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Mastopathy is a pathological change in the tissues of the mammary glands, which has a fibrocystic character. Fine-grained seals form in the chest, which are most often painful. The formations are of benign origin, but are regarded by doctors as a risk factor for the development of cancer, since the possibility of malignancy of the process is not excluded.
Mastopathy is a collective term, it combines a whole group of pathologies. All these disorders are associated with changes in the mammary glands, in which there is an imbalance in the ratio between the connective and epithelial tissue. WHO in 1984 classified mastopathy as a fibrocystic disease.
Statistics show that the risk of developing this disease increases significantly after a woman crosses the forty-year age limit. In young patients, mastopathy due to various reasons is diagnosed in 30-45% of the total number of breast diseases. In addition, women with a history of many gynecological diseases suffer from mastopathy in 70-95% of cases.
The development of the disease directly depends on neurohumoral regulation. It is known that numerous hormones are responsible for the development and growth of the mammary glands. The most important in this regard are estrogens, prolactin, progesterone and growth hormone. The state of the female breast directly depends on their ratio in the body. When hormonal imbalance occurs, then the risk of developing mastopathy increases.
Signs and symptoms of mastopathy of the mammary glands
The severity of the symptoms of mastopathy depends on what form of the disease the woman has. Her emotional state, the presence of concomitant pathologies, and even character traits are also important.
Painful sensations in the chest can be of varying severity, their nature and intensity vary. The initial stages of mastopathy are manifested by pains that occur in the mammary glands only before the next menstruation. Most women do not pay attention to them, considering this phenomenon part of the premenstrual syndrome. Pain can be dull, aching, pulling, sharp. Sometimes it is even impossible to touch the chest. Painful sensations arise as a result of the fact that blood stagnates in the veins, the surrounding tissues swell, and this leads to an increase in breast volume. In addition, fibrous growths put pressure on the nerve endings penetrating the mammary glands. When the menstruation ends, the pain disappears. As the mastopathy progresses, the pain begins to haunt the woman constantly with a tendency to increase before the next menstruation. This negatively affects the state of health: sleep is disturbed, excessive irritability appears, unmotivated aggression against the background of mental lability. The pain may radiate to the arm or shoulder blade. However, up to 15% of women note that at the initial stage of mastopathy, pain did not bother them. Moreover, they are diagnosed with pathological formations of a significant degree of severity. Scientists attribute this to a different threshold of pain sensitivity and individual characteristics of the branching of the nervous system of the mammary glands in women.
Breast engorgement in the second phase of the menstrual cycle. This symptom is due to venous congestion in the vascular system of the mammary glands. Connective tissue can swell so much that a woman notes an increase in glands by 15%. At the same time, the breast becomes hypersensitive, the patients react sharply to an attempt at palpation.
Discharge from the nipples of varying intensity. Perhaps their appearance only after pressure on the nipple. But sometimes the discharge is quite pronounced, and to detect them, no effort is required. As for consistency, it varies. The color may be white, greenish, brown, bloody or absent altogether – in this case, the discharge is transparent. Of particular danger are the secretions containing blood impurities. They may indicate malignant processes occurring in the gland. However, even transparent discharge should not be ignored – if they are found, it is necessary to consult a doctor. A woman needs to remember: normally, there are no discharges from the nipples (if there is no pregnancy and lactation). Any discharge from the breast in another period indicates that the milk ducts are involved in the pathological process.
The appearance of nodes – one or more. If a seal is detected during palpation of the breast, this is a reason for an immediate appeal to a mammologist.
Signs of mastopathy may vary depending on its form:
Diffuse fibroadenomatosis. Most often, this type of mastopathy is diagnosed in women at a young age. During the examination, enlarged mammary glands with engorgement are found. In addition, fine graininess is palpable. The chest is often painful, its lobulation is strongly pronounced. A woman may need analgesics to relieve pain.
Nodular mastopathy. If diffuse mastopathy has not been subjected to timely treatment, then it turns into a nodular form. During palpation, individual seals or cystic formations are palpated. Seals do not have clear boundaries, lobulation is not palpable.
