Mastopathy

Mastopathy
Mastopathy is a concept that combines a certain number of certain diseases of the mammary glands, which are characterized by the development of pathological changes in the gland tissue itself. At the same time, the ratio of the components of connective and epithelial tissues is also violated. The nosological classification of the World Health Organization characterizes mastopathy as a fibrocystic disease of the mammary glands.

The content of the article:
Classification of mastopathies
Causes of mastopathy
Symptoms of mastopathy
Diagnosis of mastopathy
Treatment of mastopathy
Prevention of mastopathy
Prognosis for mastopathy
Mastopathy
The chance of being affected by various mastopathies of any etiology in a female at a young age ranges somewhere in the range of forty percent, but increases significantly after forty years.

Mastopathy itself is a change in the gland tissue of a benign nature, which is dependent on nervous and humoral regulation. It can be argued that the main factors in the development of mastopathy are pathological processes that are closely related to disorders of nervous regulation (neuroses, stress, depression) and hormone balance disorders (including internal homeostasis).

Classification of mastopathies
The most common classification in clinical practice is mastopathy, where there are 3 forms: mastalgia (mastoplasia, mastodynia), as well as diffuse and localized fibroadenomatosis.

Mastalgia is characterized by the predominance of pronounced pain syndrome, which is the main indication for the appointment of special analgesic drugs to the patient.

Diffuse adenomatosis is a process of development of cysts and diffuse seals in glandular tissues. There are two types: fibrotic mastopathy (in this case, connective tissue seals are formed mainly in the breast tissues) and fibrocystic mastopathy. In the case of the latter, in the mammary gland, in addition to foci of fibrosis, cysts also appear (cavities that are filled with fluid).

In the case of localized fibroadenomatosis, pathological changes manifest themselves only in a very limited area of the breast (quadrant or segment) and do not spread throughout the parenchyma of the gland.

If a localized neoplasm is detected in the breast tissues, a biopsy should be performed to exclude the presence of a malignant tumor.

Causes of mastopathy
Unfortunately, there is no complete and detailed understanding of the causes and mechanisms of the development of mastopathy, but there is every reason to assert the fact that hormonal status plays a key role in the development of this pathology.

There is an assumption that the most significant pathogenetic cause of mastopathy is a deficiency of the hormone progesterone with an excess of the hormone estrogen. In this case, there is such a phenomenon as increased proliferation (reproduction) of cellular elements of connective tissue, as well as epithelial cells. In addition to this phenomenon, the production of prolactin by the body plays an essential role in the pathogenesis of mastopathy. Prolactinemia affects an increase in the sensitivity of breast tissue in relation to the hormone estrogen.

Symptoms of mastopathy
The most characteristic symptom of mastopathy is the detection of a compacted area in the breast tissues during palpation. Most often, this seal is slightly painful. Pain tends to increase in the second phase of the menstrual cycle, as well as immediately before menstruation itself. These seals can be either single or multiple. Several nodules can be detected, and the entire mammary gland can be palpated. Mastopathy is also characterized by the disease of both glands at once, most often their upper parts.

The excessive presence of a fibrous component manifests itself to the touch as a kind of compaction, and changes of a cystic nature in the tissues at the first stages of the disease may not be felt at all during palpation of the gland (microcysts of the ducts).

The pain in the mammary glands itself most often has a nagging, dull or even pulling character. The occurrence of pain is associated with compression of nerve endings by fibrous growths in the parenchyma of the mammary gland or even its partial sclerosis. The degree of intensity of the pain syndrome strongly depends on the severity of the pathology itself. Most often, the manifestation and intensification of pain is directly related to the menstruation cycle (before menstruation, the pain increases at the peak of the production of the hormone estrogen). Sometimes there is a phenomenon of irradiation of pain in the area of the shoulder blade or hands.

In some of the examined women, the pain of seals is not observed, although pathological changes of varying severity are detected during examination by a doctor. This phenomenon is associated with a distinctive threshold of pain sensitivity, as well as with an individual feature of the branching of the nervous system in the tissues of the mammary glands.

About 10% of mastopathies occur with an increase in lymph nodes in the armpits. Palpation of the lymph nodes is usually moderately painful.

An increase in the size of the mammary glands, their periodic coarsening (usually in the second period of the menstrual cycle) is a consequence of the presence of venous stagnation in the vessels of the mammary glands, including edema of connective tissue. In this case, the mammary glands can increase in size by more than 15%. At the same time, a feeling of discomfort and even soreness during palpation is characteristic (increased sensitivity of the entire breast). The combination of all these signs will be a premenstrual syndrome.

Sometimes there may be discharge from the nipples. They are of various nature, etiology and any degree of abundance. They can appear both when exposed to the nipple itself, and can be quite pronounced. According to its consistency, the discharge is usually whitish or completely transparent, but in some cases it can acquire a bloody, brown or greenish color. The greatest danger is the discharge of bloody color, for the reason that they can be the main sign of the development of malignant processes in the mammary glands. The appearance of absolutely any discharge from the nipples, of any nature, is an important reason for contacting a mammologist.

It is also extremely important to pay attention to the detection of one or more nodes. Palpation of a dense, limited in size, nodular formation can become both a sign of localized nodular mastopathy, and may turn out to be cancer. When suspicious nodes are found in breast tissues, a biopsy is always performed to exclude malignant tumors.

