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Primary consultation with a mammologist

2 000

Repeated consultation with a mammologist

1 500

Consultation with a mammologist + ultrasound of the mammary glands

3 000

Consultation on ultrasound results

1 500

What should a woman be wary of during self-examination of the mammary glands:

• swelling of the mammary gland;
• clear or bloody discharge from the nipples;
• change in the shape of the gland and nipple;
• redness on the chest;
• the presence of noticeable compactions in the structure of the mammary gland;
• chest pain;
• spots on the skin of the chest or red skin;
• sudden cessation of lactation.

When is it too early to panic?

Lumps in the mammary gland are most often discovered during self-examination. Often the cause of anxiety, panic and urgent consultation with a mammologist is ignorance of the anatomy of the female breast. The mammary gland consists of adipose and glandular tissue, the latter has a heterogeneous structure: the so-called. large and small slices. Very often, women mistake dense lumps in the breast structure for neoplasms. Asymmetrical breasts are often a cause of unreasonable anxiety: in most women, the left breast is slightly larger than the right, but this difference is not critical (only a few millimeters). However, if the difference between the left and right breasts is significant and has become noticeable in a short time, or the breast hurts and discharge from the nipple is constant, then this is a reason to consult a mammologist.

How to examine female breasts on an outpatient basis

If any of the above problems with breast health are detected, you should visit a gynecologist as soon as possible, get an examination and ultrasound examination of the mammary glands. If the doctor discovers a tumor in the mammary gland during palpation, he refers the patient to a specialist or explains where to get a consultation with an oncologist-mammologist. After an extensive consultation with a mammologist, tests, diagnostics and mammography are prescribed. Mammography is a non-invasive examination of the mammary glands using X-rays, MRI or ultrasound. Breast ultrasound is the most common and safest method of examination, especially if a woman is pregnant.

Prices

I fed the child for a year and a half and suddenly stopped and I noticed some lumps in one breast. I decided to do an ultrasound of the mammary glands and went to Dr. Elena Ivanovna Volodina. A real doctor, there are few of them these days, she checked everything and said that there was nothing wrong. Thank you and God bless you! In general, I’m happy with the Eterna clinic, the prices are reasonable - health is more expensive!

Marina 18.02.2019

Recently I have had to see a mammologist about my breast problems, I want to say that I really like the service from the administration to the doctor. I don’t know how long this idyll will last, but so far everything is at a decent level, and the prices are reasonable and justified. We'll wait and see what happens next, but for now, come to you))

Linda 19.12.2017

I was examined by a mammologist, had a mammogram, and was happy with everything, because I saw participation and literacy. There was once a confusion with the schedule due to the administrator’s fault, but they met me and offered me a free consultation. The atmosphere is good and conducive to calm.

Ruslana 09.07.2017

I liked that the gynecologist does not charge prices out of the blue for services, they are all indicated and agreed upon in advance, they do not oblige me to buy medications from them, they do not impose additional services, and they all explain in detail what is happening with my health and how they are going to solve this problem . I respect clarity and transparency.

Miroslava 23.06.2016

They monitor the condition of the mammary gland and hormones, I like the approach of the specialists from Eterna, they are very competent and attentive) I feel calm, I have respect for the doctor’s opinion and his experience. There are delays when you need to wait, but it doesn’t last long, but if necessary, they also give me a little more time.

Valentina 17.02.2016

How pleasant it is to communicate with a competent gynecologist, especially when nothing bothers you, and if it bothers you, it’s in vain, and it’s all the more pleasant to follow the doctor’s recommendations and take care of your women’s health, about which, sometimes, you can read such nonsense, fortunately even a gynecologist your brain will be straightened out and your life will be easier. Thank you.

Ruslana 12.09.2014

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Elena Maysenya
Oncologist-mammologist of the medical center "LODE", candidate of medical sciences, associate professor

About breast health monitoring

— First of all, I advise all my patients to conduct an independent breast examination once a month on days 5-9 of the cycle (from the beginning of menstruation), which I always do myself. I think many women know how to do this, but just in case, I’ll remind you of the sequence:

• examination of the skin, nipples, mammary glands with arms lowered and raised;
• palpation of the mammary glands and axillary areas in a standing and lying position;
• squeezing the nipple between the thumb and forefinger.