Sometimes quite large nodes are found, up to 70 mm. A cyst is indicated by the presence of a clear border with clear contours, moreover, there is no connection between the formation and the surrounding tissues. The shape of the cyst is often oval or round.
Causes of mastopathy
All etiological factors that influence the development of the disease are to some extent associated with the hormonal imbalance that occurs in the body of a woman. First of all, this is a lack of progesterone, ovarian dysfunction, as well as an increase in estrogen levels to extremely high or relatively high values. After all, it is estrogens that contribute to the growth of the epithelium by dividing it in the milk ducts and alveoli of the glands. In addition, estrogens have an effect on enhancing the activity of fibroblasts, which also provoke the division of the stroma of the glands.
In the mechanism of development of mastopathy, an increased level of prostaglandins and hyperprolactinemia are important. Prolactinemia makes breast tissue more receptive to estrogen.
It is important to understand that even with the existing hormonal imbalance, breast mastopathy will not begin to develop rapidly. For the manifestation of the disease, several years of constant influence of risk factors and their interaction with each other will be required.
The reasons that can provoke mastopathy include:
Early puberty and early onset of menstruation. Menarche that occurs before the girl reaches the age of 12 is especially dangerous. This can provoke accelerated hormonal changes, which ultimately will negatively affect the condition of the mammary glands.
Late onset of menopause. As a rule, if a woman’s period stops at the age of over 55, this negatively affects the tissues of the mammary glands. Pathological processes are provoked by too long exposure to hormones.
Violation of the natural course of pregnancy – its termination. This leads to the fact that in the body of a woman there is a sharp decline in hormones and a complete restructuring of the hormonal background. And it doesn’t matter how exactly the abortion happened: the woman had a miscarriage, or she had an abortion.
The complete absence of pregnancy and childbirth during life.
Refusal to breastfeed the child, or a short period of lactation with its artificial completion.
hereditary factor. Of particular importance in this regard is the presence of any breast disease (benign or malignant) in the mother or maternal relatives.
The woman is over 35 years of age.
Having bad habits.
Stress resulting in endocrine disorders.
Any inflammatory processes, the localization of which is the mammary glands.
Injury to the chest, wearing the wrong size bra – tight or uncomfortable.
Diseases associated with iodine deficiency.
Taking inappropriate hormonal birth control pills. Any drug containing hormones should be prescribed exclusively by a doctor after a thorough examination.
Gynecological diseases caused by hormonal disorders. These include anovulation, amenorrhea, uterine fibroids, endometriosis, and infertility.
Diseases of the thyroid gland and liver.
Overweight. The fact is that adipose tissue is the base for storing estrogens. The more it is, the more hormones accumulate in the body. And this leads to corresponding violations.
Tumors of the hypothalamus and pituitary gland.
Irregular sex life. This leads to congestion in the pelvic organs. Circulatory failures, in turn, provoke ovarian dysfunction and, as a result, hormonal imbalance.
What is dangerous mastopathy of the mammary glands?
Mastopathy of the mammary glands is a disease that does not go away on its own. He needs to be treated. The main danger of mastopathy is degeneration into breast cancer. Therefore, doctors regard any form of mastopathy as a precancerous condition, although initially it has a benign nature.
The risk of developing cancer increases when cystic changes are observed. In addition, the degree of proliferation of the epithelium of the mammary glands – ductal and intralobular, as well as the presence of signs of calcification, is of great importance.
If the proliferation of the epithelium is pronounced, then the risk of malignancy increases to 31%. With a moderate form of proliferation, this risk is 2,34%, and with a non-proliferative form of mastopathy – 0,86%. That is why the diagnosis and treatment of mastopathy in modern medicine is regarded as a secondary prevention of breast cancer. (read also: breast cancer prevention)
In addition to the risk of malignancy of the process, it is worth noting the likelihood of developing a background inflammatory process and subsequent infection of the cystic formation with its further suppuration. There is also a risk of violation of the integrity of the cyst.
How to treat mastopathy?
