What does fcm mean in gynecology? Cystic mastopathy of the mammary glands: what a woman should know. Diagnosis of the presence of a neoplasm

Fibrocystic mastopathy is a pathology of a fibrocystic nature, which is characterized by rapid proliferation of cells in the tissues of the mammary glands, as well as an abnormal ratio of the epithelium and connective tissue components. This disease in medicine is classified as a group of benign dysplastic processes in diseases of the mammary gland.

Cystic fibrous mastopathy is considered a benign disease, but it is always worth considering the fact that in some of its forms the degeneration of benign formations into malignant ones is possible. Therefore, every woman needs to closely monitor her health, especially if this diagnosis has already been made. Regular medical examinations, during which the mammologist will evaluate the shape and nature, as well as the localization of the pathological process, will help prevent the degeneration of a benign tumor into a malignant one.

Signs of fibrocystic mastopathy are detected in almost half of women of reproductive age. Often women themselves discover a lump in their breast tissue upon palpation and rush to immediately consult a doctor. Some begin treatment with folk remedies, which is not recommended without an accurate diagnosis.

Kinds

The symptoms of fibrocystic mastopathy for any type are very similar, but despite this, in medicine there are several forms of this disease:

• localized fibrocystic mastopathy. It is also called nodal. Pathological signs of this pathology appear in a limited area of ​​the mammary gland. For example, a compaction forms on one of its quadrants;
• mastalgia. In medicine, this form is considered the initial stage of the disease. The woman begins to feel severe pain in one or two mammary glands at once, but no tissue compaction is noted. In this case, the disease can be treated even with folk remedies;
• diffuse fibrocystic mastopathy. The symptoms of the disease are pronounced. Cysts form. Seals can be felt over the entire area of ​​the mammary glands.

Diffuse mastopathy is also divided into several types (important for more accurate diagnosis):

• diffuse fibrous mastopathy. When palpating the mammary glands, areas of increased density are noted. In most clinical cases, this pathological process occurs with the formation of fibroadenoma. This is a benign tumor. Symptoms can be reduced with the help of folk remedies and a properly selected diet;
• diffuse cystic mastopathy. In this case, among all pathological formations that are localized in the tissues of the mammary glands, cysts predominate. These formations are small cavities filled with liquid inside. There are also areas of fibrosis in the breast, but in much smaller quantities;
• mixed mastopathy. In this form of the disease, no single type of pathological change predominates. In the chest they are located in almost equal numbers. The most dangerous form. It should be treated exclusively in a hospital setting. No folk remedies will help in this case.

Etiology

The main role in the occurrence of this disease in women of reproductive age belongs to an increase in the level of estrogen and a decrease in the level of the hormone progesterone. In most clinical cases, it is hyperestrogenism that predominates. Against the background of this process, areas of connective tissue gradually begin to grow, the alveoli and ducts of the mammary glands become denser. Development is also facilitated by increased production of prolactin in a woman’s body. It is this hormone that is responsible for the functions of the breast. If it is produced in excess, the sensitivity of the glands to the influence of estrogen will increase several times.

Reasons for the development of mastopathy:

• numerous births;
• taking hormonal contraceptives for a long period of time;
• absence of childbirth before age 30;
• history of miscarriages or abortions;
• abnormalities in the structure and functioning of the genital organs;
• in most clinical cases, mastopathy develops if a woman refuses to breastfeed her child after childbirth (one of the main reasons);
• menstrual irregularities;
• polycystic ovary syndrome.

Also, the reasons for the development of mastopathy may be hidden in some diseases of the organs responsible for the production of hormones. Often in women with diseases of the pituitary gland, thyroid gland, and adrenal glands, fibrocystic mastopathy is detected. Hereditary factors play a major role in the development of this disease.

Symptoms of the disease in some cases occur in women who suffer from pathologies of the kidneys, pancreas or liver.

Secondary causes:

• vitamin deficiency;
• smoking;
• violation of water-salt balance;
• obesity.

It is important, when the first symptoms are detected, to immediately visit a qualified specialist for diagnosis, confirmation or refutation of the diagnosis. Timely consultation with a doctor reduces the risk of developing possible complications. It is also recommended to pay attention to the causes of the development of pathology in order to avoid them if possible in the future.

Symptoms

The symptoms of mastopathy are quite varied. There are cases when there are no symptoms at all, so the woman does not see a doctor to treat the disease. This course is typical for nodular mastopathy, during which a single fibroadenoma of small size is formed. But in this case, its treatment can be carried out even with folk remedies. As a rule, the presence of a pathological process is detected during a routine medical examination.

Symptoms of the disease are also absent at the first stage of development of diffuse mastopathy. At this stage, microcysts of the mammary gland ducts form, so the woman does not notice a deterioration in her general condition.

The most important symptom for diagnosis is the detection of lumps in the breast tissue. Multiple or single ones may predominate. In most clinical cases, their location is the upper outer quadrants of the chest. When touching such an area, a woman feels pain, which tends to intensify before menstruation.

Main symptoms of mastopathy:

• The mammary gland swells greatly and becomes rough before menstruation. This is due to venous stagnation and edema;
• severe pain appears in the chest, which has a pulling, aching or tugging character. The intensity varies. It can be eliminated using folk remedies;
• Regional lymph nodes enlarge, but there are no signs of inflammation. The nodes are painful on palpation;
• nipple sensitivity increases;
• Chest pain tends to radiate to the shoulder, armpit or shoulder blade. This symptom occurs due to compression of small nerve roots by formations;
• nipple discharge. They may appear when pressing on the gland or flow freely. This doesn't happen all the time. They are typically white, clear, or bloody brown in color. Blood may also appear. In this case, you should immediately rush to see a doctor! This condition is extremely dangerous for a woman’s health.

Complications

In most clinical cases, this disease does not pose a threat to a woman’s life. Women often complain that it is the symptoms of the disease that cause them great inconvenience, as they reduce their quality of life and even their ability to work. But more recently, scientists have conducted some studies, during which it was revealed that fibrocystic mastopathy is a precancerous disease. Do not panic right away, since the transformation of the disease into cancer does not occur in all cases. But it was still found that in women who suffer from mastopathy, the risk of developing breast cancer increases by 4–5 times.

Hormonal disturbances in the body during mastopathy create a favorable background for the development and. If we put all these components together, then we can say that fibrocystic mastopathy is a complex disease that needs to be treated in a timely manner, as well as undergo regular preventive examinations to prevent the development of complications.

Mastopathy and pregnancy

Doctors always reassure women who are interested in whether fibrocystic mastopathy and pregnancy are compatible. In almost 100% of cases, the disease does not affect the course of pregnancy and fetal development. Quite the contrary. Increased production of the hormone progesterone helps reduce the production of estrogen and cure mastopathy. If you breastfeed a small child for a long time, then cysts and fibroadenomas decrease. Therefore, even with mastopathy, a woman can become a mother and not be at all afraid that something will happen to her baby.

Diagnostics

The following methods predominate in the diagnosis of fibrocystic mastopathy:

• MRI of the mammary glands. This technique is highly informative, but is rarely used due to its high cost;
• . This is a leading diagnostic technique that allows you to identify the presence of nodes and cysts in women of reproductive age;
• As a result of the study, the patient receives images in two projections, which are very informative for making the correct diagnosis;
• Ductography. A technique during which a substance is injected into the ducts through the nipple, the components of which have coloring properties. Helps determine the location of pathological formations;
• Biopsy. The main method for diagnosing precancerous or cancerous tumors.

