The author - Sozinova AV practicing obstetrician-gynecologist. Experience in the specialty for over 14 years. (2015).
Fibrocystic breast disease or fibroadenomatosis currently affects more than 50% of women. The disease is usually diagnosed in the fairer sex at the age of 30 to 50 years.
When fibrocystic breast disease in the mammary glands show multiple nodules and cysts or separate units / large size cysts. Fibroadenomatosis though it is considered a benign process, but needs to be treated as possible degeneration of lesions in breast cancer.
Kinds
Distinguish diffuse and nodular fibrocystic breast disease. Diffuse form of the disease, in turn, subdivided into:
- mastopathy, in which prevails a ferrous component (adenosis);
- mastopathy, wherein the fibrous component predominates (fibroadenoz);
- mastopathy, at which the cystic component predominates (Fibrocystic breast disease);
- mixed form;
- sclerosing adenosis.
nodular form includes:
- cysts;
- fibroadenoma;
- intraductal papilloma;
- lipogranulemy;
- lipoma;
- angioma (lesion of blood vessels);
From the viewpoint of localization fibrocystic mastopathy can be either two-way (affects both breasts), and one-sided.
According to the results of histological studies (review of the biological material under a microscope) is isolated proliferation (abnormal cells are actively dividing) and non-proliferative fibrocystic breast disease.
Diffuse mastopathy of clinical manifestations may be small, moderate, and severe forms.
Causes
The reasons lie fibroadenomatosis and external factors, and in the condition of the body. These include:
- precocious puberty (rapid hormonal changes reflected on the state of the mammary glands);
- late menopause (too long the impact of hormones on mammary glands);
- late pregnancy and childbirth (over 30 years);
- rejection of pregnancy and childbirth;
- short lactation period, or a complete rejection of it;
- abortion (more than two);
- prolonged and constant stress (problems at work, family life, etc.);
- age (over 40 years);
- liver disease;
- endocrine problems (diabetes, Overweight, thyroid pathology);
- chronic inflammatory diseases of appendages;
- other gynecological pathology (hysteromyoma, endometriosis);
- uncontrolled taking hormones for contraception;
- thoracic spine osteochondrosis;
- genetic predisposition;
- disturbed water exchange (inadequate fluid intake).
symptoms fibroadenomatosis
Leading feature in fibroadenomatosis is breast pain. Pain syndrome especially intensified during the premenstrual period, when there is a venous stasis and swollen mammary glands and nagrubayut.
The pain can be so intense that it is impossible to touch the breast, it is difficult even to wear a bra or dress. Arching pain, acute and can be given in the shoulder, under the shoulder blade, or in the armpit. After the onset of menstruation discomfort subside somewhat, becoming aching or pulling during the first phase of the menstrual cycle.
Along with these problems arise from the psycho-emotional sphere. Patients lose sleep, become irritable, aggressive or depressed, can easily cry.
Another symptom of fibrocystic mastopathy are discharge from the nipple. This characteristic is common to all patients, and serves as proof that in the pathological process involved the milk ducts. As a general rule, at the other end of the duct is a cyst. Spin can be transparent, whitish or greenish (accession secondary infection).
Important! In the case of brown nipple discharge or mixed with blood woman should be wary, as this feature inherent in oncological diseases.
Signs of diffuse forms of fibrocystic breast disease
For typical diffuse mastopathy uniform increase in mammary gland swelling and day before menstruation.
In this case, breast palpation to determine the precise boundaries of the seal with coarse lobate, tyazhistostyu and fine grit. Variably expressed pain syndrome, increased breast before menstruation returns to its original dimensions after closure.
Diffuse fibrocystic breast disease is diagnosed more often in young women.
Signs of nodular
Nodular or nodular form diffusely cystic mastitis - a next stage of the disease, which develops in the absence of treatment diffuse form.
In one or both breasts probed portion of the seal and / or cysts. Dense nodes retain lobulation do not have clear boundaries and reach a fairly large size (up to 5-6cm in diameter). Cysts are palpated as a rounded, smooth-surfaced and elastic texture formation.