Therapy of the disease is a prerequisite for the detection of mastopathy.
Medical tactics depend on several factors, including:
The age of the woman in need of treatment for mastopathy;
Existing comorbidities – endocrine, extragenital, gynecological;
The form of the disease;
The desire to preserve reproductive function, or vice versa, the priority of contraception;
The nature of menstrual irregularities.
Conservative treatment of mastopathy is possible if a diffuse form of the disease is detected. The appointment of drugs occurs after consultation with a mammologist and a thorough examination of the patient.
With regard to fibrocystic formations, conservative therapy is possible, however, surgical intervention may also be required. With a confirmed suspicion of a malignant tumor, its removal is mandatory.
Sectoral resection of the mammary gland is used as the optimal surgical technique. At the same time, the woman’s breast is preserved, and the fibroadenoma itself and part of the glandular tissue are excised. The operation is performed under general anesthesia. The marking of the performed incisions is applied in advance. Everything is done under the control of ultrasound, which minimizes the cosmetic defect.
List of medicines for mastopathy
Medicines designed to save a woman from this disease should be prescribed only by a doctor.
Hormonal preparations
Antiestrogen drugs. Their main task is to reduce the level of estrogen in a woman’s body.
Most often, doctors prescribe the following drugs:
Forest. This drug has a minimum list of contraindications. The result of its use will be noticeable after the first 30 days from the start of therapy. The course of treatment for fibrocystic form of mastopathy can last up to six months. The minimum period is three months. Most often, women complain of side effects associated with the antiestrogenic action of fareston: hot flashes, increased sweat glands, vaginal discharge, nausea, skin rashes, and depressive mood. Serious side effects from taking the drug are rare.
Tamoxifen. This drug helps to eliminate the pain caused by mastopathy, normalizes the menstrual cycle, and reduces the risk of cancer. The effect, as a rule, occurs after 8-12 weeks from the start of the intake. As for side effects, they are also most often associated with the suppression of estrogen production. In addition to hot flashes, feelings of heat and increased sweating, women note an increase in body weight, alopecia, itching in the genital area. In addition, at the initial stages of therapy, an increase in the volume of soft tissue formations of the breast, accompanied by the appearance of skin erythema, may occur. However, after two weeks, these symptoms self-destruct, so treatment should not be interrupted.
Drugs belonging to the group of oral contraceptives. These pills are most often prescribed to women whose age does not exceed 35 years. Hormonal contraceptive pills effectively protect against the occurrence of unwanted pregnancy and at the same time normalize the menstrual cycle. Against the background of their intake, the signs of fibrocystic mastopathy are significantly reduced.
Among the most popular drugs in this group:
Femoden, produced in tablet form. It contains gestodene and ethinyl estradiol. During the reception, the menstrual cycle normalizes, the pain of menstruation decreases, the risk of developing anemia decreases.
Silest. The drug is also available in tablets. Its active ingredients are ethinylestradiol and norgestimate. While taking this oral contraceptive, the production of gonadotropins is suppressed, the viscosity of the mucus of the cervical canal increases, and the menstrual cycle normalizes.
Marvelon and its analogue Mercilon. The composition also includes ethinylestradiol, and the second active ingredient is desogestrel. While taking these drugs, the ovulatory ability is suppressed and the menstrual cycle is normalized. Pain preceding the onset of menstruation decreases, bleeding becomes less profuse. (read also: scanty and heavy periods, delayed or absent periods) In addition, there is evidence of a reduced risk of developing ovarian and endometrial cancer in women who regularly take Marvelon or Mercilon.
Androgen preparations. To get rid of breast mastopathy, it may be recommended to take drugs with androgens. Their therapeutic effect is due to the fact that they are estrogen antagonists, that is, they are able to suppress the excessive activity of the latter.
Most often, women are recommended to take Danazol. This drug helps to reduce the production of gonadotropic hormone, although so far experiments in this regard have only been carried out with the participation of animals. If we evaluate the effectiveness of this drug in relation to the treatment of mastopathy, then the effect will be obtained in about 2 out of three women. As a result of therapy, the mammary gland is leveled, the risk of formation of large cysts is reduced.