If you notice any suspicious signs, you should consult a doctor, especially if you notice:

• changes in the skin of the mammary glands (swelling, retraction, redness);
• lumps, formations in the mammary gland or axillary area;
• thickening, nipple retraction, nipple discharge.

Since I myself am a qualified specialist, I don’t go to a mammologist, but I advise every woman to do so. Don't miss consultations and examinations and, of course, contact your doctor if you have any questions. In addition, once a year you need to do an ultrasound of the mammary glands, and at the age of 50, a mammogram. Only thanks to these examinations can we say with certain accuracy that you have no suspicion of serious illness. Many problems are not even felt; only a professional can identify them.

About hygiene

— Breasts are just a part of the body that requires normal hygiene. However, special care rules should be followed when breastfeeding. During lactation, it is enough to wash your breasts twice a day. The practice of washing with soap before each feeding is gradually being abandoned, since frequent procedures disrupt the water-fat balance of the skin, that is, dry it. As a result, the skin of your nipples may become cracked. During the feeding period, you can use special creams.

If there is something wrong with the skin of your breasts, you should not buy all the lotions that are in the pharmacy. Contact a specialist, he will rule out the possibility of illness and advise which remedy is best for you.

About choosing a bra

— The main function of a bra is to support the breasts. At the same time, it should not squeeze, cause discomfort, or interfere with blood circulation and lymph outflow. I try to choose natural fabrics. If the straps and belt of your bra rub, leaving red marks and dents, my advice to you is that, despite the fact that the purchase looks very beautiful on your body, do not mock yourself, throw it away without unnecessary regrets.

In reality, we don't really need a bra that much. This is especially true for women with small breasts. For hundreds of years, ladies somehow managed without this element of their wardrobe and, I think, felt quite comfortable. Over time, traditions and fashion pulled us first into corsets, then into foam rubber.

Why is this happening? Some wear a bra to support their breasts, some are afraid of their sagging, some are worried about their small size, in some cases the dress code dictates the rules. And yet, a woman must make her choice herself. Listen to your body and mood.

— There are studies according to which women who wore a bra 24 hours a day suffered breast cancer several times more often than those who wore it for less than 12 hours. At the very least, you definitely shouldn't sleep in it.

About dietary supplements and vitamins

— People sometimes ask me whether it is necessary to purposefully take some vitamins for the breast. There is no need to do this on purpose. But as a preventive measure for health problems, in winter, in principle, I drink a complex of vitamins and microelements.

Today dietary supplements have become very popular. These are concentrates of natural or natural-identical biologically active substances intended for direct administration and/or introduction into food products. In the treatment of mastopathy (dishormonal disease of the mammary glands), herbal medicine and dietary supplements are widely used, but only those certified and sold through the pharmacy chain. Don't buy something at random. Approach everything thoughtfully.

About the dangers of solarium

— I’ve never gone to a solarium myself and don’t plan to. From spring to autumn, both in Belarus and especially on vacation outside of it, I use sunscreen SPF 30-50.

Tanning is a response, a protective reaction of the skin to exposure to sunlight, resulting in hyperpigmentation, photoaging, and an increased risk of melanoma.

About exercise

— The mammary glands do not have their own muscles. Physical exercises can only strengthen the pectoral muscles, on which the mammary glands are located. I would recommend swimming and light gymnastics. Be sure to monitor your spine health. Correct posture primarily affects the beauty of the breasts.

About myths

— Is it possible to enlarge breasts thanks to nutrition? It is possible if you gain 10-15 kilograms. I don't think cabbage or other foods will make your bust a couple sizes bigger, no matter how much you eat them. Regarding foods that are harmful to breast health, I agree with the statement of the famous physician and philosopher Paracelsus: “The difference between poison and medicine is in the dose.” I don’t forbid myself anything, but I don’t abuse it either.

They also say that massage can affect the shape and even size of the bust. In fact, it can even be harmful if there are any formations in the mammary glands. Therefore, a preventive examination is first necessary. After this, theoretically, a light breast massage, which increases blood flow and lymphatic drainage, will not harm. But don't expect amazing results.

About breast surgery

— I have two minds about this issue. There are times when it is necessary. After surgical interventions (for example, mastectomy), plastic surgery is both physical and psychological rehabilitation of a woman. In some cases, for example, with gigantomastia, reduction mammoplasty is indicated - that is, reducing the size of the breast. Of course, much more often women go to clinics to perform breast enlargement operations, but it is worth remembering that an implant is a foreign body and the complications of implantation are quite varied.

