Fibrocystic mastopathy or fibroadenomatosis currently affects more than 50% of women. The disease is usually diagnosed in women from the age of 30 to 50 years.
In case of fibrocystic mastopathy in the mammary glands, numerous nodules and cysts or individual large nodes / cysts are found. Fibroadenomatosis, although considered to be a benign process, needs to be treated, since it is possible for the pathological foci to degenerate into breast cancer.
There are diffuse and nodular form of fibrocystic mastopathy. Diffuse form of the disease, in turn, is divided into:
- mastopathy, in which the glandular component ( adenosis ) prevails ;
- mastopathy, in which the fibrous component ( fibroadenosis ) prevails;
- mastopathy, in which the cystic component prevails ( fibrocytosis );
- mixed form;
- sclerosing adenosis.
The nodal form includes:
- intraductal papillomas;
- angiomas (damage to blood vessels);
From the point of view of localization, fibrocystic mastopathy can be both bilateral (affects both mammary glands) and unilateral.
According to the results of histological examination (viewing of biological material under a microscope), proliferative cells are distinguished (abnormal cells actively divide) and non – proliferative fibrocystic mastopathy.
Diffuse mastopathy for the severity of clinical manifestations may be insignificant, moderate and severe form.
The causes of fibroadenomatosis lie in external factors and in the state of the body. These include:
- premature puberty (rapid hormonal alteration affects the state of the mammary glands);
- late menopause (hormones have too long effects on the mammary glands);
- late pregnancy and childbirth (older than 30 years);
- rejection of pregnancy and childbirth;
- a short period of breastfeeding or complete rejection of it;
- abortions (more than two);
- long and constant stress (problems at work, in family life, etc.);
- age (over 40);
- liver disease;
- endocrine problems ( diabetes, overweight, pathology of the thyroid gland);
- chronic inflammatory diseases of the appendages;
- other gynecological pathologies ( uterine myoma , endometriosis );
- uncontrolled hormones for contraception;
- osteochondrosis of the thoracic spine;
- genetic predisposition;
- impaired water metabolism (insufficient fluid intake).
The leading symptom in fibroadenomatosis is pain in the mammary glands. Pain syndrome is particularly enhanced in the premenstrual period, when venous congestion occurs and the mammary glands swell and heal.
The pain can be of such intensity that it is impossible to touch the chest, it is difficult to even put on a bra or a dress. The pain is arching, acute, and can give to the shoulder, under the scapula, or to the axillary region. After the onset of menstruation, the discomfort subsides somewhat, becomes aching or pulling during the first phase of the menstrual cycle.
Along with this, problems arise from the psycho-emotional sphere. Patients lose sleep, become irritable, aggressive or depressed, they can easily burst into tears.
Another symptom of fibrocystic mastopathy is nipple discharge. This feature is characteristic of all patients and serves as evidence that the milky ducts are involved in the pathological process. As a rule, at the other end of the duct is a cyst. The discharge may be clear, whitish, or greenish (when attaching a secondary infection).
Important! In the case of brown discharge from the nipple or mixed with blood, the woman should be alerted, as this symptom is inherent in oncological diseases.
Signs of diffuse fibrocystic mastopathy
For diffuse mastopathy is characterized by a uniform increase and swelling of the mammary glands on the eve of menstruation.
In this case, breast palpation to determine the precise boundaries of the seal with coarse lobate, tyazhistostyu and fine grit. The pain syndrome is expressed impermanently, the breast enlarged before menstruation returns to its original size after its completion.
Diffuse fibrocystic mastopathy is more often diagnosed in young women.
Signs of the nodal form
The nodular or nodular form of diffuse cystic mastopathy is the next stage in the course of the disease, which develops without the treatment of a diffuse form.
Seals and / or cysts are palpated in one or both mammary glands. The nodes are dense, retain lobulation , do not have clear boundaries and reach fairly large sizes (up to 5-6 cm in diameter). Cysts are palpable as round, with a smooth surface and an elastic texture of formation.
In some cases (approximately 10%) an increase in axillary lymph nodes is observed.
When the nodular form of the disease in the mammary gland may be one node / cyst or more.
Differential diagnosis of fibrocystic mastopathy is necessary, since its symptoms are similar to manifestations of fibroadenoma (benign tumor), breast cancer, premenstrual syndrome, and hyperprolactinemia (in the case of nipple discharge).
In the diagnosis of the disease in addition to collecting anamnesis, complaints, examination and palpation of the mammary glands also use additional methods of examination:
- X-ray examination of the mammary glands, which is carried out on the 6-7 day of the menstrual cycle. The picture is taken in frontal and lateral projections, it allows to identify micro- and macrocalcinates (cysts and fibrous nodes).
ultrasound examination of the mammary glands;
- held in the first phase of the cycle. Effective in combination with mammography.
- helps to identify foci of increased thermal activity. In case of fibrocystic mastopathy, focal hyperthermia is determined.
- using a fine needle, the knot or cyst is punctured, and the collected material is sent for histological examination, which confirms the good quality or malignancy of the process.
magnetic resonance imaging;
- With the help of this method, you can examine in detail the layers of pathological education.
research of the hormonal status;
- levels of estrogenic hormones and progesterone are determined in the first and second stages of the menstrual cycle, prolactin, thyroid hormones.
- necessary to exclude diabetes and determine the causes of obesity and other pathologies.
Fibrocystic mastopathy is treated by a medical oncologist.
Therapy is selected individually, depending on the form of the disease, the severity of clinical manifestations, age and other factors.
First of all, the treatment must begin with a diet. When mastopathy should limit the intake of tea, coffee, cocoa and chocolate, especially in the second phase of the menstrual cycle. Food should be varied and include in large quantities fresh vegetables and fruits (to normalize the work of the gastrointestinal tract).
- vitamins A, C, P, which strengthen the vascular wall and help reduce edema;
- vitamin E, which is a natural antioxidant and affects fat and hormonal exchanges;
- B vitamins that improve metabolism.
Diuretic drugs (furosemide, veroshpiron) and nonsteroidal anti-inflammatory drugs (ibuprofen, indomethacin ) are prescribed to relieve swelling of the mammary glands (with a diffuse form) and relieve pain .
In order to normalize the neuro-psychological condition, patients are prescribed sedatives (tincture of peony, valerian, motherwort).
Correction of chronic diseases is carried out, iodine preparations (iodide) are also indicated. When the disease is markedly cyclical, drugs that block the secretion of prolactin ( bromkriptin ) and homeopathic preparations (“ Mastodinon ”) are used.
Fibroadenomatosis treatment with hormones
Hormone therapy depends on the age of the patient.
Oral hormonal contraceptives are selected for women in the reproductive period. Also effective progestins, which are assigned to the second phase of the menstrual cycle ( utrozhestan , djufaston ).
Androgen ( methyltestosterone , testobromide ), antiestrogens ( tamoxifen ), danazol are recommended for women of premenopausal age .
In the case of the presence of a nodular form of mastopathy, the issue of surgery is resolved. Surgical treatment is necessary:
- with large amounts of pathological education;
- with its rapid growth (within three months);
- in case of suspicion of rebirth in a malignant tumor;
- in the presence of complications (suppuration).
The nodes are excised in part along with healthy mammary gland tissues, such an operation is called sectoral resection. When a cyst is detected, it is punctured, cystic fluid is removed, and sclerosing drugs are injected into the cavity .
It is possible to exfoliate the cyst with subsequent suturing of the breast.
In the course of the operation, an urgent histological examination of the excised material is carried out, and if results are obtained confirming the cancer, the volume of surgical intervention expands to the removal of the entire breast.
Fibrocystic mastopathy is dangerous in that it is able to degenerate into a malignant tumor of the breast. In the presence of a cyst in the chest, its inflammation and suppuration is possible.
The prognosis of the disease depends on the form of mastopathy, the adequacy and timeliness of treatment, the age of the patient and other factors.
With timely correct treatment, the prognosis for fibrocystic mastopathy is favorable.