Diagnosis of mastopathy
The main, most significant and main way of timely detection of neoplasms and pathologies in the mammary glands is the method of self—examination (in other words, self-examination (palpation) of the mammary glands).

To detect formations, as well as to determine their size, shape, quantity; to find diffuse pathological changes in the parenchymal tissues of the breast, instrumental diagnostic methods are used.

Biocontrast mammography is a study of the mammary glands using X—rays. Mammography is best performed during the first phase of the menstrual cycle. Pictures of each breast are taken in front and side projection. This survey is one of the most specific and informative.

In addition to this method, ultrasound of the mammary glands is currently used. Fibrocystic pathologies of mammary gland tissues affect the echogenicity of their structures. For this reason, changes can be detected in time and studied sufficiently qualitatively, thanks to this technique.

MRI of the breast determines the zones of lowering and increasing the temperature of the breast tissue.

The method of diaphanoscopy consists in the lumen of the breast using a bright light source. When using this method, the neoplasm in the thickness of the gland will look like a darker-colored spot.

Using the method of ductography, a study of the system of the mammary ducts of the gland is carried out. At the same time, contrast is injected into the mammary gland through the nipple, after which radiography is done. In the picture you can see the system of the milky ducts. Areas in which the contrast agent is insufficiently expressed may be signs of formations and various pathologies.

Pneumocystography is performed under the control of ultrasound. With this method, air is pumped into the cavity of the cystic formation using a needle. This allows you to sufficiently straighten the walls and examine them well in order to detect wall neoplasms.

When a nodular formation is found, a breast biopsy is performed. In this method, a sample of gland tissue is extracted for histological examination using puncturing with a thin needle.

When determining the etiological factors of the development of mastopathy, methods of studying the hormonal status of the body are actively used.

Colposcopy methods and cytological examination of vaginal epithelial cells allow us to make an objective conclusion about the total and general hormonal background, since the shape, size and structure of vaginal cells are directly dependent on the influence of sex hormones. This method also directly determines the amount of hormones in the blood such as estrogen and progesterone, luteinizing, follicle-stimulating hormones, adrenal hormones, as well as thyroid hormones and thyroid-stimulating hormone.

Sometimes a study is conducted for the presence of autoantibodies to thyroid cells. This is necessary to identify a pathology such as autoimmune thyroiditis.

To find out the general hormonal state of the patient’s body, comprehensive studies of the organs of the endocrine system are carried out to identify their possible pathologies. These include: Ultrasound of the thyroid gland, liver, adrenal glands; CT of the pituitary gland, radiography of the Turkish saddle.

To exclude immune and metabolic pathologies, a biochemical blood test is performed and an immunogram is made.

Treatment of mastopathy
In the treatment of mastopathy, one of the most important roles is played by the correction of the balance of hormones in the body. When choosing treatment methods, it is necessary to consult specialists such as a gynecologist and an endocrinologist. Doctors jointly conduct a thorough analysis of the state of the endocrine system, prescribe medications that correspond to the identified pathologies of organs and systems, if necessary.

With a pronounced form of estrogenism, as well as with severe soreness, drugs (for example, tamoxifen, faresteron) can be prescribed that reduce the effect of these hormones on the mammary gland.

To normalize the menstrual cycle, oral contraceptives are used, which are selected depending on the hormonal status of the patient.

For the treatment of thyroid disorders, drugs that regulate the production of thyroid hormones are used.

Vitamin complexes improve liver function, as well as normalize metabolic processes in the body.

Among other methods, homeopathic remedies and preparations of the hormone progesterone of local action are used. They act directly on the breast tissue, which helps to reduce the proliferation of epithelial cells and connective tissue, relieving swelling.

Patients who suffer from mastopathy should significantly limit the use of beverages and drugs containing caffeine, as well as give up smoking. It is recommended to enrich the diet with vegetables, fruits and foods that contain a large amount of fiber and vitamins.

If there is a suspicion of malignant formations, the node is surgically removed. In other cases, treatment is limited to conservative methods.

Prevention of mastopathy
A large number of factors that contribute to the development of mastopathy complicates the development of a consistent and unified prevention scheme.

Nevertheless, it is easy to identify the most significant factors affecting the prevention of mastopathy: stressful situations (in case of stress, as a preventive measure, the use of soothing therapeutic drugs of biological origin — valerian root, motherwort), a positive way of thinking, a psychologically comfortable environment is recommended.

Balanced, low-calorie, proper nutrition (but without a passion for a variety of mono-diets and poor-quality methods of weight loss), as well as the prevention of obesity and excess weight, support the internal homeostasis of the body and the proper functioning of the regulatory neurohumoral system.

One of the main components of the diet, which negatively affects the hormonal background of patients, is caffeine. Women need to limit, and it is better to completely exclude foods containing caffeine from their diet, and also should not abuse strong coffee or tea on an empty stomach.

Women who use oral contraceptives should stop smoking. In particular, it will be useful to limit the use of alcoholic beverages.

A very significant factor for the preservation of the patient’s health is regular high-quality sex life and in general any prolonged physical activity of the body.

Prognosis for mastopathy
The most common cases of mastopathy do not entail complications and malignancy. The prognosis of the disease is positive, but only with proper management of the hormonal state. However, one should be wary of hormonal failures that can provoke relapses.

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