is diagnosed in women of reproductive age (30-45 years).

Those at risk include those who suffer from various gynecological problems. Fibrocystic mastopathy is very easy to cure in the early stages. Therefore, timely consultation with a doctor will prevent many life-threatening consequences for a woman.

The mechanism of pathology development

The mechanism of development of fibrocystic mastopathy is the presence of hormonal imbalance in a woman’s body. Most often, this pathology occurs due to insufficient production of progesterone.

Also, cystic fibrous mastopathy appears in the presence of concomitant problems with the ovaries, which leads to hyperfunction of estrogen. This hormone causes increased cell division in the mammary glands, which should be inhibited in the second phase of the menstrual cycle when sufficient progesterone is produced.

Excessive prolactin production also has a negative effect on the condition of the mammary glands. This hormone is responsible for lactation and normally begins to be released during pregnancy. If the level of prolactin has increased for other reasons, then the development of fibrocystic mastopathy is quite possible.

Causes of the disease

Changes in hormonal levels that lead to fibrocystic mastopathy occur in the presence of certain negative factors. To provoke this disease, it is necessary that they act on the woman’s body for a long period of time.

Also, cystic fibrous mastopathy often appears with the simultaneous negative influence of several factors. These include:

• early puberty, which leads to rapid hormonal changes and subsequently to mastopathy;
• late menopause. Long-term hormonal effects on the mammary glands can provoke fibrocystic mastopathy;
• absence of pregnancy and childbirth before age 30;
• refusal or premature termination;
• hereditary predisposition to mastopathy;
• prolonged exposure to stress or depression;

• presence of bad habits – smoking, alcohol abuse;
• injury to the mammary glands;
• the presence of hormone-dependent gynecological diseases - fibroids, endometriosis, and others;
• pathologies of the liver, thyroid gland, adrenal glands;
• obesity. Subcutaneous fatty tissue is involved in the process of estrogen synthesis, which leads to an increase in its level;
• the presence of tumors in the hypothalamic-pituitary region;
• lack of regular sex life, sexual dissatisfaction.

Symptoms of mastopathy

Fibrocystic mastopathy - what is it and how does it manifest? This pathology can be determined based on the main symptoms that accompany it. With mastopathy (fibrocystic mastopathy), the following negative manifestations are observed:

• painful sensations. Initially, fibrocystic mastopathy manifests itself as minor discomfort, which intensifies on the eve of the next menstruation. Subsequently, the woman experiences severe pain. It can be dull, aching or even sharp. so large that the chest is almost impossible to touch;
• the appearance of discharge from the nipple. The presence of this symptom is not necessary for mastopathy. If discharge is present, it may be transparent, white, or greenish (indicates the addition of a secondary infection). The appearance of blood in their composition indicates a malignant course of the disease. Discharge may appear when you press on the nipple or flow out on its own;
• During palpation, many formations are detected, which can have different sizes and character. Usually these seals are quite painful.

Symptoms, treatment, and prevention of this pathology are determined based on its course characteristics. There are two main forms of the disease – diffuse and nodular. In the latter case, formations characteristic of fibrocystic mastopathy are localized in one area of ​​the mammary gland. They appear in the form of dense nodes without obvious boundaries, the size of which can reach 6-7 cm. When a cyst forms, a round formation is detected. It is elastic, has clear boundaries and is not connected to surrounding tissues.

With the development of a diffuse form of the disease, painful lumps are located throughout the entire volume of the chest. In this case, fibrocystic mastopathy is divided into several types:

• adenosis Characterized by a predominance of glandular tissue. In this case, there is an increase in the density of the mammary glands in combination with pain;
• fibrous form. Characterized by the appearance of compactions that lead to a significant narrowing of the ducts;
• cystic form. Characterized by a predominance of cysts;
• mixed form. It is characterized by the appearance of various pathological formations in almost equal proportions.

Diagnosis of mastopathy - initial examination

Fibrocystic mastopathy of the mammary glands is diagnosed using an integrated approach. First of all, the mammologist examines the patient’s medical history and conducts an examination. It involves palpation of the mammary glands, which makes it possible to determine the presence of nodes and dense inclusions, which can be found in single or multiple quantities.

Palpation of the chest is performed in two positions - standing and lying down. This examination is used to diagnose mastopathy only in the first phase of the cycle. At other times, palpation is not advisable, since the result obtained will be distorted.

The doctor also carefully examines the breasts. It determines their symmetry, the presence or absence of swelling, and the position of the nipples. The initial examination of a woman necessarily includes palpation of regional lymph nodes. Those located in the armpits, near the collarbones, are of diagnostic value. The presence of any seals is taken into account. Also, when examining a woman, the doctor squeezes the nipples. This allows you to determine the presence of discharge, its nature and volume.

