Consultation with a mammologist may be required by a woman of any age, health status and lifestyle, because he treats diseases of the mammary glands, and the list of them is quite extensive.

Most often, people turn to this specialist when unpleasant or disturbing symptoms already appear, but not everyone knows that they also need to visit him regularly, at least once a year, for the purpose of prevention.

When to consult a mammologist

It is worth noting that, due to the peculiarities of physiology, women most often turn to a mammologist, but in some cases men also need his help. Hormonal disorders can cause gynecomastia - female-type breast enlargement.

In addition, breast cancer in men, although it occurs approximately 100-130 times less frequently than in women, is also quite possible. And the main difficulty in diagnosing it is precisely the conviction of men that it is impossible for them to develop diseases of the mammary glands.

There are a number of characteristic symptoms that accompany the appearance of certain breast diseases in women. Therefore, it is important to pay attention to the following signs:

• Changes in breast sensitivity and tenderness . Unpleasant sensations may not be specific to a specific area or localized, occur with pressure, or be constant.
• Nipple discharge. If a woman is not breastfeeding or pregnant, then nipple discharge is a sign of pathology.
• Appearance of compaction . If you find even a small lump in the tissues of the gland, painful or not, you should not hesitate to consult a mammologist.
• Breast changes. In a woman who has gone through puberty, breasts should not enlarge, except during pregnancy and lactation. The case of unilateral enlargement of the mammary gland should be even more alarming.
• Changing the nipple. If the nipple on one or both glands is deformed, retracted, bent, tilted to one side, or changes color or size, then this is abnormal.
• Changes in skin areas . You should also be alerted by the appearance of an area on the skin of the chest that differs from the general background. Wrinkled, lumpy, abnormally smooth skin may be a sign of the disease.
• Enlarged and painful lymph nodes. Often, the lymph nodes located nearby are the first to react to diseases of the mammary glands, primarily the axillary ones.

It is worth noting that both women and men should monitor the appearance of such signs, since they are also not immune to certain diseases of the mammary glands.

Preventive visit to a mammologist

In addition to the listed cases, you should also consult a mammologist for preventive purposes in the following cases:

• After injuries to the mammary glands, bruises.
• In preparation for pregnancy.
• As prescribed by the observing gynecologist during pregnancy.
• After the end of the lactation period.
• At least once a year, even in the absence of indications.

Timely treatment and preventive control can significantly reduce the risk of severe consequences of breast diseases.

If you need a consultation with a mammologist

If you want to find a clinic where he works and make an appointment with him with a minimum of difficulties and get a mammogram as quickly as possible, you may find the “Your Doctor” website useful.

Through our service, visitors can find out where Moscow clinics are located, what specialists they employ, and what services I provide. And after making your final choice, directly on the website you will be able to make an appointment with a mammologist at the selected clinic.

Choose one of 477 breast oncologists based on ratings and reviews, make an appointment by phone or online.

Mammologist-oncologist in Moscow: cost of appointment

The price of an appointment with a mammologist-oncologist in Moscow starts from 900 rubles. up to 12277 rub.

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Who is a mammologist

A mammologist is a doctor who deals with the diagnosis, prevention and treatment of mammary glands. A mammologist examines a woman for both oncological and non-oncological diseases. These include:

• tumor formations in the mammary gland;
• diseases caused by hormonal disorders: mastopathy, fibroadenomatosis, gynecomastia, etc.;
• inflammatory diseases of the mammary gland.

An initial examination of the mammary glands can also be carried out by other specialists - if necessary, they give a referral to a mammologist.

When to see a mammologist

It is necessary to make an appointment with a mammologist for hormonal disorders, breast injuries and gynecological diseases. You should also consult before starting oral contraceptives, before IVF, and when planning pregnancy.

You should consult a mammologist unscheduled if:

• sudden change in breast shape, size or symmetry;
• the appearance of lumps or painful areas;
• changing the shape of the nipples;
• nipple discharge;
• swelling and redness of the breast;
• chest pain even after menstruation;
• enlarged axillary lymph nodes.