In some cases (about 10%), an increase in the axillary lymph nodes.
With nodular form of the disease in the breast may be one node / cyst or more.
Diagnostics
Require differential diagnosis fibrocystic breast disease because its symptoms are similar to manifestations of fibroadenomas (benign tumor), breast cancer, premenstrual syndrome and hyperprolactinemia (In the case of discharge from the nipple).
In addition to diagnosing disease anamnesis, complaints, inspection and palpation of the mammary glands are also using additional methods of examination:
mammograms;
- X-ray method for studying breast, which is carried out for 6-7 days of the menstrual cycle. The picture is taken in direct and lateral projections, it reveals the micro- and makrokaltsinaty (cysts and fibrous components).
ultrasound of the breast;
- It held in the first phase of the cycle. It is effective in conjunction with mammography.
breast thermography;
- It helps to identify pockets of increased thermal activity. When fibrocystic mastopathy determined focal hyperthermia.
needle biopsy;
- using a thin needle punctured node or a cyst, and taken back material sent for histological examination which confirmed benign or malignant process.
magnetic resonance imaging;
- using this method it is possible to consider in detail the formation of pathological layers.
study of hormonal status;
- determined levels estrogenic hormones and progesterone the first and second stage of the menstrual cycle, prolactin, thyroid hormones.
blood chemistry;
- necessary to exclude diabetes and determine the causes of obesity and other pathologies.
Treatment of fibrocystic breast disease
Treatment of fibrocystic breast disease has been a doctor of mammalogy oncologist.
Therapy is chosen individually, depending on the form of the disease, clinical manifestations, age and other factors.
First of all, treatment should begin with diet. When mastitis should limit intake of tea, coffee, cocoa and chocolate, especially during the second phase of the menstrual cycle. Meals should be varied and include plenty of fresh vegetables and fruits (for the normalization of the gastrointestinal tract).
Shown reception:
- vitamins A, C, F, which reinforce the vessel wall, and reduce edema;
- Vitamin E is a natural antioxidant and affecting the fat and the hormonal exchanges;
- B vitamins that improve metabolism.
To remove breast edema (in diffuse form), and pain relief are assigned diuretic drugs (furosemide, veroshpiron) and nonsteroidal antiinflammatory drugs (ibuprofen, indomethacin).
For the purpose of normalization of mental state of the patient being prescribed sedatives (pion tincture, valerian, motherwort).
Correction is carried chronic diseases also illustrates reception of drugs iodine (iodide). In severe disease recurrence used drugs that block the secretion prolactin (Bromocriptine), and homeopathic medicines ( "Mastodinon").
Treatment with hormones fibroadenomatosis
Hormone therapy depends on the patient's age.
Women of reproductive age are selected oral hormonal contraceptives. Also effective progestins, which are assigned to the second phase of the menstrual cycle (utrozhestan, djufaston).
Premenopausal women recommend androgens (methyltestosterone, testobromletsid), antiestrogens (tamoxifen), danazol.
Operation at fibroadenomatosis
In the case of nodular mastitis deals with the surgical intervention. Surgical treatment is necessary:
- when large amounts of the pathological education;
- during its rapid growth (over three months);
- suspected degeneration of a malignant tumor;
- in the presence of complications (abscess).
Nodes partially excised together with normal breast tissue, such operation is called a sector resection. When it is detected punktirujut cysts, cystic fluid was removed, and the cavity is administered sclerosing agents.
Perhaps husking cysts followed by suturing the breast.
In the course of the operation carried out urgent histological examination of the excised material, and, if prepared results confirming the cancer, the amount of surgery extends up to the removal of the entire breast gland.
Consequences and outlook
Fibrocystic mastopathy is dangerous because it is able to regenerate in breast cancer. When the presence of cysts in the breast it is possible to inflammation and suppuration.
Disease prognosis depends mastopathy, adequacy and timeliness of treatment, age of patient and other factors.
With timely correct treatment the prognosis of fibrocystic breast disease is favorable.
