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Fibrocystic mastopathy – this is a violation of the ratio of the connective and epithelial components of the breast tissue, accompanied by changes in the proliferative and regressive nature.
It is customary to distinguish two forms of the disease:
proliferative form characterized by the launch of the proliferation process, that is, the growth of epithelial and connective tissue by dividing their cells. With moderate proliferation, the risk of degeneration of the pathological process into a malignant one is 2,34%. With a pronounced degree of proliferation, these values increase to 31,4%.
Non-proliferative the form. With this form of the disease, cysts of different sizes form inside the chest: from a few millimeters to several centimeters. At the initial stage of the development of the disease, the formation of structures resembling bunches of grapes occurs. As the pathology progresses, the process of increased collagen production starts, which leads to compaction of the connective tissue, its growth and scar formation. As a result, the lobules that represent the mammary gland are stretched and cysts are formed inside them. The non-proliferative form of the disease does not give a high risk of malignancy of the pathological process. It is no more than 0,86%.
If we turn to the statistics of the disease in general, then among women around the world there is a tendency for an increase in pathology. In reproductive age, the disease affects up to 40% of women on average. If there are multiple gynecological diseases in the anamnesis, then the risk of encountering mastopathy is from 70 to 98%. The high-risk group includes women who suffer from hyperplastic pathologies of the genital organs. During menopause, diffuse fibrocystic mastopathy is less common. It affects up to 20% of women. After menopause occurs, new cystic formations most often do not appear. This statistical fact is also another proof of the direct involvement of hormones in the development of the disease.
Symptoms of fibrocystic mastopathy
It is known that in Russia 90% of women independently detect breast pathology and only 10% of all cases are diagnosed by doctors.
Symptoms of the disease rarely occur hidden and it is quite difficult not to notice them:
Pain, with localization in the mammary glands. This pain is called mastalgia. She most often begins to disturb a woman in the second half of the cycle, or in its middle. The nature of mastalgia can vary from aching to stabbing and bursting. Possible irradiation of pain in the neck, hypochondrium, shoulder and back. When menstruation begins, the pain either significantly decreases or subsides altogether. After the end of menstruation, they disappear and the woman is not disturbed until the next middle of the cycle. However, as the disease progresses, the pains become more intense and do not go away after the end of the cycle, giving the woman discomfort throughout the entire time. Sometimes even a slight touch to the chest causes pain.
Breast tissue evenly compacted and swell.
During palpation, you can feel the granular structures of the gland.
If you press on the nipple, a discharge appears from it. They may be clear or resemble colostrum. During the premenstrual period, the discharge from the nipples increases. A woman can detect stains on the inside of her bra. If the discharge acquires a greenish or slightly yellow tint, then this indicates the addition of a secondary infection or the onset of an inflammatory process. In this case, it is strictly forbidden to postpone a visit to the doctor.
Enlargement and soreness of the lymph nodes located in the immediate vicinity of the mammary gland.
Carcinophobia is another common symptom of women with mastopathy. This is a pathological fear associated with the fear of getting cancer. It develops against the background of discomfort in the chest. Often, precisely because of cancerophobia, women postpone a visit to the doctor, fearing that their own fears will be confirmed. Often cancerophobia is accompanied by panic attacks, anxiety disorders, hypochondria.
Sleep disturbance due to pain. Insufficient night rest entails increased irritability, anxiety, nervousness, decreased performance.
Elevated estrogen levels and insufficient progesterone leads to the corresponding symptoms of hormonal failure. Menstrual irregularities, pronounced premenstrual syndrome, heavy bleeding, the occurrence of spotting between periods – all these signs often accompany mastopathy.
Often, during a comprehensive gynecological examination of women with diffuse fibrocystic mastopathy, ovarian cysts and uterine fibromas are found in them. Endometriosis and endometrial hyperplasia are also diseases adjacent to the pathology of the mammary glands.
Dryness of the skin, brittle nails and hair – all these are indirect signs indicating the pathology of the mammary gland of a fibrocystic nature.
It is also worth distinguishing the symptoms of various forms of cystic-fibrous mastopathy:
Mastopathy with a predominance of the fibrous component. With this form, fibrous changes occur in the connective tissue located between the lobules of the mammary gland. Often there is a proliferation of the intraductal epithelium, this causes either narrowing or complete fusion of the milk ducts. Women experience severe pain, seals are well palpable. Fibrous severity can have varying degrees of severity, depending on the stage of the disease.
Mastopathy with a predominance of the glandular component. This form of the disease is accompanied by the formation of small cysts. Women, as a rule, rarely pay attention to soreness and swelling of the breast, since the symptoms of the disease are mild. Most often, mastopathy with a predominance of the glandular component is diagnosed in patients aged 30 to 40 years.
