The author - Sozinova AV practicing obstetrician-gynecologist. Experience in the specialty for over 14 years. (2015).
When the pathological process involves one or both breasts to produce them in knots and knots, talking about a nodal mastopathy.
disease of the breast It is the result of disorders of hormonal balance and refers to the benign processes. As a rule, the disease is diagnosed in women 35-45 years old.
Kinds
This pathology can be diagnosed in one or in both breasts, respectively, and emit a unilateral duplex nodal mastopathy.
Depending on how the active processes occur proliferation (proliferation) in a pathologically altered locus breast, distinguish simple and proliferative mastopathy. Nodular proliferative breast disease prognostically less favorable.
According to the histological structure (widening of a certain type of tissue) are distinguished:
- fibroadenoma;
- intraduct papilloma;
- lipoma;
- angiomu;
- and other types of tumors.
Causes
The basis of the mechanism of the nodal mastopathy is an imbalance between the
estrogen and progesteroneThat are produced during certain phases of the menstrual cycle.The factors causing this form of mastitis include:
- abortionAnd especially - the frequent use of this method;
- lack of parity;
- chronic gynecological disease;
- endocrine pathology (thyroid disorders, overweight, diabetes);
- breast injuries;
- hyperprolactinemia;
- alcoholism;
- smoking;
- constant stress;
- destruction of the environment;
- liver pathology;
- abandonment of lactation.
Symptoms of mastitis nodal
Patognomichnym (key) node feature is the presence of mastitis in the mammary gland of one or more nodes. Similar formations woman may discover during the of self.
Dimensions of nodes may be different from the seal to the size of a pea walnut and more. They are not soldered to the skin and surrounding tissues, or have a bumpy surface lobed virtually painless in the first phase of the menstrual cycle. Pain syndrome usually characteristic for the second phase of the cycle, when the breast tissue is swollen. Due to the swelling increases in size and assembly. This pain is called mammalgia or mastalgia. After the onset of menstruation pain diminishes or disappears altogether, may be given in the scapula or shoulder.
Also nodal mastopathy characteristic of such sign as negative symptom Koenig: palpation mammary nodes are defined in a standing position, but they are not defined in a horizontal position.
Diagnostics
Differential diagnosis of nodular mastopathy is necessary to distinguish it from malignant breast tumors.
When the diagnosis of the important role played by careful history taking, inspection and palpation of the breast.
Of additional research methods used:
mammograms;
- This X-ray examination of mammary glands, which are found during blackout areas (components), are defined by their size and location.
Breast ultrasound;
- helps identify nodules, their location and size.
ductography;
- method is based on the introduction of the milk ducts radiopaque substance, followed by X-ray examination. Ductography to determine the presence of tumors in the mammary ducts (indicated for secretions from the nipple).
Aspiration biopsy;
- produced fine needle fence tissues from pathological focus, and then conducted histological examination of the resulting material.
Treatment of nodular mastopathy
Treatment of mastitis nodal prescribed and conducted by physician-mammolog.
In this disease the way to solve the problem only one - surgical. Depending on the received histology results, decide on the amount of surgery. When simple nodal mastitis usually carried sectoral resection, i.e. removal assembly with a portion of breast tissue. Operation can be performed under local anesthesia and under general. For suspected malignancy, rapid growth or formation of the presence of multiple nodes mammary gland was removed completely.
Before the surgery, the woman is assigned to drug therapy for the correction of hormonal status, sedatives drugs, and in case of pain - nonsteroidal anti-inflammatory drugs (ibuprofen, indomethacin).
Consequences and outlook
Nodular breast disease may recur if:
- saved etiological factors;
- conducted an inadequate hormone therapy;
- the volume of transactions was insufficient.
In addition, there is a certain risk of degeneration disease in breast cancer.
Prognosis is generally favorable.