How is a mammologist examination performed?

Before the examination, the mammologist will collect anamnesis: study complaints, medical history, ask about concomitant diseases and genetic predisposition. Next, the doctor will use palpation to evaluate the mammary glands for homogeneity, elasticity and the presence of compactions.

If the mammologist suspects abnormalities, he will prescribe examinations. Usually this is ultrasound and mammography. In addition, the doctor may order a puncture biopsy, cytological examination of fluid from the nipples, blood tests and tumor markers.

A mammologist is a doctor who specializes in diseases of the mammary glands. In Russian medical practice, doctors involved in the diagnosis, treatment and prevention of diseases of this organ have a basic specialization in gynecology, surgery or oncology.

Pathology of the mammary glands can occur in both women and men, but in women it is detected much more often. This is explained by the fact that female mammary glands are much more developed, as well as their dependence on hormonal fluctuations. All major changes in a woman’s life inevitably affect the condition of her breasts. Breasts form during puberty. With the advent of menstruation, the mammary glands begin to respond to the menstrual cycle. Significant restructuring occurs during pregnancy: the body prepares for the fact that breastfeeding will follow the birth of a child. Despite the fact that breastfeeding is inherent in nature, it carries its own risks - mechanical damage, lactostasis (clogging of the milk ducts). A decrease in hormonal levels associated with the attenuation of reproductive function, however, like other age-related changes, also affects the condition of this organ.

Women's breasts are very vulnerable. The most dangerous threat is breast cancer. Cancer of this localization is currently considered the most common among oncological diseases. It is detected in every eighth woman over 45 years of age. Moreover, in the early stages it is curable, and the earlier the pathology is identified, the less damage to the body the treatment will be. The creation of a mammologist as a separate medical specialty is connected precisely with the need to achieve the widest possible early diagnosis.

Breast cancer also occurs in men, only less frequently (the ratio of cases in men and women is 1:100). Therefore, doctors recommend that men contact a mammologist if disturbing symptoms appear, and women over 35 years of age undergo an annual preventive examination.

If you need an appointment with a mammologist in Moscow, contact Family Doctor JSC. Below you can choose the clinic that is most convenient for you and check the prices for doctor’s services. You can make an appointment through the call center, mobile application or the patient’s personal account.

Why should you contact a mammologist?

The area of ​​expertise of a mammologist includes all diseases of the mammary glands. There are two main groups of diseases:

inflammatory

non-inflammatory nature.

The first group includes mastitis: lactation and non-lactation.

Lactation mastitis occurs during breastfeeding and is usually associated with lactostasis. If milk is not completely sucked out of the breast, it stagnates, which leads to the development of inflammation.

Non-lactation mastitis is an inflammation not associated with lactation.

The group of non-inflammatory diseases consists of neoplasms, which can be benign and malignant.

Benign formations include:

mastopathy (pathological change in gland tissue, which is fibrocystic in nature. Manifests itself in the form of fine-grained compactions, usually painful);

fibroadenoma (tumor developing from glandular tissue);

cyst (formation in the form of a cavity with liquid contents);

intraductal papilloma (caused by the human papillomavirus);

lipoma (popular name - “wen”, formed from adipose tissue).

Mastopathy is considered a precancerous condition. Other formations can also degenerate malignantly - fibroadenomas, cysts, intrastream papillomas. Therefore, any lump in the gland should be a reason to contact a mammologist and undergo an examination.

The competence of a mammologist also includes gynecomastia in men (pathological increase in the size of the mammary glands), as well as malformations and injuries of the mammary glands in women.

When do you need to see a mammologist?

Doctors recommend that every woman conduct a self-diagnosis once a month. Self-diagnosis consists of visually examining the breast in front of a mirror, palpating (each breast and armpits are palpated in turn), squeezing the nipple (checking for discharge). It is best to do a self-exam within a week after your period ends.

If alarming signs are detected, you should consult a mammologist as soon as possible. Such signs may be:

changes in the size and shape of the breast or nipple

lumps or redness;

soreness or feeling of tension in the gland area;

discharge from the nipple.