When mastopathy is detected, a woman is often referred for additional examination to a gynecologist, as well as an endocrinologist, to undergo additional tests.

Treatment

Before prescribing any treatment plan for women with a nodular form of the disease, it is mandatory to puncture the formations using fine-needle aspiration. This technique allows the doctor to diagnose mastopathy from cancer.

At the initial stage of diffuse mastopathy, the use of medications has a good effect. Non-hormonal herbal preparations are often prescribed (their components are safe for a woman’s health and effectively help overcome mastopathy). As a result, pain decreases, cysts resolve, and the mammary glands become softer. The following drugs are widely used:

• "Fitolon";
• "Mastodinon";
• "Mastofit";
• "Klamin."

Combinations and dosage should be selected only by a doctor, depending on the form and severity of the disease.

Treatment of fibrocystic mastopathy will be more effective if you also use external agents - creams, gels, ointments. They contain components that help relieve pain and other unpleasant symptoms. Mastofit, Mastokrel, Progestogel, etc. are often prescribed.

Vitamin-mineral complexes are also used in the treatment of mastopathy. Particularly valuable and effective are vitamins A and E, as well as iodine, which help improve hormonal metabolism processes. For severe chest pain, patients are prescribed NSAIDs. This group of drugs helps eliminate pain, as well as relieve inflammation, if any.

Herbal medicine has become widely used for the treatment of all forms of mastopathy. Herbs have anti-inflammatory, analgesic and absorbable effects. It is these properties that help eliminate the unpleasant symptoms of the disease and even cure it completely. Treatment of fibrocystic mastopathy with herbs is very effective, but it is recommended to use it not individually, but in combination with other methods. Folk remedies have also proven their effectiveness. Recently, women have resorted to them very often. The reason is efficiency and completely natural ingredients (herbs, berries).

Hormonal medications are prescribed if all of the above methods were not effective. Oral contraceptives from the progestogen group are often the means of choice. The use of tableted gestagens gives a good effect. In this case, the course of taking these drugs is from three to six months. Their components are completely safe for women's health.

ethnoscience

Folk remedies should be used only in combination with conservative therapy, and with the consent of the attending physician. It is not recommended to treat the disease with them alone, as this can be harmful to health. Experts recommend taking various herbal infusions based on the following herbs:

• St. John's wort;
• nettle;
• burdock;
• valerian (the herb has a sedative effect);
• calendula.

It is important to be able to correctly prepare folk remedies from these herbs, since violating the recipe may not only not help cure the disease, but also cause harm to health.

Diet

A diet for fibrocystic mastopathy is exactly what helps to cure the disease faster. The nature of nutrition has a huge impact on the production of hormones. A woman is not recommended to consume the following products:

• meat;
• animal fats;
• coffee;
• Black tea;
• cocoa;
• alcohol;
• soda;
• fried food.

You should add vegetables, fruits and whole grain bread to your diet, as these foods contain a lot of fiber. If it is not possible to completely abstain from eating animal foods, then you can eat small amounts of lean meat, steamed or boiled.

Fibrocystic mastopathy is a complex disease, but it can be successfully treated if you promptly seek help from a specialist. Drug therapy, diet, folk remedies - all this will help eliminate unpleasant symptoms and even completely cure the disease. The main thing is that the treatment is prescribed by a competent doctor, taking into account the characteristics of the woman’s body.

Fibrocystic mastopathy is a benign neoplasm in the mammary gland, which is a compaction in the form of single or multiple cysts. With timely diagnosis, cystic mastopathy of the mammary glands responds well to treatment, but if such a disease worsens, this is fraught with the degeneration of a benign form into a malignant one.

Fibrocystic mastopathy is a benign neoplasm in the mammary gland

FCM occurs due to hormonal imbalance in the body. Therefore, the disease is diagnosed more often in women after pregnancy, childbirth, during menopause or menopause. An imbalance in the hormonal system, in turn, occurs under the influence of the following factors:

• early sexual life;
• late onset of menopause;
• no history of pregnancy in a woman over 40 years of age;
• frequent abortions;
• too long period of breastfeeding or complete absence of lactation;
• frequent stressful situations;
• problems with excess weight;
• disruption of the metabolic process;
• chronic diseases of the genitourinary system;
• constant use of hormonal contraceptives.

FCM will not occur only because a woman, for certain reasons, could not or did not want to breastfeed her child, or because she has chronic cystitis. The causes of fibrocystic mastopathy are associated with the presence of many factors that lead to pathological changes in the endocrine system.

The risk of developing lumps in the mammary gland increases in women after the age of 40, when reproductive function gradually declines and the organs of the reproductive system begin to produce fewer hormones. The situation is aggravated by the woman’s lack of previous pregnancy or frequent medically induced miscarriages, leading to hormonal imbalances.

Too early puberty is one of the common causes of fibrocystic pathology. When girls aged 13 to 16 enter into sexual activity, the reproductive system begins to produce too many hormones that the body cannot cope with. As a result, the hormonal system malfunctions, and while this may not be particularly noticeable during reproductive age, after 40 years severe symptoms and health problems will arise.

Fibrous mastopathy is a response to the fact that severe pathological processes occur in the body, and are often provoked by chronic diseases of the genitourinary system. Therefore, timely diagnosis of any diseases and their treatment play an important role in the prevention of fibrocystic mastopathy.

How does pathology manifest itself?

Patients diagnosed with FCM should not ignore the signs of the disease and delay treatment. Mastopathy is a borderline precancerous condition, so you should consult a doctor immediately as soon as the first symptoms of the disease appear. Main signs of pathology:

• chest pain;
• nipple discharge;
• menstrual irregularities;
• the presence of lumps in the chest;
• inflammation of neighboring lymph nodes.

Chest pain is the main symptom of the disease, but this symptom is present in 90% of women; the remaining patients note the absence of this symptom, which significantly slows down the diagnosis. Discharge from the nipples looks like colostrum, and if a woman is pregnant, she may not immediately pay attention to this symptom.

FCM will not occur only because a woman, for certain reasons, could not or did not want to breastfeed her child or has cystitis that occurs in a chronic form

Menstrual irregularities are observed in later stages of mastopathy development. Although there are exceptions when all the symptoms of the disease occur simultaneously. If a woman has not previously had problems with the cyclicity of her periods and a failure occurs, but there are no other symptoms, it is necessary to undergo diagnostics. It is also possible to independently detect breast mastopathy. A woman needs to palpate her breasts daily, and if a lump is felt, this is a very alarming sign.

Symptoms of fibrocystic pathology intensify during menstruation, especially with regard to pain. The severity of pain in the mammary gland can vary. How strong this symptom will be depends on the stage of development of the disease, the presence of concomitant pathologies and the degree of pain threshold in the woman.

Discharge from the nipples is an optional symptom, although it is present in most patients. Discharge may occur at the beginning of the disease or in its later stages; often such a symptom is absent. With breast mastopathy, the discharge is thick and resembles colostrum. Their intensity may vary, but it always increases with the arrival of menstruation.

In most cases, nipple discharge is colorless, but it can be yellowish or bloody. If, with fibrocystic mastopathy, the discharge from the nipples is bloody in color, you should immediately consult a doctor. This symptom indicates the rapid development of the disease with a number of complications.