Mastopathy with a predominance of the cystic component. This form is characterized by the formation of single cysts, rather large in size (they can reach 7 cm in diameter). This type of mastopathy is most often diagnosed in women aged 35 and older. Multiple small cysts may also be diagnosed. Pain intensifies at the time of the onset of menstruation. Large cystic formations have an elastic consistency. They are well palpated, as they are delimited from the surrounding tissues of the mammary gland. The higher the degree of proliferation of the ductal epithelium, the higher the risk of cyst formation.
Causes of fibrocystic mastopathy
In the occurrence of pathology, the main role of all scientists is assigned to dishormonal disorders occurring in the body of a woman. At the same time, not one, but a whole complex of hormones takes part, among which: gonadotropin releasing hormone of the hypothalamus, prolactin, gonadotropins, estrogens, progesterone, chorionic gonadotropin, thyroid stimulating hormone, androgens and some others. Violations of their balance leads to the fact that dysplastic changes are triggered in the tissues of the mammary gland. Against the background of an absolute increase in the level of estrogen and a fall in the level of progesterone, the process of pathological changes is gaining full strength. Estrogens stimulate the proliferation of the epithelium and stroma, and the critically low level of progesterone is unable to counteract this mechanism. As a result, the woman develops mastopathy.
The study of the hormonal status of a woman with fibrocystic disease most often shows: progestogen deficiency (absolute or relative), hyperestrogenism (absolute or relative), a violation of the ratio of FSH to LH and abnormal levels of gonadotropins.
Gynecological diseases. Diseases of the female genital area also negatively affect the condition of the breast tissue. Among such pathologies: oophritis (inflammation of the ovaries), adnexitis (inflammation of both the ovaries and appendages), ovarian dysfunction (violation of their hormonal function), etc.
Childbearing period. During pregnancy, it affects the hyperplasia of the mammary glands, hormones that are produced by the placenta.
Thyroid dysfunction. Currently, the relationship between mastopathy and thyroid pathologies is scientifically proven. This is primarily due to a drop in the level of corpus luteum hormones. In addition, the thyroid gland affects the thyrotropic and luteinizing function of the pituitary gland. This disrupts the ovarian cycle and leads to dyshormonal processes in the mammary gland.
Diseases of the liver. It has been established that a violation of its functioning causes multiple changes in the hormonal balance.
Adverse factors associated with the function of reproduction. These factors include abortions suffered by a woman, as well as unsuccessfully completed pregnancies (miscarriages, premature births). Late onset of pregnancy, or its absence, also negatively affects the tissues of the mammary gland. In addition, infertility therapy, refusal to breastfeed, or a short lactation period may have an effect. It is a known fact that women who have interrupted the natural course of pregnancy more than three times are more prone to developing mastopathy. Their risk of pathology increases by 7,2 times.
Features of sexual development, the period of menopause. In this case, the greatest danger is the too early onset of puberty with menarche before the age of 12 years. If a woman’s menstruation ends too late – over the age of 55, then this is also a risk factor that can lead to mastopathy.
Disease. Some diseases can have an impact on the development of pathology, including: diabetes mellitus, arterial hypertension, adrenal diseases. With hypothyroidism, the risk of developing pathology increases by almost 4 times.
Overweight. The greater the weight of a woman, the more she has stocks of adipose tissue. It is known to be a depot for estrogens, and therefore there is always a risk of developing hyperestrogenism and mastopathy against its background.
exogenous reasons. Breast injuries, ionizing radiation, exposure to ultraviolet rays (obtained both from sunlight and in a solarium) on unprotected chest skin, and unfavorable environmental conditions in the area of residence can negatively affect.
Features of sexual life. It is known that irregular sex life or its absence leads to stagnation in the pelvic area. This provokes diseases of the female genital area, disruption of hormone production and, as a result, mastopathy.
factor of heredity. Particularly attentive to the state of their own mammary glands should be those women whose closest maternal relatives have suffered breast diseases of benign or malignant origin.
Stressful situations. The greatest danger is presented by severe and long-term psycho-traumatic situations.
Is fibrocystic mastopathy dangerous?
Diffuse fibrocystic mastopathy is a dangerous disease. Doctors consider it precancerous, although it is benign. If the pathology is left untreated, then the next stage of mastopathy will come – nodular, with it the risk of malignancy increases several times.
So, the dangers of fibrocystic mastopathy are as follows:
The risk of malignancy of the process;
The development of an inflammatory reaction in the mammary gland, infection and suppuration of the existing formation;
Growth of cystic formation, deformation of the shape of the breast;
Violation of the integrity of the cystic formation.
In addition, the disease significantly reduces the quality of life of a woman. She constantly or periodically experiences discomfort and pain in the chest, which causes neurosis, psychosis, becomes the reason for the impossibility of proper rest, decreased performance, etc.
If mastopathy is suspected, a woman should seek advice from a gynecologist or mammologist. Timely treatment will allow you to get by with conservative methods and not resort to surgical intervention.
Treatment of fibrocystic mastopathy
The leading place in the treatment of diffuse fibrocystic mastopathy belongs to drugs of the hormonal group. Most often, oral gestagens are used for this purpose. Progestins are prescribed in the case when the patient’s mastopathy is combined with hyperplastic processes in the endometrium, or progesterone deficiency is detected.
Widely used drugs such as:
Duphaston. It is an analogue of progesterone of natural origin. Therefore, it can be used without fear for the risk of developing side effects that occur when taking androgens. Even long-term treatment with Duphaston is safe and does not cause anabolic effects. Therapy allows you to achieve a progestogenic effect.
Utrozhestan. This drug is represented by natural micronized progesterone. It can be used both vaginally and orally. Micronized progesterone is absolutely identical to its natural counterpart and practically does not give side effects from taking the drug. This is one of the important differences between the natural progesterone contained in Utrozhestan and the synthetic hormone. As a rule, the full course of treatment takes up to six months.
Synthetic gestagen contains the drug Pregnin.
Regarding combined oral contraceptives, then the main purpose of their appointment is to block the ovulation process and eliminate the possibility of fluctuations in the level of sex hormones. Most often, drugs belonging to this group are prescribed to women of reproductive age. Among such funds: Silest, Femoden, Marvelon, Mercilon.
Antiestrogens can lower the level of estrogen in the body. However, when taking drugs from this group, it is worth remembering the side effects that they cause. First of all, these are violations caused by low levels of estrogen. Among these: excessive sweating, hot flashes, a feeling of heat, itching of the genitals, increased work of the sebaceous glands, dry skin, etc. In addition, their long-term use can provoke endometrial cancer, polyposis, cataracts, thrombophlebitis. Antiestrogen drugs are Fariston, Tamoxifen, Clomiphene, Torimifen, etc.
It is known that estrogen antagonists are androgens. Therefore, it is also advisable to use them for the treatment of mastopathy. Most often, doctors prescribe the drug Danazol. Treatment should last at least three months. This group includes drugs – Parlodel, Mercazolil.
GnRH agonists are drugs such as: Zoladex, Buserelin and Diferelin. They can cause temporary menopause, which is reversible. This will save the woman’s body from hormonal fluctuations due to inhibition of ovarian function in combination with the caused hypogonadotropic amenorrhea, the symptoms of mastopathy will become reversible. The course of continuous treatment should last at least a month.
Homeopathic remedy Mastodinon deserves special attention. It is made on the basis of extracts of medicinal herbs – iris chilibuha, tiger lily and cyclamen. Its intake helps to reduce the level of prolactin, narrow the ducts of the mammary gland, and reduce the severity of proliferative processes. In addition, the blood supply and swelling of the chest decreases, and a reverse change in tissues occurs. The pain symptom is reduced.
Klamin is a herbal adaptogen. It allows you to increase the immune forces of the body, protect the liver from negative effects, acts as an antioxidant. Klamina also contains iodine, which, in the event of a deficiency of this microelement, completely covers the body’s need for it.
From phytopreparations, Fitolon can be distinguished – a remedy of plant origin, which is based on the lipid fraction of brown algae dissolved in alcohol. The drug has a resolving effect, stimulates the body’s immune forces and acts as an antioxidant.
Analgesic drugs used to relieve pain, which are quite pronounced. Such drugs can serve as drugs belonging to the group of NSAIDs.
Vitamin preparations also prescribed for the treatment of mastopathy. It can be Aevit, vitamin E, Decamevit, etc.
Sedatives, and, if necessary, antidepressants are selected depending on the severity of mental disorders. It can be: Azafen, Sibazon, Amizil, Amitriptyline, etc.
Diuretics help relieve swelling – Triampur, Aneroshpiron, Lasix.
With iodine deficiency, iodine-containing preparations are indicated, such as Iodomarin, Klamin, Potassium iodide, etc.
Women with mastopathy should pay special attention to their own diet. Compliance with the dietary scheme of nutrition is not only a preventive, but also a therapeutic measure for mastopathy. It is known that an increased content in the daily menu of fats, as well as meat products, leads to an increase in the level of estrogen in the blood. At the same time, the amount of androgens decreases. In addition, a woman’s diet should be enriched with vitamins and fiber as a source of coarse fiber. Fiber is a powerful anti-carcinogen, which has been proven by many studies, which means that it can favorably affect the course of the disease.
Proper nutrition will help achieve weight loss in overweight women. This will make it possible to get rid of body fat, and hence from the supply of excess estrogens.
Increasing physical activity, exercise therapy, the use of physiotherapy techniques – all these procedures are applicable only with the permission of the attending physician. It is possible to undergo mud therapy, laser therapy, magnetotherapy, electrophoresis and other auxiliary methods of treatment. Any applications that are applied to the chest area with mastopathy should be cold or slightly warmed up.
The passage of preventive examinations by a gynecologist and a mammologist, the implementation of instrumental methods of examination will prevent the development of the disease and preserve women’s health. In addition, the self-examination procedure is a significant measure for the prevention of mastopathy.