However, if the examination does not reveal anything alarming, you still need to go for an annual preventive examination. The sensitivity of instrumental diagnostic methods is significantly superior to your hands. Those who belong to the risk group should be especially vigilant:

nulliparous women over 30 years of age. The risk is even greater if you have a history of miscarriages or abortions;

with a history of chest trauma;

women with high levels of estrogen in the blood.

It is best to undergo a preventive examination on the 5-6th day of the menstrual cycle, at which time the mammary gland experiences the least impact from hormonal levels. Women in menopause can make an appointment with a mammologist regardless of time.

Diagnostic methods in mammology

At the appointment, the mammologist will perform an examination, which necessarily includes palpation (palpation), ask about complaints, find out whether gynecological pathology has been detected previously, and whether there have been cases of oncology in close relatives.

The examination standard involves conducting instrumental studies. Women under 35 are prescribed a breast ultrasound; those over this age are referred for mammography.

Can also be done:

radiothermometry of the breast;

biopsy of gland tissue followed by histological examination

laboratory tests: blood tests for tumor markers, hormones, analysis of nipple discharge (if there is discharge)

Treatment methods

Inflammatory diseases are treated with conservative methods. Treatment of mastopathy in most cases also turns out to be conservative.

Cysts, tumors and intraductal papillomas must be removed surgically. If surgery is unavoidable, doctors try to ensure that the necessary intervention is minimal. Operations are performed at the Family Doctor Hospital Center.

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Of all malignant tumors, breast cancer is the most common in women. More than 50,000 new cases of cancer are registered in Russia every year. And in order to save such a patient’s life, doctors have to perform a mastectomy - removal of the mammary gland and nearby lymph nodes. After removal, treatment begins: hormone therapy or chemotherapy. And then you need to learn to live with your cosmetic defect again, not to become depressed, not to give up on yourself, not to close yourself within four walls and not to start hating yourself and the whole world. But all this can be completely avoided if you regularly visit a mammologist. Moscow now has everything necessary to help a patient with a tumor at an early stage.

Who is a mammologist?

This is a specialist who deals with problems of the female breast. Mammology is a relatively new area of ​​medicine, which in Russia has not yet been included in the list of specialties for municipal healthcare institutions. That is, there is a huge problem, but there are no doctors in district clinics. And if a woman wants to make an appointment with a mammologist, then at the reception she will most likely be offered a voucher to see a gynecologist. But since this is not his specialization, if a pathology is suspected, he will send his patient further, for example, if a tumor is detected, he will give a referral to an oncologist.

This is the main reason for such a catastrophic situation with breast cancer in Russia. But 20-30 minutes spent visiting a doctor preserves health and saves lives. You just need to contact a good mammologist in Moscow right away, and not travel to offices. There is such a doctor in almost every paid clinic in the capital.

What is he doing

A mammologist in Moscow deals with the prevention of breast diseases, diagnosis and treatment of various pathologies. This can be not only cancer, but also mastopathy or a cyst, fibroadenoma (benign tumor), lactostasis or mastitis in a nursing woman.

A mammologist in Moscow not only examines and treats, but also tells women how to maintain breast elasticity or tighten breasts that sag after weight loss with the help of exercises and massage, how to choose a bra, what to watch out for and how to avoid diseases, for example, with hormonal changes .

Why contact this specialist?

A mammologist in Moscow recommends that mothers bring their girls to their first appointment at the onset of puberty, when the breasts are just starting to grow. A teenage “hormonal storm” often becomes the cause of fibroadenomas at this age - the disease is diagnosed in every 10th person.

Girls should visit a mammologist at least once every 2-3 years (if nothing bothers you, if there are complaints - immediately as soon as you see any changes: discharge from the nipple, hard “balls”, pain in the lymph nodes under the arms or on the neck etc.). And for women over 40, visiting a mammologist once a year and undergoing a mammogram should become as good a habit as visiting a hairdresser.