Enlarged lymph nodes located near the chest are a possible sign, but not obligatory. If lumps are palpable in the breasts, the menstrual cycle is disrupted, pain and discharge from the nipples appear, there is no need to rely on the fact that the lymph nodes are not enlarged - with this symptomatic picture, the diagnosis of fibrocystic mastopathy is confirmed in 98% of cases.

Types of pathological process

Depending on the causes of fibrocystic mastopathy, the severity of the symptomatic picture and the rate of development of pathological cells, several types of pathology are distinguished:

• diffuse;
• nodal;
• non-proliferative;
• mixed;
• bilateral.

Diffuse fibrocystic mastopathy is characterized by the rapid development of pathogenic cells; the connective tissue affected in certain places begins to quickly grow and connect, causing the compaction to occupy most of the mammary gland.

This development of mastopathy quickly leads to clogging of the canals and destroys the lobular structure of the mammary gland. With a diffuse form of mastopathy, a cyst inevitably begins to form, and in most cases more than one. According to clinical studies, the fibrous type of mastopathy can have different causes, and not the least of them is genetic predisposition. Depending on how quickly the clinical picture of the disease develops, diffuse mastopathy can be minor, moderate or severe.

The nodular type of mastopathy is characterized by the presence of foci of neoplasms that can be distributed throughout the mammary gland. Nodules on the connective tissue are clearly felt during palpation. This form of the disease is characterized by a pronounced pain syndrome, although in some patients this symptom may be absent.

The pain intensifies if you touch the lump on the chest or during the onset of menstruation. In the nodular form of the disease, enlargement of the lymph nodes is extremely rare. For the nodular fibrocystic form of pathology, the signs can be completely individual.

The non-proliferative form of mastopathy is a combination of several factors, which are characterized by the absence of a pronounced compaction in the mammary gland. There are no main signs of the disease, pathological processes in the connective tissue, its proliferation and the formation of cysts.

A characteristic manifestation of the non-proliferative form of mastopathy is swelling of the soft tissues, which is not considered a neoplasm. This type of disease is the easiest to treat and has the most favorable prognosis. However, if the pathology is not treated in a timely manner, clinical signs may worsen and degenerate into more severe forms of mastopathy.

Mastopathy is a borderline precancerous condition, so you should consult a doctor immediately as soon as the first symptoms of the disease appear

Mixed and double-sided form

Fibrocystic mastopathy of mixed type can be characterized by all the signs inherent in other forms of the pathological process in the breast. This type of disease is characterized by the formation of cysts, usually multiple, although single neoplasms are also possible. A cyst that forms on the connective tissue of the mammary gland has a capsule that is filled with liquid contents.

The mixed fibrocystic form is always accompanied by the proliferation of damaged areas of connective tissue, causing the breasts to increase in size and become asymmetrical. Along with the appearance of multiple cysts, the appearance of fibroadenoma is possible - this is a round neoplasm, dense, and benign in nature. When you press on the fibroadenoma, it may move.

A mixed form of pathology occurs in cases where mastopathy was not cured in the early stages of its development. Mixed type FCM is a complication, but with adequate treatment it has a positive prognosis.

Bilateral type of fibrocystic mastopathy is the development of a pathological process in both mammary glands. Pathogenic cells damage connective tissue, clog canals, and change the structure of the lobular elements of the mammary gland. Against the background of circulatory and metabolic disorders, multiple cysts begin to form in the chest.

Bilateral cystic mastopathy has the highest likelihood of developing a malignant cancer process. This type of disease occurs when a woman ignores the symptoms of FCM and does not undergo treatment. Persistent, prolonged pathological processes lead to the development of bilateral mastopathy.

Before curing bilateral fibrocystic mastopathy, it is necessary to bring hormonal levels back to normal and identify the causes of hormone imbalance; if the pathology is caused by inflammatory processes in the organs of the genitourinary system, it is necessary to treat them first.

Is pregnancy possible?

The presence of fibrocystic mastopathy is not a contraindication to pregnancy. Rather, on the contrary, since there is a high probability that hormonal changes in the body during pregnancy will normalize the functioning of the endocrine system and the development of mastopathy will be stopped.

Lactation is a natural method of preventing the development of many pathological processes in the mammary gland, therefore, with a diagnosis of FCM, not only can you not be afraid to become pregnant, but in the future it is strongly recommended to feed your child breast milk.

Lactation helps a woman get rid of the unpleasant pain syndrome during the development of fibrocystic mastopathy and often leads to the fact that the pathological process slows down or stops altogether. If a woman undergoing treatment for mastopathy with hormonal drugs becomes pregnant, their use must be stopped immediately, as this can have a detrimental effect not only on the woman’s body, but also on the fetus.

If interruption of treatment threatens the rapid development of the disease and it is not possible to cancel it, the doctor will replace therapy with non-hormonal drugs. During lactation, a woman's breasts begin to produce antibodies that destroy pathogenic cells, thereby reducing the manifestation of pathology.

If a woman breastfeeds her baby for too long, and the body has already returned to normal after childbirth and stabilized hormone levels, the patient, if she is unwilling or unable to stop treatment, must undergo regular diagnostics. Excessively prolonged lactation can cause a new round of the disease and rapid growth of cysts.

The presence of fibrocystic mastopathy is not a contraindication to pregnancy

What are the consequences of lack of treatment?

With fibrocystic mastopathy, if treatment is not carried out in a timely manner, a number of complications may develop. Although this disease is considered a precursor to cancer, for the process to transform from benign to malignant, enough time must pass and provoking factors must be present. Faster than the oncological process, untreated fibrocystic pathology leads to complications in the functioning of the body, especially the functioning of the organs of the genitourinary system.

The growth of pathogenic cells that are not treated with medication can lead to the formation of multiple cysts. This phenomenon will lead to a change in the shape of the breast, the mammary glands will be unequal, one larger than the other, the shape uneven. With the development of numerous cysts, the risk of an inflammatory process in the connective tissue of the mammary gland with further infection increases.

The cyst has a tendency to self-destruct, and then the liquid contents from its capsule will flow onto the soft tissue of the mammary gland, and this is fraught with the development of sepsis, which will require emergency surgical treatment. With prolonged stages of development of mixed cystic mastopathy, there is a risk of developing an oncological process.

In itself, the presence of a cyst in the mammary gland does not pose a threat to the health or life of a woman, does not cause discomfort and is not a reason for abandoning a normal lifestyle. All pathological processes that are provoked by the presence of fibrocystic mastopathy are associated with the occurrence of an inflammatory process in soft tissues or their infection.

Conservative therapy

In the treatment of fibrocystic mastopathy, an important role is played by the relief of swelling in soft and connective tissues. This helps not only to reduce the inflammatory process, but also to significantly alleviate the patient’s condition. For this purpose, diuretic drugs are prescribed, which have a diuretic effect. All these medications, together with urine, remove elements such as calcium and magnesium from the body, so it is necessary to take diuretics in combination with these minerals.

To relieve pain and other unpleasant signs of fibrocystic mastopathy, homeopathic medications are prescribed. Their advantage lies in their natural composition; therefore, the risk of side symptoms and complications for the liver is eliminated. In addition to medications, the use of topical agents - ointments and creams with herbal ingredients - is mandatory in the treatment of fibrocystic mastopathy. They help relieve swelling, relieve pain, and normalize the regeneration process of epidermal cells so that they displace pathogenic cells.

The main role in the treatment of FCM is given to hormonal drugs. It is strictly forbidden to choose and take hormones on your own. These medications are prescribed only by the attending physician, only after a thorough medical diagnosis and all necessary tests. Systemic treatment with hormones is aimed at stabilizing hormonal levels and treating diseases of the reproductive system, which are often the cause of the development of fibrocystic mastopathy.

If the disease was diagnosed on time, there are no complications or severe chronic diseases, a month’s course of complex medications is enough - and fibrocystic pathology will recede. In case of complications and if the patient is diagnosed with a nodular form of mastopathy, surgery is prescribed.

Traditional methods of treatment, decoctions based on medicinal herbs can be used only with the permission of a doctor and exclusively as an additional method of treatment, often symptomatic

Surgical intervention

Before treating fibrocystic mastopathy of the mammary gland, a woman will have to undergo a full medical diagnosis and undergo a series of tests to determine the type of pathological process, the stage of its development and to identify the presence or absence of complications. In most cases, doctors try to normalize a woman’s condition with medications, but if conservative therapy after several courses does not produce a positive result, surgical intervention is performed. Indications for surgery are as follows:

• presence of severe chronic diseases;
• rapid proliferation of pathogenic cells;
• lack of positive dynamics from medications;
• high risks of cancer;
• hereditary predisposition to breast cancer.

For the surgical treatment of fibrocystic mastopathy, the method of sectoral resection is used, that is, removal of part of the connective tissue that is damaged by pathogenic cells. During treatment of cystic mastopathy with medications or after sectoral resection, a woman needs to give up bad habits and eat right. The therapeutic diet excludes the consumption of fried and fatty foods, fast food, carbonated drinks; in cooking it is necessary to minimize the amount of salt and spices.

ethnoscience

Traditional methods of treatment, decoctions based on medicinal herbs can be used only with the permission of a doctor and exclusively as an additional method of treatment, often symptomatic. If you use only traditional recipes, it is unlikely that you will be able to get rid of the disease, and the lost time will lead to the fact that fibrocystic mastopathy will worsen and cause a number of complications.

Traditional methods include decoctions of herbs such as red brush, plantain, wormwood, nettle and sage. Red brush is the most famous medicinal herb used in medicine, including traditional medicine, for the treatment of female diseases. It relieves inflammation and helps normalize hormonal levels.

Plantain, sage, nettle are medicinal herbs that have a generally beneficial effect on the body, normalize the functioning of all internal organs and systems, stop inflammatory processes, and reduce the manifestations of unpleasant and painful symptoms. It is better to take these herbs together.

Fibrocystic pathology of the mammary gland is dangerous due to its consequences. Its development can be prevented if a woman carefully monitors her health and undergoes regular medical examinations. It is very important not to forget about self-diagnosis, periodically palpating the mammary glands.

Any lumps, no matter how small, are not normal. They will not resolve on their own; immediate medical attention is required. The main preventive measure for FCM is timely treatment of diseases of the genitourinary system, because they are the cause of hormonal imbalance and the appearance of fibrocystic mastopathy.

Mastopathy is a disease in which small compactions, cords, nodules and cysts or large and dense formations form in the mammary glands. One of the types of pathology is fibrocystic mastopathy of the mammary gland, what is it and how to treat the pathology?

The disease fibrocystic mastopathy is a condition in which cysts appear in the mammary glands in the form of small multiple nodules formed by overgrown connective tissue and fluid. In most cases, it refers to the mixed type of diffuse mastopathy, ICD code 10 - 60.1.

The disease is benign, but in the later stages and when it becomes nodular, atypical cells can form in the tissues, leading to breast cancer.

With fibrocystic mastopathy (abbr. FCM), areas with dense connective tissue appear in the mammary glands. They fill with fluid and develop into cysts.

• The pathology is common among women from 30 years of age to menopause. During and after, the risk of disease is significantly reduced.

Symptoms of fibrocystic mastopathy

The first signs of fibrocystic mastopathy are expressed in the premenstrual period:

1. Painful sensations in the chest, occurring spontaneously or when touched, intensify in the second half of the cycle.
2. The appearance of compactions and granular formations that are detected by palpation.

Subsequently, the pain becomes stronger, is constantly present, is accompanied by a feeling of fullness, burden, and radiates to the shoulder, hypochondrium, and axillary region. In the later stages of fibrocystic mastopathy, the symptoms are pronounced and its manifestations no longer depend on the period of the menstrual cycle.

Sometimes the secretion released from the nipples is yellowish, grayish or white-green or resembles colostrum. The liquid may have a bloody tint - an alarming signal, since it often indicates the presence.

A small proportion of women do not feel severe pain in the mammary glands or experience it only during PMS and menstruation, regarding it as normal. In such cases, regular self-diagnosis and breast palpation are especially important.

Fibrocystic breast disease is caused by a hormone imbalance when progesterone levels are low and estrogen and prolactin levels are high. The following reasons may lead to this:

• Early onset of menstruation;
• Late menopause;
• Short lactation or its absence;
• Artificial termination of pregnancy - abortions are accompanied by sudden changes in hormonal activity;
• Metabolic disorders – diabetes, obesity;
• Lack of pregnancy and childbirth, infertility;
• Liver diseases;
• Endocrine pathologies, especially hypothyroidism;
• Late first birth;
• Inflammatory and other diseases of the genitourinary area;
• Incorrect selection and uncontrolled use of hormonal drugs, in particular oral contraception.

Additional provocateurs include bad habits, strict diets, and constant stress in a woman’s life.

Fibrocystic mastopathy is often diffuse. In the breast tissue, connective (fibrous) tissue forms several or many small nodules filled with fluid.

If some of them significantly increase in size, forming dense large cysts or nodes, they speak of the transition of diffuse fibrocystic mastopathy to a nodular form.

However, the formation of single fibrocystic nodules or a small number of them is not always preceded by the diffuse type - sometimes nodular FCM develops independently.

Diagnostics and examination methods

Fibrocystic mastopathy is detected during an examination by a doctor. Upon palpation, compacted tubercles are detected in the tissues of the mammary glands. They can be multiple or just a few separate formations.

To confirm the diagnosis, the following examination methods are used:

• Ultrasound – reveals the presence, size, contents and composition of the walls of cysts, and excludes other pathologies.
• Mammography - accurately determines the form of mastopathy and the presence of a cancerous tumor.
• Puncture or biopsy of the cyst with further study of the material taken.
• Analysis of fluid released from the nipple is needed for differential diagnosis with other breast diseases.
• Diaphanoscopy is a method of x-raying the mammary glands.

To identify fibrocystic mastopathy in the early stages of development, regular self-examination and visiting a mammologist at least once a year are important.

Treatment of fibrocystic mastopathy, drugs

FCM therapy is aimed at stabilizing hormonal levels and eliminating provoking factors - diseases of the reproductive and endocrine systems are treated, stressful situations are excluded, diet, physiotherapeutic procedures and medications are prescribed.

Drugs for the treatment of fibrocystic mastopathy include the following drugs:

• antiestrogens (Tamoxifen, Fareston, Toremifene);
• drugs that reduce prolactin levels (Bromocriptine);
• gestagens (Pregnin, Orgametril, Norkolut);
• androgens – used as estrogen antagonists (Danazol);
• oral contraceptive drugs (Silest, Mercilon);
• thyroid hormones.

Non-hormonal drugs for treatment are indicated:

• vitamins (A, E, C and group B);
• potassium iodide, Iodomarin;
• adaptogens to support immunity (rhodiola extract, Klamin);
• sedatives;
• gentle diuretics to relieve swelling (tea made from rose hips and herbs);
• painkillers, NSAIDs.

Some estrogens are excreted in the bile, but constipation and microflora disturbances lead to reabsorption of this hormone, that is, reabsorption into the blood. Therefore, the attending physician may prescribe enzymatic agents to normalize intestinal function - Wobenzym, Duphalac or others.

Homeopathic remedies containing extracts and extracts of plants help to reduce the level of prolactin and the activity of formation of connective tissue elements. These are Remens, Cyclodinone, Mastodinone.

Diet

During treatment, it is important to adhere to nutritional rules. The diet for fibrocystic mastopathy includes avoiding coffee, tea, cocoa, cola and other carbonated drinks, and chocolate.

Animal fats, baked goods, sweets, spicy and salty foods are subject to strict restrictions.

For good intestinal function, the diet must contain a lot of plant fiber, so fruits and vegetables, buckwheat, and legumes are useful. The menu should include oatmeal and other grains, whole grain bread, and nuts. Every day it is important to drink up to 2 liters of clean water.

Forecast

With proper diagnosis and treatment, the outcome of fibrocystic mastopathy is favorable. But, despite the initial benignity, even small cysts can grow, turn into a nodular form and a cancerous tumor.

Therefore, a favorable prognosis occurs only in the case of adequate therapy.

Prevention

A number of preventive measures help reduce the risk of developing fibrocystic mastopathy:

• detection and treatment of genitourinary and endocrine diseases;
• monitoring the stability of the menstrual cycle and its adjustment;
• examination of the thyroid gland;
• correct selection of bra size, avoiding squeezing and trauma to the breast;
• regularity of sexual activity;
• refusal of abortion;
• full lactation;
• eliminating bad habits;
• professional selection of contraceptives.

To detect mastopathy in the early stages, visiting a mammologist 1-2 times a year and self-examination of the mammary glands to detect lumps can be done.

Breast mastopathy cannot be eliminated on its own and almost always requires treatment. According to various statistics, in recent years, from 50 to 90% of women suffer from this disease, and the main danger of this breast disease lies in the ability of tumors to degenerate into a cancerous tumor. That is why any form of this pathology is considered by mammologists as a precancerous condition and requires constant monitoring and treatment. In this article we will introduce you to the principles of treatment of mammary gland mastopathy. Once you have this information, you can ask your healthcare provider any questions you may have.

The risk of tumor malignancy increases with the appearance of cystic formations. Of no small importance in the malignancy of tissues is the degree of growth (proliferation) of the mammary gland epithelium and the appearance of signs of calcification of neoplasms.

There is no single treatment regimen for mastopathy; its tactics depend on many factors:

• woman's age;
• form of mastopathy;
• character ;
• the presence of concomitant diseases: gynecological, endocrine, extragenital;
• the desire to preserve reproductive function or achieve a contraceptive effect.

In some cases, in women of reproductive age, according to the ANDI classification, some fibrocystic changes in the mammary glands may be considered normal. But in the presence of a significant deterioration in the quality of life, the presence of severe complaints and a high risk of malignancy (for example, a history), the approach to the observation and treatment of such patients should be more thoughtful and comprehensive.

If mastopathy is detected in women by chance, as a concomitant pathology, and is not accompanied by complaints, then treatment is usually not prescribed. Such patients are recommended to undergo regular breast ultrasound or mammography (sometimes diagnostic puncture) at least once a year and follow-up with a mammologist.

If mastopathy is moderately cyclical or constant and fibrocystic changes (without obvious microcysts) in the mammary glands are diffuse, then conservative therapy can begin with correction of physiological cycles and prescribing a diet. As a rule, this approach is allowed when treating young and healthy women.

For patients with severe mastopathy, accompanied by constant or cyclical pain, the presence of palpable changes in the structure of the gland or discharge from the nipples, treatment is always prescribed. In case of a diffuse form of this disease, a woman is recommended to undergo conservative therapy. The tactics of prescribing certain drugs in such cases depends on the data of a comprehensive examination of the patient. And if fibrocystic forms of mastopathy are detected, a woman may be prescribed conservative treatment, but in some cases it is necessary to perform a surgical operation.

Conservative therapy

Non-hormonal agents

Diet

Products containing methylxanthines contribute to swelling and tenderness of the mammary glands in women with mastopathy.

Many clinical studies on the treatment of mastopathy point to the fact that there is a close relationship between the appearance of structural changes in breast tissue and the consumption of products containing methylxanthines (theophylline, caffeine and theobromine). That is why avoiding foods with high levels of methylxanthines (coffee, cocoa, chocolate, tea, cola) can significantly reduce swelling and soreness of the mammary glands. Many experts always recommend such a diet correction when treating any form of mastopathy.

Nutrition and this disease of the mammary glands have another relationship. Eating food that contributes to the development of chronic constipation and disruption of intestinal microflora also contributes to the development of mastopathy and. It is likely that this relationship is dictated by the reabsorption in the intestine of estrogens already excreted in bile. That is why experts recommend that their patients introduce more foods containing fiber into their daily diet and drink enough water (up to 2 liters per day).

The condition of the liver is also important for the normal functioning of the mammary glands, since estrogen is utilized in this organ. That is why patients with mastopathy are advised to exclude from their diet any foods that adversely affect the functions of this organ. These include alcoholic beverages, fried and fatty foods, and hepatotoxic substances. And to improve liver function, women are recommended to additionally take B vitamins and dietary supplements based on them.

• fish (preferably sea);
• vegetable oils (linseed, olive, pumpkin, nut);
• low-fat meats;
• dairy products: sour cream, cottage cheese, milk, cheeses, goat milk;
• cereals: buckwheat, wheat, oatmeal, etc.;
• mushrooms;
• legumes;
• spinach;
• bell pepper;
• carrot;
• cabbage;
• beet;
• eggplant;
• zucchini;
• seaweed;
• nuts;
• fruits and berries.

• fatty meats;
• flour products;
• semolina;
• salty dishes;
• smoked meats;
• margarine;
• conservation;
• coffee;
• mayonnaise;
• ketchup;
• carbonated drinks;
• alcoholic drinks.

Choosing the right bra

Every representative of the fair sex should pay attention to the correct choice of bra, especially for patients with mastopathy. Wearing it is recommended for all women with this disease of the mammary glands.

Wearing a bra that doesn't fit properly or is shaped incorrectly can lead to breast deformation and compression. In addition, such a piece of clothing contributes to overload of the ligamentous apparatus. This point especially applies to women with large and drooping breasts.

• the product must fully correspond to the required size;
• preference should be given to natural or hygroscopic fabric;
• it is better to refuse to choose models with foam rubber seal;
• the fabric should not fade;
• wear strapless products as rarely as possible;
• choose models with wide straps (especially for large bust sizes);
• after purchase, adjust the length of the straps;
• do not sleep in a bra;
• do not wear a bra for more than 12 hours a day.

In some cases, choosing the right bra helps reduce or completely eliminate the symptoms of mastopathy.

Lifestyle change

Women suffering from mastopathy should stop smoking.

Women suffering from mastopathy should make lifestyle changes:

• quitting smoking and drinking alcohol;
• balanced diet;
• sufficient physical activity;
• refusal to visit baths and saunas;
• eliminating stress;
• refusal of natural and artificial tanning.

In addition, physiotherapeutic procedures and massage are contraindicated for them.

Vitamins

Taking vitamin supplements for mastopathy:

• helps normalize metabolism and hormonal levels;
• has an antioxidant effect;
• strengthens the immune system;
• stabilizes the activity of the central nervous system;
• normalizes the functions of the thyroid gland, liver, ovaries and adrenal glands;
• normalizes the reproduction and maturation of epithelial cells.

Diuretics

The manifestations of cyclic mastopathy, which occurs during premenstrual syndrome and is accompanied by swelling of the feet and hands a few days before menstruation, can be reduced with the help of mild diuretics. It is advisable to use diuretic medicinal herbs or preparations based on them for this purpose. In addition, during this period, a woman needs to limit the amount of salt consumed.

Means to improve blood circulation

Patients with mastopathy often experience local changes in blood circulation in the mammary glands. They usually occur due to impaired venous outflow. To normalize it, many experts recommend that their patients take foods containing vitamin P (black currants, citrus fruits, raspberries, cherries, rose hips, chokeberries) and preparations based on it (Ascorutin). Often, their use helps stabilize blood circulation, and repeated thermographic studies do not reveal such disorders.

Homeopathic medicines

To eliminate hyperprolactinemia, normalize the condition of the mammary gland ducts and eliminate pathological division of endometrial cells, women may be recommended to take medications based on various medicinal plants (twig, cyclamen, tiger lily, iris and chilibuha). The most popular homeopathic remedy prescribed for mastopathy is the drug Mastodinon. In addition to this, the following remedies may be recommended:

• Biocycline;
• Remens;
• Cyclodinone, etc.

Nonsteroidal anti-inflammatory drugs

In some cases, to reduce cyclic mastalgia, specialists prescribe their patients to take non-steroidal anti-inflammatory drugs a few days before menstruation. For this the following can be used:

• Diclofenac;
• Nurofen;
• Nise et al.

However, such prescriptions cannot be long-term and permanent, and comprehensive treatment of mastopathy is recommended to eliminate unpleasant symptoms.

Means for normalizing liver function

Hepatoprotectors can be used to eliminate liver dysfunctions that affect hormonal levels and stabilize its functioning. A woman may be prescribed:

• Essentiale;
• Legalon;
• Gepabene;
• Karsil and other drugs.

Adaptogens and iodine preparations

To normalize the functioning of the intestines, liver, thyroid gland and immune system in case of mastopathy, various iodine-containing drugs and adaptogens may be recommended:

• Klamin;
• Rhodiola extract;
• tincture of eleutherococcus;
• Iodomarin;
• Iodine-active, etc.

Sedatives

Chronic fatigue and stress at work contribute to increased chest pain with mastopathy.

In women, the condition of the mammary glands is often influenced by the psycho-emotional background. Troubles in the family and at work, frequent depression, dissatisfaction with oneself - all these factors can contribute to increased pain. To eliminate them, experts often recommend that their patients take sedatives. Typically, preference is given to prescribing mild medications based on medicinal herbs:

• tincture of valerian, motherwort, peony;
• Persen;
• Alvogen Relax;
• Novo-passit;
• Sedariston;
• Dormiplant;
• Nervoflux et al.

Only if they are ineffective can patients be recommended stronger sedatives:

• Afobazole;
• Adaptol;
• Tenoten et al.

dietary supplements

To stabilize the menstrual cycle and hormonal levels, normal functioning of the immune system, liver and intestines, various dietary supplements can be recommended:

• Indinol;
• Mastofit Evalar;
• Stella;
• Kelp;
• Diures;
• Garcisan;
• Lecithin Choline;
• Brest Care+;
• Biozyme;
• Indogrin;
• Citrus pectin, etc.

The choice of dietary supplements should be made only by a doctor, who is guided by data on the patient’s health status obtained during the examination.

Hormone therapy

The processes of development of mammary gland tissue, their differentiation, maturation and growth are completely coordinated by the interaction of the following hormones:

• estrogen;
• progesterone;
• prolactin;
• androgens;
• a growth hormone;
• thyroxine, etc.

Metabolism and the activity of the reticular formation and limbic system have a certain influence on these processes. Many facts indicate the significant influence of hormonal levels on the development of mastopathy:

• the tissues of both glands undergo changes;
• the severity of symptoms depends on the phase of the menstrual cycle;
• pain decreases after menopause;
• mastopathy is often combined with other hormone-dependent diseases (infertility);
• Taking hormonal drugs affects the condition of the mammary glands.

Based on the above facts, the following hormonal agents can be used to treat mastopathy:

• antiestrogens;
• oral contraceptives;
• androgens;
• gestagens;
• prolactin inhibitors;
• LHRH (or gonadotropin-releasing factor analogues).

Hormonal drugs can only be prescribed by a doctor who is guided by the results of the patient’s examination.

Antiestrogens

Antiestrogens such as Tamoxifen and Fareston can be used to block estrogen receptors in breast tissue. With hyperestrogenism, these drugs do not allow estrogens to bind to receptors and reduce their effect on gland tissue.

Antiestrogens have been used to treat mastopathy since the 70s. First, Tamoxifen was used, which was effective in 65-75% of cases. 2-3 months after taking it, patients noted a decrease in mastalgia (in 97% of cases), stabilization of the menstrual cycle and a significant decrease in blood loss during menstruation.

Sometimes at the beginning of treatment, patients noted increased sensations of breast swelling and pain, but over time these adverse reactions decreased. In addition to these side effects, taking Tamoxifen can cause dizziness, nausea, increased sweating and hot flashes.

A number of publications have reported that this drug can have a carcinogenic effect on endometrial tissue and lead to the development of endometrial hyperplasia and cancer. That is why another anti-estrogen drug was created - Fareston (ORION PHARMA INTERNATIONAL, Finland). According to many experts, its active component Toremifene is more effective and has fewer adverse reactions. The first therapeutic effects from taking this drug appear within a month after the start of use, and side effects are observed much less frequently.

Oral contraceptives

This group of hormonal drugs is usually prescribed to women under 35 years of age. In addition to protecting against unwanted pregnancy, oral contraceptives help normalize the menstrual cycle and reduce the manifestations of mastopathy in the first 8 weeks after starting use. When properly prescribed, the drugs suppress ovulation, steroidogenesis, the synthesis of ovarian androgens and the synthesis of endometrial estrogen receptors. In some cases, when choosing an oral contraceptive incorrectly, the signs of mastopathy in women increase; in such situations, it is necessary to select another drug.

The following drugs can be used for treatment:

• Femoden;
• Marvelon (or Mercilon);
• Silest;
• Janine et al.

When choosing an oral contraceptive, preference is given to means in which the content of estrogens is the lowest and the content of gestagens is higher. The drugs are prescribed for at least 3 months. For the treatment of mastopathy, it is not recommended to prescribe mini-pill oral contraceptives, since the dose of hormones in them is extremely low to affect the woman’s disturbed hormonal levels.

Gestagens

These drugs help suppress estrogen production and slow down the gonadotropic function of the pituitary gland. According to statistics, they are effective in the treatment of mastopathy in 80% of cases. The drugs are prescribed in courses with breaks, the duration of which is determined by the doctor individually for each woman.

Previously, gestagens - testosterone derivatives - Danazol, Linestrinol and Norgestrel were used more often. However, now preference is usually given to progesterone derivatives - medroxyprogesterone acetate. In addition, a progesterone-based topical preparation such as Progestogel (gel) can be used to treat mastopathy. When using it, a woman does not have to experience the side effects that are observed when taking hormones orally.

Androgens

These drugs are estrogen antagonists and suppress their activity. Danazol is usually prescribed for the treatment of mastopathy, which reduces the synthesis of gonadotropic hormone. As a rule, the therapeutic effect is observed in 2 out of 3 women - the structure of the mammary gland becomes homogeneous, and the risk of cysts decreases.

The following side effects may occur when taking Danazol:

• nervousness;
• weight gain;
• swelling;
• sweating;
• vaginitis, etc.

The doctor must warn the patient about their possible appearance. In addition, the woman should be informed that the contraceptive effect of the drug is very low and an unwanted pregnancy may occur while taking it without additional methods of contraception.

Prolactin inhibitors

Drugs in this group can only be prescribed for laboratory-proven prolactinemia. To obtain more accurate test results, it is recommended to administer a thyroid-stimulating hormone releasing factor (TRP test) before drawing blood.

With proven prolactinemia, patients with mastopathy can be prescribed the following prolactin inhibitors:

• Bromocriptine;
• Parlodel.

After taking them, prolactin synthesis decreases, the balance between progesterone and estrogen is normalized, the menstrual cycle is stabilized, mastalgia and nodular formations in the glandular tissues are reduced.

Gonadotropin-releasing factor (or LHRH) analogues

Taking these drugs is usually recommended for severe mastopathy and the ineffectiveness of other hormonal drugs. These drugs help reduce estrogen and testosterone levels. However, LHRH drugs have a large number of side effects such as hot flashes, amenorrhea, dizziness and hypertension. That is why their prescription should always be balanced and focused on a specific clinical situation.

Surgery

In some cases, women suffering from mastopathy cannot do without surgical intervention.

In recent years, most specialists have been wary of surgical treatments for mastopathy. Interventions do not completely eliminate the causes of the disease, and even after several operations, relapses may develop.

As a rule, surgical treatment of mastopathy may be recommended for some patients with the nodular form of this disease and a long absence of the expected effect from conservative therapy. In addition, the operation is indicated for accumulations of microcalcifications, intraductal papillomas, detection of epithelial growths during cytological analysis and the presence of large cysts with hemorrhagic contents. Treatment of such patients should be carried out in an oncology hospital.

The extent of surgical intervention may vary. Sectoral resection of the gland (i.e., removal of the affected area) is usually recommended. During the operation, an urgent histological examination of the removed tissue is performed, and if malignant cells are detected, the scope of the intervention can be expanded.

In case of multiple cysts and nodes, intraductal papillomas, extended resection of the gland is performed, and in some cases its complete removal is performed. After such interventions, the patient may be recommended reconstructive plastic surgery - mammoplasty.

If solitary cysts are detected, the patient undergoes sclerotherapy of the cysts.

After surgical treatment of mastopathy, all patients are recommended to undergo clinical observation and a course of conservative therapy is prescribed, since the intervention allows eliminating only the foci of tumors, but not the cause of the disease. If atypical cells are detected during histological analysis of removed tissues, the patient is recommended to undergo chemotherapy.

Is it possible to cure mastopathy on your own?

Self-medication of mastopathy is unacceptable, since it is impossible to identify the cause and form of the disease without a comprehensive examination and consultation with a mammologist. Many women try to treat this disease on their own using folk remedies, but this attitude towards their health can cause the development of breast cancer, since mastopathy is considered by all specialists as a precancerous disease.

Only long-term and comprehensive treatment aimed at eliminating the causes of the disease will help you get rid of mastopathy. In some cases, it can be supplemented with traditional methods, but their use should always be discussed with a doctor and combined with the main therapy.

Patients with mastopathy may be recommended sedative, choleretic, diuretic and restorative herbal infusions, which in some cases can be an alternative to pharmacological agents. Before using them, it is necessary to exclude all possible contraindications to their components.

Linseed oil

Flax contains substances that help normalize hormonal levels and Omega-3, which help activate the body's anti-cancer defenses. Flax oil can be prescribed in capsule form or in its pure form.

Infusion or decoction of Rhodiola cold (or red brush)

This medicinal plant has an anticarcinogenic effect and promotes:

• normalization of estrogen and progesterone levels;
• restoration of the functions of the endocrine glands;
• elimination of inflammatory reactions in the mammary glands;
• strengthening the immune system;
• removing toxic substances from the body.

One or more courses of taking an infusion or decoction of red brush helps eliminate pain and swelling of the glands, stop discharge from the nipples and reduce the size of the nodes. In addition, taking this medicinal herb is recommended for concomitant diseases such as uterine fibroids, cervical erosion, inflammatory processes in the genitals and infertility.

Infusion of horse chestnut flowers

To eliminate inflammatory processes in the mammary glands and pain due to mastopathy, it may be recommended to take an infusion of horse chestnut flowers. A teaspoon of plant material is poured into a glass of boiling water and left for half an hour. The strained infusion is taken in between meals, 1/3 cup three times a day.

Compresses with cabbage leaves

To reduce pain due to mastopathy, you can use cabbage leaves. They are applied to the chest in the evening or at night and secured with a bra. Instead of cabbage leaves, you can use burdock, and to enhance the effect, put a mixture of 3 parts grated beets and 1 part honey under the leaf.

Lotions with wormwood infusion

You can eliminate mastalgia with the help of lotions made from wormwood infusion. To do this, pour 5 tablespoons of plant material into 3 cups of boiling water and leave to steep overnight. After this, the infusion is filtered, a little warm water is added, linen or cotton cloth is moistened in it and applied to the chest for 15 minutes three times a day.

Compresses made from burdock leaves, honey and castor oil

Such compresses are prepared from crushed burdock leaves (100 g), two lemons, castor oil (100 g) and honey (100 g). The components are mixed, applied to a linen or cotton napkin and applied to the chest overnight.

Herbal collection of wormwood, nettle, sage and plantain

To prepare the collection, take two parts of wormwood and one part each of nettle, sage and plantain. A tablespoon of the mixture is poured into 220 ml of boiling water and left for an hour. The infusion is filtered and taken ½ glass 20 minutes after meals three times a day. The course of admission is 2 months. After 14 days the course can be repeated.

Mastopathy is a precancerous disease and requires complex treatment from a specialist. The treatment plan may include non-hormonal and hormonal agents, the use of which is aimed at eliminating the causes of the disease. In some cases, a woman may be recommended surgical treatment.

Which doctor should I contact?

If signs of mastopathy appear - periodic or constant swelling of the mammary glands, pain, discharge from the nipples, lumps in the breast - you should definitely consult a mammologist. To draw up an effective treatment plan for the patient, the following diagnostic tests may be prescribed: ultrasound of the mammary glands, mammography, tests for hormone levels, biopsy with histological examination, etc.

Women are extremely sensitive to various hormonal and age-related influences, which is manifested by various changes in organ tissue. Cystic mastopathy of the mammary glands is a clear manifestation of such changes. How does the disease manifest itself, is it possible to restore damaged tissue, and what treatment options does modern medicine offer?

Frequency of cystic mastopathy

The sharp increase requires careful monitoring of each representative of the fair sex.

Cystic mastopathy also requires vigilance regarding malignant degeneration. The exact percentage of this form of breast pathology is unknown, since there is a generalized concept of “mastopathy”, which includes different forms of the disease. But the approximate number of cystic mastopathy is about 26.4% of cases.

Etiology

The exact cause of cystic changes in the gland is not known. However, there are a huge number of factors that increase the risk of pathological changes. There are two main culprits of the disease:

1. Pathology of the ovaries, in which the hormonal balance of levels changes in the direction of their sharp increase. It has been proven that these hormones accelerate the growth of epithelial and connective tissue, causing cystic degeneration;
2. Deficiency, which accelerates involutive changes in gland tissue.

They play a certain role in the development of pathology. They promote the growth of altered tissue in two ways:

• A decrease in their number leads to a shift in hormonal balance towards a sharp increase in estrogen;
• In some cases, androgens themselves provoke the development of cystic mastopathy, for example, causing hyperplastic processes in the uterus and mammary gland.

Interestingly, even the adrenal glands can cause the development of cystic changes. A similar situation occurs when there is excessive production of cortisol, which directly interacts with corticosteroid receptors in the gland and leads to pathological tissue proliferation.

Pathogenesis

Under the influence of unfavorable factors, increased growth of connective tissue and gland stroma begins. The secretion of the glands begins to stagnate, which leads to the expansion of the milk ducts. Gradually, the secretion becomes too much, which leads to blockage of the duct and the formation of a cyst. At first they are small, but as the disease progresses, the cysts merge, resulting in the formation of multi-chamber formations. The number of nodes varies; they can be either single or multiple. The disease most often affects both mammary glands.

Symptoms

Manifestations of cystic mastopathy are quite scanty. Sometimes, a woman does not even know about the existence of the pathology, attributing the unpleasant sensations to PMS. But few people know that mastopathy is a common component of premenstrual syndrome. The manifestations are familiar to many women of childbearing age, the only difference is that in the presence of cysts, the symptoms will be more pronounced. If there are a large number of cystic formations, severe pain in the organ is noted, which sharply intensifies 2-3 days before the onset of menstruation.

Sometimes the cysts are “silent”, and pain is localized in the shoulder and shoulder blade of the corresponding side. If the changes affected both mammary glands, then this may manifest itself as attacks of thoracic osteochondrosis on the eve of the onset of mensis.

If a woman has a nodular form, then often You can palpate dense elastic bumps in the tissues of the gland. Before the start of the menstrual cycle, they swell slightly, and local soreness may be noted.

Another common manifestation of the cystic form is breast swelling. In some patients, the size of the mammary glands even changes, which is clearly visible when wearing a bra. Overstretching of tissues leads to pain in the organ. Rarely, cysts can provoke inflammatory changes in tissues, which leads to a slight increase in temperature.

Among the general symptoms, one cannot fail to note a change in the emotional background: depressive states, excessive aggressiveness.

The manifestations of cystic mastopathy in women during menopause are slightly different. Pain in the mammary glands can occur at any time; with a long course of the disease, its intensity is low. When trying to press on the nipple, patients release a greenish secretion.

Diagnostics

Detection of cystic mastopathy requires an integrated approach, which includes several stages.

Anamnesis

Collection of anamnestic data - at the appointment, the gynecologist finds out whether the patient has pain symptoms, whether there is a hereditary component, learns about extragenital and somatic diseases, identifies mental abnormalities (for example, increased anxiety);

Inspection of the glands

It must be remembered that palpation should be carried out in two positions - standing and lying down– although often practicing doctors neglect this rule. With cystic mastopathy, the following changes are detected: tissue density, the presence of nodular seals, the presence of galactorrhea (secretion).

The doctor must evaluate the condition of the lymph nodes and skin over the nodular formations, which is necessary for the timely diagnosis of cancerous degeneration. It should be noted that upon palpation, only large cysts can be detected, and small ones can be identified only on the basis of additional diagnostic measures.

Laboratory methods

Classic blood and urine tests will not help in diagnosing cystic mastopathy. However, this type of diagnosis is necessary to identify concomitant pathologies. For example, they conduct a blood test for hormones to diagnose hyperestrogenemia.

Instrumental research methods

Instrumental diagnosis is the only accurate method for detecting cystic mastopathy. There are quite a large number of manipulations that a doctor performs when examining the breast; we will analyze each in more detail.

Mammography

X-ray examination of the glands is the main objective method for screening pathological changes in the breast. But he does not allow one to accurately distinguish cystic formations from. From the image, in case of single nodular formations, rounded or elongated areas of darkening are revealed. The sizes of cysts are completely different: from a minimum of 0.3 cm to large formations of 8 cm. The contours of the cysts are clear, even, and sometimes there is a light rim around the node. With multi-chamber forms, the contours are torn.

Ultrasonography

As with radiography, a round or oval node is visualized, the boundaries of which are clearly defined. The contents of the cavity are homogeneous, there are no inclusions. If there is a multi-chamber cyst, ultrasound can show part of the destroyed septum that previously separated the cysts.

In case of infection, examination reveals inflammation around the formation and pronounced fibrosis of the capsule.

This technique is used everywhere because it is the safest and fastest diagnostic method. It can be used to screen for the presence of cysts in pregnant and lactating women. However, the value of ultrasound depends on the professionalism of the doctor who performs the procedure.

Targeted puncture under ultrasound control

The method allows for an accurate diagnosis of cystic mastopathy. The doctor performs a puncture of the cyst, observing the progress of the needle using an ultrasound image on a computer screen. This method allows you to simultaneously perform a therapeutic manipulation - aspiration of the cyst cavity. The contents of the cyst are sucked out and then a special drug is injected into the cavity - Sulfacrylate, which causes sclerosis of the cystic node. This method is effective for large single cysts in 95% of cases.

MRI

An invaluable method for diagnosing cystic growths without painful punctures and radiation. Despite the rather high cost, magnetic resonance imaging is an ideal method for diagnosing cystic mastopathy, and subsequent monitoring of the process. The study allows you to assess the number of cystic formations, their location, boundaries, tissue involvement, etc.

There are auxiliary methods that are used for more detailed visualization: ductography, pneumocystography, electrical impedance tomography.

Treatment

For single cystic formations, treatment can be conservative - using Sulfacrylate.

The method allows you to achieve the disappearance of large cysts without the use of a scalpel. Surgical treatment is used in the following cases:

• Detection of atypical cells after targeted biopsy;
• Pronounced proliferation of epithelial tissue around the formation - this may indicate malignant degeneration and one should not take risks;
• Recurrence of cysts after treatment with sulfacrylate;
• Suspicion of the presence of blood in the cyst cavity by ultrasound.

After treatment, control diagnostic studies (ultrasound, mammography, MRI) are carried out at 6 and 12 months. Then the woman undergoes standard examinations annually.

With multiple small cysts, a wait-and-see approach is more often used: the woman undergoes periodic examinations to monitor the process. Medications are prescribed: bromocriptine, COCs, progesterone gel, mastodinone. The choice of therapy is determined by the attending physician.

Treatment with folk remedies for cystic mastopathy is ineffective. But you can use various decoctions and tinctures to maintain a woman’s gynecological health, which will affect the course of the cystic process. The most valuable are: hogweed, elecampane, nettle, oregano and lemon balm.