In any case, the woman should choose. But the operation must be approached consciously, to understand whether this is the only option, to weigh all the pros and cons.

About nipple piercing

— This fashion trend worries me. I don’t want to scare anyone, but I will still list the possible negative aspects of such a decision:

• the procedure is invasive, that is, associated with penetration through the natural external barriers of the body - skin, mucous membranes - therefore, infection with HIV and viral hepatitis is possible;
• an allergic reaction to metal may also occur;
• damage to the milk ducts or infection is possible;
• problems may arise when feeding;
• Often the decoration gets caught on the linen, which sometimes even leads to injury.

About permitted caresses

“Patients ask me questions on this topic as well. There are no specific restrictions, but still the female breast is a delicate organ, it was created by nature for feeding offspring and the attitude towards it should be appropriate. I do not recommend using anything that causes obvious discomfort, much less injures the breasts! The consequences can be dire.

Love yourself, follow simple rules, contact specialists. A problem noticed in time is a big advantage that could one day save your life.

It is used as a primary method for examining the mammary glands during preventive examinations by a mammologist and gynecologist in order to identify external and palpable signs of disease. Indications for its implementation, as well as palpation, may be:

• preventive examination;
• complaints of chest pain;
• the presence of compactions, retractions in the gland;
• change in the color of the skin of the glands;
• local increase in skin temperature;
• discharge of fluid from the nipple;
• the appearance of a pathological formation near the gland;
• enlargement of mammary glands in males

HOW IS THE INSPECTION PERFORMED?

To examine the mammary glands, the gynecologist and mammologist use various body positions: standing, with arms down; standing, with hands thrown back behind head; lying on your back, with your arms down or with your arms thrown back behind your head. At the same time, a comparative examination of the mammary glands is carried out in various positions, the color of the skin, the size and shape of the areola and the degree of expression of the nipple, the presence of hair growth, formations on the surface of the skin, retractions, the presence of the “lemon peel” symptom, the condition of the armpits, supra- and subclavian pits. In men, if an enlarged mammary gland is detected, one should think about gynecomastia

PALPATION OF THE BREAST

Palpation is carried out first with the patient sitting or standing, while both mammary glands are palpated separately and compared simultaneously with both hands. Then the mammary gland is palpated in the supine position. The mobility and connection of the neoplasm with surrounding tissues can best be determined using light rotational movements of two or three fingers. Further examination involves palpation of the armpit. To do this, the doctor stands in front of the patient and takes her by the hand. Using the fingertips of the second hand, she feels the armpit, and at this time the patient relaxes her hand as much as possible. If lymph nodes are present, the latter are found in the gap between the pectoralis major muscle and the latissimus dorsi muscle. Then, with two fingers, the supraclavicular, subclavian, parasternal and other lymph nodes are identified

If the patient complains of pain in the mammary gland, you should find out whether there is a relationship between its occurrence and the onset of menstruation. Pain in the mammary gland that occurs or intensifies during menstruation usually indicates mastopathy. Malignant tumors are often asymptomatic. The appearance of pain and at the same time lumps in the mammary gland should alert you. The cause of their occurrence may be a malignant tumor.

All formations found in the thickness of the gland, in order to clarify the disease, require the use of special diagnostic methods: ultrasound of the mammary gland, mammography, cytological examination of discharge from the gland, puncture biopsy.

Our breast oncologist, based on examination, palpation, ultrasound of the mammary gland, histological, cytological examination, medical history, and the patient’s detailed story about complaints and sensations, will make a diagnosis and prescribe a treatment regimen. Our specialist can also advise a woman on breastfeeding issues.

According to obstetricians and gynecologists from around the world, the incidence of breast diseases is increasing. Some of the reasons are the lack of serious attitude towards self-examination of the breast at home and late referral to specialists.

To protect yourself from cancer or other breast pathologies, you need to know how to palpate yourself and when to contact a mammologist.

Self-examination at home

Breast examination should be perceived as an ongoing hygienic procedure. Conduct in a calm state on days 5-12 of the menstrual cycle.

The first stage of the examination should be done in front of a mirror. Pay attention to:

• shape of the mammary glands;
• their symmetry;
• are they on the same line?

Next you need to make slow bends to the right and left, forward and backward, raise and lower your arms. At this time, observe the movement of the chest, whether there is a difference between them, whether any of them are fixed or other changes.