When prescribing Danazol, the doctor should warn the woman about the risk of developing side effects: amenorrhea, sweating, vaginitis, nervousness, swelling, weight gain and other endocrine disorders. In addition, the contraceptive effect when taking Danazol is low, so additional methods of protection against unwanted pregnancy will be required.
Gestagens. Drugs in this group are able to have an effect aimed at suppressing the production of estrogen and slowing down the gonadotropic function of the pituitary gland. These drugs are recognized as a means for the treatment of mastopathy with high efficiency. Their reception increases the chances of successfully getting rid of the disease up to 80%. Therapy should be a course with interruptions. The rest time from taking gestagens is determined by the attending physician.
The most popular in this group are the following drugs:
Rotten. The composition of the drug contains human chorionic gonadotropin. This hormone contributes to the normalization of the growth and maturation of female gametes, which are involved in the formation of sex hormones. As a result, the woman’s hormonal background stabilizes, and mastopathy recedes.
Norcolut. The drug contains norethisterone. To get rid of the symptoms of mastopathy, you will need to take pills starting from the 16th day of the cycle, and up to the 25th. Norkolut is forbidden to use with an existing oncological disease, therefore, before starting therapy, such a diagnosis should be completely excluded.
Pregnin. This drug is a synthetic analogue of a progestogen.
Orgametril. Linestrenol acts as the main active ingredient. It is used to eliminate nodular formations in the mammary glands. Reception should be long. The minimum treatment period is 3 months. The drug is prohibited for use during pregnancy. When it occurs, the therapeutic course is interrupted.
Progestogel. This is a gel for external use. It is based on micronized progesterone. The main advantage of using this drug is that the woman will not experience the side effects usually caused by oral hormones.
Prolactin secretion inhibitors. These drugs are prescribed for abnormal lactation associated with elevated levels of the hormone prolactin. The most popular means of this group are:
Parlodel. The drug has an effect on the cysts of the mammary glands, contributing to their reduction. The number of formations also decreases, the balance between the production of progesterone and estrogen is normalized. The function of reproduction improves and the production of prolactin decreases.
Bromocriptine. The drug has a direct effect on dopamine receptors. As a result, the menstrual cycle normalizes, nodules in the mammary glands decrease in size, the intensity of pain decreases. However, this drug is not allowed to be used in cases of suspected cancer.
Gonadotropin releasing hormone analogues or LHRH. Drugs from this group are prescribed to women who have been diagnosed with a fibrocystic form of mastopathy, and only when other drugs are ineffective.
Non-hormonal drugs
Drugs of non-hormonal origin in the treatment of mastopathy are used in order to reduce the symptoms of the disease and to combat comorbidities, if any.
It is possible to assign the following funds:
Mammoline. Created on the basis of kelp seaweed, effective for fibrocystic mastopathy. Reduces the manifestations of premenstrual syndrome, leads to regression of cysts, normalizes the proliferation of the epithelium of the mammary glands, reduces pain. It can be used for mastopathy both in the form of monotherapy and as part of complex therapy.
Vitamin complexes. When they are taken simultaneously with drugs for mastopathy, the effect of the latter is enhanced. In addition, properly selected vitamins can increase the overall resistance of the body, reduce the likelihood of side effects from hormone therapy. Most often, with mastopathy, doctors recommend taking vitamins E, A and B.
Adaptogens. Often, with breast mastopathy, women are prescribed Klamin. This product is made from herbal ingredients. It can positively affect the functioning of the liver, the functioning of the immune system and intestines (it has a mild laxative effect). In addition, the drug helps rid the body of toxins, acting as an adsorbent and antioxidant. Iodine deficiency can also be replenished with Klamin. The content of iodine in it covers the daily requirement of a woman’s body for this substance. Also, as an adaptogen, a woman may be recommended to take Eleutherococcus tincture or a liquid extract of Rhodiola. The intake of each of these funds should be long – the minimum duration of therapy is four months, after which a break is made for 8 weeks and the course is repeated. The minimum number of courses is 4.