Appointment with a mammologist

Every woman needs her own good mammologist in Moscow who will observe her. Remember that a preventive examination can save your life. Don’t be afraid to go to a mammologist for an appointment - cancer doesn’t develop in 2-3 months! It is easy to detect even at stage zero, when the tumor is still only in the area where it originated (for example, inside the duct). In 85-90% of cases, stage 1 breast cancer is completely curable, preserving the mammary gland and without consequences.

Make an appointment with a doctor!

Mammologist– medical specialist in diseases mammary glands. Mammologist ( from the Latin word “mamma” – mammary gland) deals with inflammatory, dyshormonal and tumor diseases of the mammary gland.

The need for a doctor who would deal exclusively with breast pathology arose, first of all, due to the prevalence of breast cancer, which was most often discovered at a stage when treatment was ineffective.

This medical specialty is not officially registered in Russia. To qualify as a mammologist, in addition to higher medical education, the doctor must have a primary specialty in one of three areas - gynecology, surgery, oncology.
After this, the doctor undergoes retraining on the topic “Mammology” and receives the right to work as a mammologist. Thus, mammologist services are provided by doctors who, in their work, constantly encounter breast pathology.

The following specialists are distinguished among mammologist doctors:

• oncologist-mammologist– deals with the prevention, diagnosis and treatment of malignant breast tumors;
• breast surgeon– deals with breast pathologies that require surgical intervention ( benign tumors, nodular mastopathy, mastitis and other diseases);
• gynecologist-mammologist– deals with dyshormonal diseases of the mammary gland;
• radiologist-mammologist– carries out diagnostic tests such as mammography and tomosynthesis ( X-ray examinations of the breast);
• Ultrasound specialist-mammologist– conducts ultrasound examination ( Ultrasound) mammary gland.

“Radiologist-mammologist” and “mammologist-ultrasound specialist” are not official names of specialties, but only an indication that these radiologists have in-depth knowledge of the signs of breast pathology, which can be identified using X-ray or ultrasound examinations.

The mammologist works in the following institutions:

• antenatal clinic– as an obstetrician-gynecologist who has undergone thematic advanced training in breast pathology;
• cancer centers ( institutions) – as an oncologist, surgeon, radiologist or ultrasound specialist ( Ultrasound specialist) who work in the mammology department;
• mammology centers– highly specialized medical centers where mammologist-surgeons, mammologist-oncologists, mammologist-gynecologists work ( including gynecologists-endocrinologists), as well as diagnostic doctors ( radiologists and ultrasound specialists).

What does a mammologist do?

A mammologist deals with the identification and treatment of various pathologies of the mammary gland, carries out the prevention of malignant tumors of the mammary gland, as well as the rehabilitation of women after treatment. Some breast surgeons also deal with aesthetic problems related to the mammary gland, perform plastic surgery and prosthetics.

The responsibilities of a mammologist include:

• identification of risk factors for breast cancer;
• conducting a comprehensive preventive examination of the mammary glands ( mammological screening);
• training women in breast self-examination;
• clinical examination ( registration and active surveillance) women with any pathology of the mammary gland;
• detecting cancer at early stages;
• carrying out clarifying diagnostics ( radiologists and ultrasound specialists);
• treatment of breast diseases in women;
• treatment of dishormonal diseases of the mammary glands in men.

A mammologist treats the following breast diseases:

• benign breast tumors ( lipoma, fibroadenoma);
• intraductal papilloma;
• lipogranuloma;
• breast cysts;
• mastopathy ( benign breast dysplasia);
• breast cancer;
• Paget's cancer;
• gynecomastia;
• galactorrhea;
• mastodynia ( Cooper's disease);
• ductectasia;
• mastitis;
• breast injuries;
• congenital anomalies of breast development;
• problems associated with lactation ( secretion of milk) and breastfeeding ;
• Mondor's disease.

Benign breast tumors

Benign breast tumors occur most often between the ages of 15 and 35 years. They consist of tissues that are present in the mammary gland, do not in any way affect the general condition of the female body, and do not form again after their removal.

The main cause of benign tumors is considered to be hormonal imbalance, since there are many receptors in the mammary gland ( sensory nerve endings), which react very sensitively to any excess of hormone levels, especially estrogen, progesterone and prolactin.

Benign breast tumors include:

• adenoma– a tumor of glandular tissue that secretes breast milk;
• fibroma– connective tissue tumor ( component of the supporting frame of the organ);
• fibroadenoma– a tumor that consists of glandular and connective tissue in equal proportions;
• lipoma– tumor of their adipose tissue ( wen).

Intraductal papilloma

Intraductal papilloma ( wart) is a benign tumor that is formed from epithelial ( lining the inside) mammary duct cells. Intraductal papilloma has its own characteristics. It is almost impossible to detect when palpating the mammary gland, but it is manifested by frequent bloody discharge from the nipple, which very frightens the woman. Because of this symptom, intraductal papilloma is called “bleeding mammary gland.”

Lipogranuloma of the breast

Lipogranuloma ( oleogranuloma) is non-inflammatory necrosis limited to healthy tissue ( necrosis) fatty tissue of the mammary gland. Often occurs after a bruise of the mammary gland, surgery or injections into the gland. Sometimes observed in systemic connective tissue diseases ( rheumatoid arthritis, systemic lupus erythematosus).

Depending on the prevalence, mastopathy is:

• nodal– one or more nodes are detected;
• diffuse– changes occur throughout the mammary gland.

Depending on the predominant element, mastopathy is:

• fibrous– mastopathy due to the proliferation of connective tissue in the gland;
• adenous ( adenomatous) – enlargement of lobules, that is, mastopathy due to the glandular component;
• cystic– mastopathy, with the formation of grape-shaped cavities with liquid inside.

Most often there are mixed forms.

Breast cancer

Breast cancer is a malignant tumor that mainly has a hereditary cause and develops in the presence of favorable factors ( risk factors).

The following risk factors for developing breast cancer are:

• breast cancer in the mother, especially if it occurred before age 60;
• breast cancer in two relatives;
• detection of mutations in the BRCA1 and BRCA2 genes ( Breast Cancer - breast cancer);
• onset of menstruation before age 13;
• first birth after 30 years;
• absence of childbirth;
• frequent abortions;
• refusal to breastfeed;
• menopause before 50 years of age;
• the presence of a benign breast tumor;
• the presence of diseases of the female genital organs;
• alcohol consumption.

Paget's cancer

Paget's cancer is a malignant tumor of the nipple and adjacent pigmented skin ( areolas) mammary gland. The tumor manifests itself as redness, eczema ( itching, rash, burning, weeping) and ulceration of the nipple. Sometimes scales form that resemble psoriasis. This type of cancer occurs in both women and men.

Galactorrhea

Galactorrhea is a milky discharge that occurs in non-pregnant women and men. The reason for such discharge is hormonal changes associated with the pituitary gland, thyroid gland or adrenal glands. Sometimes galactorrhea is a side effect of certain medications. The result of all these diseases is the same - a high level of the pituitary hormone prolactin, which stimulates the formation of milk in the mammary glands.

Gynecomastia

Gynecomastia is enlargement of the mammary glands in men. This pathology is a consequence of endocrine disorders, so it is most often dealt with by endocrinologists and andrologists, however, due to the existing risk of developing breast cancer in men ( usually in old age), gynecomastia is also included in the scope of activity of a mammologist.

Mastodynia ( Cooper's disease)

Mastodynia is a feeling of fullness in the mammary glands that occurs during the premenstrual period and disappears after the onset of menstruation.

Ductectasia

Ductectasy is an extension ( ectasia) large channels ( ductus) mammary glands located closer to the nipple. The cause of expansion is a chronic inflammatory process. Ductectasia is more often observed in older women, when involutive processes begin in the mammary gland ( organ reversal).