You need to palpate with three guns, keeping your fingers together. Make a spiral movement from the edge to the nipple. So in a circle examine the entire mammary gland. You need to pay attention to the elasticity of the skin of the breast. Are there folds, seals, tubercles, dimples?

Look at the color of the skin; redness may be noticeable in some area. Examine the nipple and areola separately to see if there are any cracks or lumps there. Gently squeeze the nipple with two fingers to see if there is any discharge. This can be checked when removing it to see if there are any stains on it.

The final stage is palpation, lying on a hard surface. You need to place the hand behind your head on the side of which you are examining the chest. With your other hand, make the same circular movements as in front of the mirror. In this position, the entire structure of the mammary gland can be clearly felt. Research after some time is to determine if there is a difference between the previous result.

Signs of healthy breasts

To distinguish between pathological formations, you need to know which mammary gland is normal. It should not cause pain. Not counting the unpleasant sensations before and during menstruation. Then there may be slight pain in the breast itself and in the nipple area, increased sensitivity.

It is worth remembering the structure of the breast: about 15 lobules, which are separated by fatty tissue and septa. The lobule itself consists of glandular tissue. Therefore, this particular relief can be felt.

In general, the breast should be free of lumps, elastic, with a healthy skin color, and without nipple discharge.

Examination by a doctor

When standing, the patient places both hands behind her head. The mammologist begins to examine with the pads of his fingers from the upper outer quadrant of the breast and moves towards the nipple in a spiral, and so on in a circle, clockwise. If there is a suspicion of some pathology, then they start with a healthy mammary gland.

This is how superficial palpation is carried out, and then they proceed to deep palpation. After this, the patient is placed on his back and on his side, repeating all stages of the study. The doctor also looks at the presence of discharge from the nipple. Inspecting the inner surface of the bra, and presses on the nipple.

Then the mammologist palpates the axillary and subclavian lymph nodes to check their mobility, size, and tenderness. The woman is asked to relax and place her hands on her waist or on the doctor’s shoulders. When examining the supraclavicular lymph nodes, the specialist stands behind the patient. She is asked to slightly tilt her head in the direction where palpation is being performed. This is done in order to relax the muscles, and there was access to deep research.

At this point the palpation ends, the woman gets dressed. After this, the doctor explains about the patient’s condition. Suggests further examination by other means or prescribes treatment.

What it shows

During examination, a mammologist may suspect some pathological processes or formations. In addition to obvious palpation of the seal, there are several signs that may indicate this:

1. Symptom of lemon peel - the skin in some places of the mammary gland looks like the surface of a citrus fruit. This happens due to the clear appearance of pores against the background of swelling of the organ.
2. The symptom of the site is the formation of a flat tension surface in the area of ​​tumor formation. As a result, the normal contour of the mammary gland is disrupted. The reason is the tightening of tissue under the skin towards the tumor itself.
3. A symptom of umbilification is the retraction of the skin itself in the area of ​​pathological formation.
4. Enlarged lymph nodes indicate the development of a tumor in the mammary gland or an inflammatory process. Because the lymphatic system reacts sharply to diseases of the body as a whole. The lymph nodes that are closest to the affected organ are the first to suffer.

The criteria by which a mammologist should describe the formation after palpation:

1. Approximate size in centimeters.
2. Shape: round or oblong. Formed, clear edges or not.
3. Location relative to the areola and four quadrants of the breast.
4. Consistency – how dense or soft the tumor is, mobile or not.
5. Are there any painful sensations, how strong, are they associated with direct touching the mammary gland, is there a connection with the onset of menstruation.
6. Has the pathological process spread to nearby tissues?
7. The presence of swelling, redness of the skin, local increase in temperature, retraction, and the formation of a lemon crust.

Separately, it is worth highlighting the signs of a malignant tumor, which has long arisen and is developing progressively:

1. Changes in the skin of the breast due to an ulcer. This indicates tumor growth into the skin.
2. Breast enlargement, swelling. Occurs due to impaired lymphatic drainage in the mammary gland and inflammation of the axillary lymph nodes.
3. Reddish color of the skin of the entire chest. This suggests that the pathological process has spread throughout the entire organ.

