How to treat mastopathy of the breast
Mastopathy is considered a very common disease among the fair sex.According to various data, this pathology suffers from 40 to 90% of women.Despite such a wide prevalence of the disease, it is not worth taking lightly to it.Mastopathy is considered to be a precancerous condition, which is why it is important to be examined regularly and to observe the prescribed treatment.Table of Contents: Causes of Mastopathy Types of Mastopathy Symptoms of Mastopathy Diagnosis of Mastopathy
Causes of Mastopathy
Mastopathy is a disease that is based on the proliferation of glandular and connective tissues of the mammary glands.Similar changes are provoked by hormonal disorders.The growth and development of glandular tissue, structures of the breast gland is affected by a large number of hormones, but the most important are estrogen, progesterone and prolactin.
Estrogen gynecologists are called the hormone of the first half of the menstrual cycle.It stimulates the development of glandular tissue.Prolactin also has a similar effect.And progesterone( the hormone of the second half of the menstrual cycle) depresses the development of breast tissue.The causes of the hormonal background disorders can be:
- Stresses, chronic fatigue, inferior sleep;
- Abortions, miscarriages, early termination of breastfeeding;
- The absence of delivery until the age of thirty;
- Polycystic ovaries( an increase in the synthesis of androgens, which under the action of enzymes is converted into estrogens, while the level of progesterone can be reduced);
- Breast Injury;
- Hypothyroidism( high level of thyroid stimulating hormone stimulates the synthesis of prolactin);
- Chronic diseases of the liver and biliary tract( the synthesis of the protein that binds estrogen is broken, which increases the concentration of this hormone in the blood);
- Tumors of the hypothalamic-pituitary region( there is an intensification of synthesis in the pituitary gland of follicle-stimulating, luteinizing hormones, prolactin).
Types and forms of mastopathy
There are several classifications of mastopathy. But the most convenient is the clinical-x-ray version of the classification, according to which the following types of mastopathy are distinguished:
- Diffuse mastopathy;
- Nodal mastopathy;
- Diffusive-nodular mastopathy.
Diffuse is called a mastopathy when changes occur throughout the gland.The growth of the glandular tissue( lobules) may prevail, in which case the diagnosis sounds like a diffuse mastopathy with a glandular component.A similar form of the disease is observed mainly in young girls
Diffuse mastopathy with fibrotic component is a consequence of proliferation of connective tissue.And in the presence of cysts in the parenchyma, they speak of diffuse mastopathy with a cystic component.
The mixed form of diffuse mastopathy combines the signs of proliferation of both glandular and connective tissues.
In the nodular form of , diseases in the parenchyma of the breast produce nodes that have clear boundaries that are not soldered to surrounding tissues.
Symptoms of mastopathy
The first and, as a rule, the most disturbing sign of mastopathy is the appearance of pain in the mammary glands.Both glands can ache equally, or some more.Pain intensification is usually observed in the premenstrual period.At this time, women with mastitis also complain of a feeling of heaviness in the mammary glands and their increase in volume.When probing the breast, it is possible to detect seals.
When mastopathy can also be observed liquid or mucoid-like discharge from the nipples of gray-white color.The appearance of blood is an alarming symptom, as this is not characteristic of benign breast diseases.
Mastopathy can be detected with the help of such instrumental research methods as ultrasound, mammography.To identify the cause of the disease, it is necessary to examine the hormonal status.But the simplest and most accessible diagnostic method is self-examination.Recommended to read:
Palpation of the mammary glands should be performed in a standing or lying position.Finger pads should be probed the surface of the breast in a clockwise direction.Then you need to press on the nipples to determine if there is a discharge.It is superfluous to investigate and axillary lymph nodes.Doctors recommend conducting such self-examination regularly, optimally for the fifth-tenth days of the menstrual cycle.During palpation try to remember the tactile sensations to next time to compare whether there are any changes.
What signs should alert a woman?Condensation, soreness of the gland, a sensation of tuberosity under the fingers indicate the presence of a diffuse form of mastopathy.Women can feel under the skin and small foci of compaction scattered throughout the gland( usually at the top of it).
In the cystic form of the disease against the background of uneven compaction of the gland, it is possible to detect nodal formations that can reach various sizes.Formations usually become more pronounced in the second half of the menstrual cycle.
Instrumental research methods
All diagnostic methods of research are performed on the fifth to the twelfth days of the menstrual cycle.In the absence of a woman's menstruation, the study can be conducted any day.
The ultrasound of the mammary glands is performed in the position of the patient lying on the back.In the study, the doctor can detect heterogeneity of the structure of the gland, the expansion of the milk ducts, the presence of nodes and cysts.The procedure can be conducted for women of any age.
Women over the age of forty must undergo an mammogram once a year.If the patient is suspected of mastopathy, the doctor may direct the patient to undergo this examination unplanned.X-ray mammography is carried out in two planes: direct and lateral.It is worth noting that mammography is not performed for women under the age of thirty.
For the exclusion of malignant diseases of the mammary gland, a puncture biopsy of the tissue can be performed with further examination of the material.
Because the cause of mastopathy is a violation of hormonal status, it is necessary to investigate the level of certain hormones.On which day of the cycle should be selected venous blood for the determination of a hormone is decided by the doctor.Usually the study of hormonal status is performed from the fifth to the ninth or from the twentieth to the twenty-second days of the menstrual cycle.
For the diagnosis of mastopathy, the level of such hormones is examined:
- Thyroid-stimulating hormone, thyroxine, triiodothyronine;
- Follicle-stimulating( FSH) and luteinizing( LH) hormone .
Treatment of mastopathy
Combating mastopathy should be comprehensive.Diffuse form of the disease is treated medically, in the case of a nodular form the doctor can recommend surgical removal of education.
Correction of hormonal disorders - the causes of the disease development is the basis of mastopathy treatment. Apply hormonal agents such as:
- Antiestrogens( tamoxifen, raloxifene, phareston) - reduce the level of estrogens;
- Combined oral contraceptives( diane-35, regulon, ovidon) -increases the level of progesterone in the blood;
- Gestagens( morning, djufaston, gel for external use progestogen) - block estrogen receptors;
- Dopamine receptor agonists( norprolak, dostinex, parlodel) - increase the level of dopamine, which inhibit the secretion of the pituitary gland prolactin;
- Antigonadotropins( danoval, danazol) - inhibit the release of gonadotropic hormone from the hypothalamus, which leads to a decrease in the synthesis of FSH and LH by the pituitary gland;
- Thyroid-stimulating substances and thyroid hormones - reduce the level of increased thyroid-stimulating hormone and prolactin.
In the treatment of mastopathy, additional drugs can be used that can not only affect the pathological process, but also eliminate the disturbing symptoms of .Non-hormonal therapy includes the assignment of such drug groups:
- Vitamins( Aevit, Triovit);
- Anti-inflammatory drugs( diclofenac, indomethacin);
- Sedative preparations;
- Antidiarrheal preparations.
No less significant role is played by the correction of the diet.It is necessary to reduce the consumption of foods containing fat in large quantities, flour products, since such food leads to the development of subcutaneous fat, in which estrogen is produced.Preference should be given to cereals, vegetables, fruits, dairy products.
In addition, you should minimize the consumption of chocolate, caffeinated drinks, alcohol, because they retain fluid in the body, thereby contributing to swelling of the breasts and increased pain.
Surgical treatment of mastopathy
The extent of surgery is determined by the size of the node.So, if the site is small, the surgeon removes it, while maintaining the maximum volume of the breast.If there are many nodes or they are large, the sectoral removal of the mammary gland is carried out.A fragment of the removed tissue is sent for histological examination.In the cystic form of the disease, sclerosis or vyshushchivanie cysts.
Grigorova Valeria, medical reviewer