Instrumental and laboratory methods for diagnosing mastopathy

If FCM is suspected, the doctor prescribes additional tests and diagnostic procedures, which makes it possible to more accurately determine the nature of negative changes in the mammary glands. These include:

• mammography. Consists of conducting an X-ray examination of the mammary glands. This diagnostic procedure is performed for women over 35 years of age. At an earlier age, mammography is indicated if there is a high risk of breast cancer. Using this research method, it is possible to identify the smallest formations in the mammary glands during mastopathy, which are not detected during palpation;
• Breast ultrasound. For fibrocystic mastopathy, treatment can be prescribed only after undergoing this diagnostic procedure. This is an effective research method that is most often used for young women during pregnancy or lactation. Sometimes ultrasound for mastopathy can be uninformative, especially if this procedure is performed by a doctor with low qualifications;
• puncture with biopsy. If, as a result of an examination or other diagnostic procedure, a suspicious area is identified, a histological examination of its tissue is performed. For this purpose a puncture is made;
• blood test for hormones. First of all, the level of estrogen, progesterone, and, if necessary, prolactin is determined. In some cases, a test is performed for thyroid and adrenal hormones;
• Ultrasound of the pelvic organs. This diagnostic procedure allows us to identify gynecological problems that often lead to fibrocystic mastopathy;
• biochemical and general blood test. This study is necessary to identify other pathologies.

Conservative treatment with non-hormonal drugs for mastopathy

How to treat fibrocystic mastopathy to get rid of this problem forever? In the early stages of the disease, doctors recommend resorting to non-hormonal therapy, which is aimed at normalizing the functioning of the entire body.

This technique is also used in more severe cases of mastopathy in combination with other treatment methods. Non-hormonal therapy is based on the use of the following medications:

• vitamin and mineral complexes. Drugs from this group have a positive effect on the functioning of the entire body, which directly affects the condition of the mammary glands and relieves mastopathy. Most often, vitamins A, E, P, PP, C, B6 are prescribed;
• iodine preparations. Have a positive effect on the functioning of the thyroid gland, which plays a major role in the production of many hormones that directly affect the condition of the mammary glands;
• sedatives. They are used if the sick woman is prone to excessive emotional distress, anxiety, or has more serious psycho-emotional problems;
• herbal remedies. Prescribed to eliminate hormonal imbalance in a woman’s body. Herbal medicines act more mildly than their synthetic counterparts, but to achieve a positive result it is necessary to undergo a long course of treatment;
• anti-inflammatory drugs (non-steroidal). Used to eliminate pain and swelling, which cause a lot of suffering with fibrocystic mastopathy;
• diuretics. They are used only in some cases to eliminate large swelling in the mammary glands.

Hormonal therapy for mastopathy

How to cure fibrocystic mastopathy of the mammary glands in the presence of serious pathological changes? In many cases, hormonal therapy will be effective in eliminating the hormonal imbalance that leads to this disease. Women with mastopathy are most often prescribed:

• gestagens. Prescribed for the second phase of the cycle to normalize the levels of estrogen and progesterone. Treatment with gestagens should last at least 4 months. Also, drugs from this group can be used topically in the form of gels, which minimizes the possibility of any side effects;
• inhibitors of prolactin production. Prescribed to reduce the level of this hormone, which is determined based on a blood test;
• androgens. Treatment with these data is indicated for women at a more mature age (after 45 years). Androgens are prescribed for a long period - 4-6 months;
• antiestrogens. These drugs inhibit the production of estrogen, which leads to an improvement in the condition of women with mastopathy;
• . Prescribed for women under 35 years of age. They help normalize the cycle, which has a positive effect on the condition of the mammary glands.

Surgical treatment for mastopathy

Surgical treatment of mastopathy occurs if, as a result of an examination, large formations (fibroadenomas, cysts) are identified in the breast, the size of which exceeds 1.5 cm. Surgery is necessary if there is a high risk of developing malignant processes. Surgical intervention is also indicated for relapse of the disease or when the size of the formations rapidly increases. The operation to remove them is carried out in several ways:

• enucleation. Used if you need to remove a small formation. To do this, a small incision is made on the chest, and the tumor is removed using enucleation;
• sectoral resection. It is carried out during the development of malignant processes or in other severe cases. In this case, not only the formation is removed, but also a small part of the surrounding tissue;
• laser ablation. When it is carried out, modified tissues are burned out, while healthy cells are minimally injured.

How to treat mastopathy? In many cases they help. The following recipes are considered the most popular and effective:

• cabbage with honey. The fresh leaf is washed under running water and wiped. It is smeared with honey and applied to the mammary gland. The cabbage is fixed with a cloth or bandage and left for 6-12 hours. The procedure is repeated every day;
• herbal collection To normalize hormonal levels, you need to take nettle, sage, wormwood and plantain (1:1:2:2). A small amount of this mixture should be poured into 220 ml of boiling water and left for an hour. It is recommended to drink the resulting liquid throughout the day, dividing it into several doses;
• burdock ointment. This product should be used to lubricate the breasts daily. To prepare the ointment, take 150 ml of sunflower oil, to which add 50 g of crushed burdock leaves (dried).