Benign tumors include:

1. Cysts – have a fibrocystic structure, are mobile, soft and round in shape. As a rule, they increase during menstruation and decrease after it. Once women reach menopause, they regress. Since such cysts are hormone-dependent formations. They do not cause any complications on the body: no fever, no pain, no inflammation.
2. Fibroadenoma is an elastic, mobile, clearly limited formation. They can be either round or oblong. Occurs after 20 and before menopause.

Inflammatory processes can also develop in the mammary gland. They are divided into local and diffuse. The first are manifested by an acute formed breast abscess, swelling, and pain. Diffuse ones include inflammatory carcinoma and mastitis. Characterized by general weakness and malaise, fever.

An important diagnostic criterion is nipple discharge. If they are milky in color in a patient who was pregnant more than 3 years ago or has never been in this position, we need to look for the cause of galactorrhea. If the liquid is green or transparent, then this is characteristic of the development of inflammatory processes. Yellow or brown - may be a sign of tumor formations.

In addition, when examining the nipple and areola, Paget's disease can be suspected. It is a malignant lesion of the pigment tissue of the mammary gland due to the spread of tumor cells along the milk ducts. It manifests itself as dermatitis with the formation of scales and crusts, sometimes erosion is visible. May be accompanied by itching. Over time, the progressive process develops, the disease can spread to the skin around the areola. To confirm the diagnosis, additional histological examination is necessary.

What changes and symptoms should you report to your doctor?

If you come for an appointment with a mammologist, you must tell about all the changes that, first of all, relate to the mammary gland. This includes:

• pain not associated with menstruation (both in the breast area and lymph nodes);
• change during self-palpation since the last time;
• secretions;
• increased general body temperature, weakness;
• about cases of chest trauma (a blow, for example).

Do not forget that endocrine diseases can often lead to changes in the mammary gland. For example:

• reduction in the amount of glandular tissue;
• development of fatty involution of the mammary glands;
• hyper- or hypopigmentation of the areolas;
• total lack of breast development;
• diabetic mastopathy.

Diseases that can lead to this:

• type 1 diabetes mellitus;
• Shereshevsky–Turner syndrome;
• testicular feminization syndrome;
• Itsenko-Cushing syndrome.

Therefore, if there are such pathologies of the endocrine system, you need to notify the specialist who performs the palpation. So that he knows the cause of the occurrence, and what should be paid special attention to. This also includes disruptions in the menstrual cycle, non-age-related amenorrhea, recent history of diseases of other organ systems, what medications the woman took during treatment, and whether she uses a hormonal form of contraception.

Palpation of the mammary glands after childbirth

Women who have given birth have their breasts examined more frequently than usual. Because this organ undergoes changes during feeding.

After 4 hours after birth, the doctor examines the mammary glands of the mother who gave birth. Determines how ready they are to feed the baby. They take into account the increase in breast size, and whether there is any redness, pain, lumps, or increased temperature in the area of ​​the mammary glands.

Throughout breastfeeding, a woman should pay attention to her condition, palpate herself or come for examination to a specialist. Milk stagnation is possible when an excessive amount of milk is produced in the mother, or the baby does not eat enough. This condition is called lactostasis. Palpation is manifested by compaction and increased local temperature. Cracks in the area of ​​the nipple and areola are also possible. Can be seen or felt when running a finger over a surface.

Prevention

To avoid the development of pathological processes and difficult treatment in the final stages of tumor formation, you should adhere to simple rules:

1. Protect the mammary glands from injury: cover your breasts with your hands in large crowds of people, wear seat belts in the car (especially when driving). A small bruise may develop into a lump over time.
2. Do not use the solarium. Or at least cover the chest area. And also, sunbathe on the beach only when the sun is not so dangerous (before 12 am and after 5 pm). Since direct rays provoke the formation of a tumor, especially in areas of increased pigmentation (areola, nipple).
3. A healthy diet means healthy breasts. Here we are talking not only about giving up bad habits, but also about increasing the amount of vitamins A and C. They contribute to the normal development of the mammary gland and maintaining its tone.
4. At the birth of a child, natural feeding reduces the likelihood of breast tumor formation in the future several times. Therefore, you should not refuse this and transfer your child to artificial nutrition if this is not necessary.
5. You need to choose the right bra. The size of the item must correspond to your bust size. It is advisable not to wear “” often, as they impede blood circulation in the mammary glands. An additional and no less important criterion is a wide strap, since this is how the weight of the breast is evenly distributed throughout the underwear.

And most importantly: systematically engage in self-examination and consult a doctor on time to avoid negative consequences.