Sedatives. They are recommended for admission if there are psychological disorders that were provoked by mastopathy. To begin with, doctors try to get by with light drugs, for example, motherwort tincture, or valerian.
Preparations of iodine and potassium. These funds include Iodomarin, Iodine asset and the aforementioned Klamin.
Enzymes They contribute to the normalization of the intestines and the growth of beneficial microflora, eliminate constipation. Doctors associate mastopathy with impaired functioning of the gastrointestinal tract and reabsorption of estrogens from the intestines that got there with bile. Among the most popular enzyme preparations: Wobenzym, Duphalac.
Preparations for the normalization of the functioning of the liver. As you know, interruptions in the work of this organ aggravate the course of mastopathy in the same way as hormonal dysfunction negatively affects the liver itself. The following hepatoprotective drugs can be recommended for a woman: Legalon, Karsil, Essentiale.
non-steroidal anti-inflammatory drugs, which are necessary to eliminate pain – Diclofenac, Nise, Nimika, etc.
diuretics, which allow you to get rid of edema with mastopathy. However, most often, doctors recommend light diuretics, for example, rosehip tincture, teas based on medicinal herbs, etc.
Biologically active additives.
In addition to the above remedies, for the treatment of mastopathy, a woman may be recommended to take the following drugs:
Mastiol
Mastopol
Janine
Dyufaston
Utrozhestan
Zoladex
Answers to popular questions about mastopathy:
Is it possible to get pregnant with mastopathy? In itself, the disease is not an obstacle to conceiving a child. With mastitis, you can get pregnant. Therefore, if a woman found out that she was expecting a child, and she was diagnosed with mastopathy, this is not a reason to terminate the pregnancy. In addition, an increase in the production of progesterone during gestation has a positive effect on the course of the disease, up to its complete disappearance. However, it is not always possible for women to conceive a child with mastopathy. This is due not to the disease itself, but to the causes that caused it. First of all, the likelihood of successful conception reduces hormonal imbalance. Therefore, the best option is to plan pregnancy with a complete preliminary examination.
Is it possible to breastfeed with mastopathy? Doctors strongly recommend not to refuse breastfeeding with mastopathy. If the disease occurs in the first trimester of pregnancy, then most likely it is caused by hormonal changes in the woman’s body. Refusal to breastfeed after the birth of a child or short-term breastfeeding (less than 3 months) can adversely affect the course of the disease. In the event that the pathology was diagnosed before pregnancy, but not completely cured before the baby was born, doctors recommend that women breastfeed the baby for as long as possible. Nevertheless, although it is possible to reduce the severity of mastopathy during lactation, no one can give a guarantee of a complete cure. Therefore, medical supervision and the passage of mammograms are mandatory measures.
Is it possible to massage the back and chest with mastopathy? Massage of the back and chest with mastopathy is contraindicated. It should not be done with soreness of the mammary glands, as it will not help get rid of the problem. Mastopathy is a hormonal pathology, and only correction of the hormonal background can lead to recovery. As for the back, the massage of this area should also be abandoned. The fact is that when exposed to the cervical-collar region, the pectoralis major muscle is captured. This, in turn, can lead to serious complications, up to the rapid progression of mastopathy.
Is it possible to bathe in a bath with mastopathy? Steaming with mastopathy is strictly prohibited. Any mechanical and thermal effect on the diseased mammary gland can lead to an aggravation of the problem.
Is it possible to sunbathe with mastopathy? With mastopathy, you should not sunbathe, since any thermal effect contributes to the malignancy of a benign formation. In addition, you should always be aware of the risk of developing skin cancer. Modern medicine has established a clear relationship between oncological diseases of the dermis and exposure to ultraviolet rays. In order not to expose your body to additional risk, you need to protect your skin from direct sunlight and remember the rules for spending time in the sun.
Dr. Evdokimenko – Academician of the Academy of Medical Sciences of the Russian Federation, will talk about mastopathy, how to treat it, myths: