Mammary gland tissues regularly undergo natural changes, which are caused by the specific functioning of the female reproductive system (thelarche, pregnancy, menarche, menopause, lactation). However, some structural modifications that occur in fibrous (fibrous) and glandular breast tissues can be pathological and cause diffuse changes in the mammary glands. Experts say that such violations are typical for 45% of women in the reproductive period.
Causes of this pathology
Diffuse changes in the mammary glands affect:
- Parenchyma - the main functional glandular-epithelial breast tissue with fibrillar fibers of the milk ducts and alveoli.
- Strom - fibrous connective tissue that surrounds the ducts and divides the lobules.
- Adipose tissue protecting the parenchyma.
With an increase in the number of tissuebreast cells or their reduction, as well as with dysplasia (developmental disorder), we can only talk about hormonal origin. The causes of diffuse changes in the mammary glands may be due to:
- Pathologies of the thyroid gland (it produces the synthesis of the hormones triiodothyronine and thyroxine that regulate the material metabolism).
- A chronic inflammatory process (adnexitis) or an ovarian cyst that produces the female hormone estrogen.
- Diseases of the adrenal glands (their cortex synthesizes glucocorticoids).
- An insufficiency of the pituitary gland (it is responsible for the production of prolactin and luteotropic hormone).
- Obesity. It leads to an increase in estrogen levels. What it is will be discussed below.
- Diseases of the pancreas that interfere with insulin production.
These are the main causes of burning in the mammary glands.
Of no small importance in the appearance of diffuse changes, experts attribute to such reasons as menstrual irregularities, first pregnancy over the age of 35, repeated abortions, lack of postpartum lactation, late menopause, hereditary predisposition. It should be noted that the pathogenesis of the factors listed above is in any case associated with hormonal disorders.
It should also be noted that diffuse changes in the mammary glands occur in he althy women. For example, thanks to estrogen, the development of the stroma, the deposition of fat cells and the growth of ducts are ensured. Progesterone, with estrogen balance, allows glandular tissue to grow andlobular structures, promotes clearance and alveolar secretory changes. In women of reproductive age during the cycle of menstruation (at the end of the luteal phase), part of the epithelial cells of the alveoli and ducts of the mammary glands under the influence of progesterone undergoes replication and further apoptosis (physiological natural death). However, increased levels of estrogen in women and a lack of progesterone can disrupt this process and cause a diffuse fibrotic change.
During pregnancy, placental lactogen, human chorionic gonadotropin and prolactin stimulate the process of milk secretion and lactation after childbirth. If a hormonal imbalance appears, the natural processes in the female breast tissues are disrupted. As doctors note, most often there is a pathological proliferation of certain cells, they replace others. Such tissue structural changes in mammology are defined as dyshormonal diffuse changes in the mammary glands.
About estrogens
This is the collective name of one of the groups of female sex hormones. They are produced in the ovaries in women, in small amounts in the testicles in men, and in the liver and adrenal cortex (both men and women). Sex hormones, in general, provide reproductive function.
Sex hormones are always present in a woman's body. Their level and ratio depends on the period of her life. The main female hormones are estrogens. In the fetus, they are responsible for the formationgenitals of the female type, in childhood - support the growth of the genital organs. During adolescence, the amount of estrogen in the body increases. Due to their influence, secondary sexual characteristics are formed.
Estrogen levels are highest in women of reproductive age. At this time, her body undergoes periodic cyclical changes (menstrual cycle).
Symptoms of breast changes
The very first symptoms of such changes can manifest as increased discomfort in the chest, its hypersensitivity before the onset and during critical days. Many women do not pay attention to this, because after the completion of the next menarche, all unpleasant signs disappear.
However, a consultation with a mammologist will not be superfluous.
Doctors call the most characteristic signs of diffuse changes:
- Tension and heaviness in the mammary glands, which is often accompanied by swelling.
- Burning of the mammary gland, itching in the area of the nipples, their increased sensitivity.
- Small, moving lumps in the texture of the breast tissue, which may be more felt during menstruation.
- Nagging pains of various strengths (intense pains can radiate to the area of the shoulder blades, shoulder or armpit).
- Soreness in the breast area.
- Discharge of clear color from nipples when squeezed.
Many do not feel any of the symptoms listed above, and a lump in the chest is accidentally detected, as the manifestations of symptoms are diffusechanges in the mammary glands are predominantly periodic and are due to the menstrual cycle.
Possible Complications
There may be complications such as the formation of benign tumors of different sizes. The most dangerous complication is the malignancy of these tumors.
Although this pathology is benign in nature, in the presence of cancer of the reproductive system (mammary glands, ovaries, uterus) in blood relatives, serious consequences are not excluded that require medical intervention. In general, with diffuse changes in the mammary gland, the prognosis is positive. However, it is necessary to take into account the possibility of the appearance of a malignant tumor that occurs against the background of such a pathology much more often than when it is absent.
Classification of forms of diffuse mastopathy
According to the clinical-radio-morphological tissue changes in the mammary glands, diffuse mastopathy is classified as follows:
- Adenosis is a diffuse pathology with a predominance of the glandular component.
- Diffuse mastopathy, in which the cystic component predominates.
- Fibroadenomatosis - diffuse mastopathy, in which the fibrous component predominates.
- Sclerosing type of adenosis.
- Fibrocystic mixed form of mastopathy.
When determining one or another clinical variant, they proceed from the proportion of fatty, glandular and connective tissue elements on mammograms.
Separate according to the degree of changes presentslightly pronounced, pronounced and moderate diffuse mastopathy.
Diagnosis of diffuse changes in the mammary glands
Diffuse mastopathy is diagnosed based on the results of a breast examination by a mammologist, mammography, ultrasound, laboratory tests, biopsy and MRI of the mammary glands.
With diffuse mastopathy, external changes in the mammary glands are not determined. During palpation examination of the breast, different in size and length, painful, without clear boundaries of compaction with a lobed or granular surface are established. In diffuse mastopathy, seals are most often located in the upper outer quadrants of the glands.
The standard echographic picture, determined by ultrasound in diffuse changes in the mammary glands, is characterized by thickening of the gland tissue, fibrotic changes in the interlobular septa and ducts, changes in glandular echo density, multiple cyst formation, inconsistency of the glandular type of structure with age, ductectasia.
Mammography (plain radiography) with diffuse mastopathy finds tissue heterogeneity of the glands with small foci of compaction, dense structure or cystic formations.
Thanks to mammography, it is possible to exclude the presence of tumors in the gland and determine the type of mastopathy.
If there is discharge from the nipples against the background of diffuse mastopathy, this may indicate the need for ductography, which usually determines the deformation of the milk ducts and cysts of various sizes. The study of a smear obtained from the nipple makes it possible to differentiate diffuse mastopathy from other lesions - syphilis, actinomycosis, tuberculosis of the mammary glands.
With concomitant genital and extragenital background, an analysis of sex hormones and thyroid hormones, liver enzymes, consultation of an endocrinologist-gynecologist, ultrasound of the small pelvis are prescribed.
If the data of the previous diagnosis is doubtful, then a biopsy of the breast is performed, a cytological analysis of the biopsy, MRI, determination of the marker CA 15 - 3 in the blood.
Treatment of pathology
To prescribe a course of therapy, a consultation with a mammologist is required.
With diffuse mastopathy, conservative treatment and dynamic monitoring are prescribed. It is advised to change the diet, include more dairy products and vegetable fiber, limit animal fats. If the patient has intestinal dysbacteriosis, which disrupts the absorption of trace elements and vitamins, treatment by a gastroenterologist is required. Vitamin complexes, potassium iodide, homeopathy, dietary supplements, adaptogens, herbal remedies are prescribed. From non-hormonal therapy, drugs of the enzymatic, sedative and diuretic type can be prescribed.
With diffuse mastopathy, it is recommended to increase physical activity, connect psychotherapy and exercise therapy. Among physiotherapeutic procedures, the use of electrophoresis, laser therapy, galvanization, magnetotherapy, balneotherapy (mud therapy, climatotherapy, clay therapy, sea and mineral healingbath).
In diffuse mastopathy, hormone-regulating therapy is aimed at eliminating hormonal defects and may include prescribing gestagens (dydrogesterone, progesterone, etc.), thyroid hormones, and the correct selection of contraceptive methods to the patient. All these remedies will help to equalize the level of estrogen. What is it, now it is clear.
To reduce the feeling of tension and soreness in the mammary glands, a gel containing progesterone is applied topically.
When is surgery required?
If drug treatment of diffuse changes in the mammary glands for six months did not give an effect, then they resort to surgical intervention - the seals are removed. During the operation, the following techniques can be used:
- Resection. Under it, excision of the inflamed area is supposed. The resulting tissues are then sent for histological analysis to rule out breast cancer.
- Sclerosis. It is used for the cystic form of diffuse changes. This method is understood as the introduction of a sclerosing substance, leading to the overgrowth of its defects in the mammary gland.
- Surgical (operative) therapy of multiple formations is not carried out: it is possible to remove or excise breast tissue through nucleation only when diagnosing oncology. If there are diffuse changes, then monitoring of the state of the glands and conservative treatment are prescribed. The patient is registered with a mammologist. She undergoes examinations every six months.
Folk Therapy
Among the folk methods used in the treatment of pathological diffuse fibrous changes in the mammary gland, external agents and herbal therapy in the form of decoctions that are taken orally can be distinguished.
The first category includes compresses from infusions of a number of medicinal plants: red clover, sweet clover, St. John's wort, cuff and wormwood. And although the first two plants contain phytoestrogens, it is not entirely clear how they work in the form of compresses.
In addition, popular treatment has become popular with the help of compresses from cabbage leaves, grated raw beets, propolis with lard, aloe with honey (compresses are usually applied at night on the chest).
Herbal treatment contains recommendations for taking a soothing infusion of valerian (for 200 milliliters of boiling water, five grams of roots), a decoction of a mixture of equal amounts of peppermint and motherwort (a tablespoon of the mixture per glass of water), a decoction of cumin and fennel seeds (an equal amount ingredients are mixed, take 1 tbsp per glass of water) - twice a day, 100 milliliters. Fennel is most often used for flatulence and bloating, and its use in diffuse breast pathology can be explained by the presence of essential oils in the fruits of the plant, which consist of unsaturated fatty acids, including oleic and linoleic. Cumin fruit, related to fennel, is used to improve digestion. They are also rich in terpene compounds, phenol carboxylic acids and oils.
How dangerous is breast disease?
Can diffuse changes mastopathy cause cancerchest? This question is of great concern to women who are faced with a similar problem. Mastopathy itself does not cause malignant transformation and is not considered a precancerous condition. However, the factors that provoke the appearance of this disease are common with oncological pathologies. There is a certain similarity of these diseases in morphology. There are statistics that show a combination of benign formations with malignant tumors in half of all cases, but the probability of transforming an extraproliferative form of mastopathy into cancer is less than one percent.
But diffuse mastopathy can develop into nodular, which is essentially the next stage. With this type, the formation of nodes occurs constantly. It does not depend on the female menstrual cycle. That is why women with diagnosed diffuse mastopathy should be examined by a mammologist every six months. You need to regularly check the level of female hormones estrogen.
Prevention and advice for diffuse mastopathy
The key to effective prevention and timely diagnosis of diffuse mastopathy is the periodic examination of a mammologist with a number of instrumental studies. It is necessary to treat gynecological diseases and their accompanying genital pathologies in time.
An important role belongs to the regular examination by the woman herself of the condition of her mammary glands. Particular attention should be paid to the appearance of seals andsoreness, spots on the skin of the chest, changes in the shape of the mammary glands, discharge from the nipples. It is advisable to choose the right bra so that it does not squeeze the chest, protect the mammary glands from shock, pressure, and injury. During breastfeeding, the appearance of nipple cracks, mastitis, lactostasis should not be allowed. To prevent mastopathy, modern contraceptive methods should be used and abortions should not be allowed.
If there is diffuse mastopathy, this is a contraindication for mammoplasty, the use of local wraps and hot compresses on the chest, visiting baths and saunas, tanning in the sun and in a solarium.