Mastitis

Mastitis ( from the Greek word “mastos” - breast, nipple) – inflammation of the mammary gland. The cause of mastitis is an infection that penetrates the mammary gland ( usually through the nipple). Sometimes breast cancer occurs under the guise of mastitis ( inflammatory form of cancer).

Mastitis can be caused by the following pathogens:

• nonspecific microorganisms– staphylococci and streptococci;
• specific microorganisms– Treponema pallidum ( causative agent of syphilis), Mycobacterium tuberculosis, actinomycetes ( fungi that cause actinomycosis).

Problems associated with lactation ( secretion of milk) and breastfeeding

They also contact a mammologist if after childbirth the process of breastfeeding is difficult or causes pain. In this case, the woman is observed by a mammologist-gynecologist who works in the antenatal clinic at the maternity hospital.

Lactation disorders include:

• Milk fever ( lactation mastitis) – develops 3–5 days after birth due to stagnation of milk, which begins to be reabsorbed. The milk that is absorbed back has pyrogenic properties, that is, it can cause an increase in temperature. Unlike infectious mastitis, the mammary gland does not thicken.
• Hypogalactia ( galactos - milk) – insufficient milk supply in a woman;
• Agalaktiya– complete absence of milk in the mammary glands after childbirth;
• Cracked nipples– small linear defects or tears in the skin of the nipple and around it. Cracks occur if the skin of the nipples is overdried by certain cosmetic products ( alcohol based), or the nursing mother does not observe hygiene rules before and after feeding.

Congenital anomalies of breast development

Breast malformations are usually dealt with by breast surgeons, since their correction requires surgery.

Congenital breast defects include:

• amastia– both mammary glands are absent;
• monomastia– there is only one mammary gland;
• polymastia– there are additional nipples or lobes of the mammary gland.

Breast injuries

A breast injury is a soft tissue contusion, that is, it causes swelling, cyanosis and breast pain. In some cases, hemorrhage occurs in the mammary gland ( hematoma), which quickly spreads throughout the gland, due to the organ’s weak ability to limit this process.

Mondor's disease

Mondor's disease is an inflammation of the superficial veins of the anterior or lateral chest, as well as in the breast area. This pathology is of interest to a mammologist, since, when inflamed, the veins and the skin over them tighten, which is reminiscent of the tightening of the skin over the mammary gland during cancer.

How is an appointment with a mammologist?

Women are seen by a mammologist on certain days of the menstrual cycle. A woman should make an appointment with a mammologist so that the day of the visit falls on days 5–12 of the cycle ( you need to count from the first day of menstruation). The fact is that after ovulation ( 13 – 14 days after the start of menstruation) the mammary glands swell somewhat and become a little denser than usual, which is associated with hormonal changes. Examinations these days may lead to false positive results. This rule applies to women of reproductive age. After menopause, you can apply any day.

At the appointment, the mammologist performs the following actions:

• asks the patient about her complaints;
• asks questions to find out if she has risk factors for breast cancer;
• examines and palpates the mammary glands;
• prescribes the necessary tests;
• directs for the necessary instrumental studies.

The mammologist's office is located on the bright side of the building, since natural light is needed for examination and examination; the blinds are closed during the examination.

At the appointment, the mammologist asks the following questions:

• At what age did you have your first menstruation?
• When was your last menstruation?
• What is the duration and regularity of the menstrual cycle?
• At what age did menopause begin?
• How many pregnancies have you had?
• How many births were there?
• How many abortions were there?
• At what age did you have your first birth?
• Was enough milk produced in the mammary glands during breastfeeding?
• Is there a history of breast cancer in the family?
• Has the woman had or currently has diseases such as ovarian cysts, uterine fibroids or polyps, endometriosis, ovarian dysfunction or infertility?
• Has the woman had breast surgery?
• Has the woman ever had mastitis or breast bruises?
• Is the woman taking birth control pills or hormonal medications?
• Has the woman experienced in the past ( or whether she currently has) severe stress associated with personal life, family, work, and so on?
• Does the woman drink alcohol heavily and/or regularly?

After questioning, the mammologist asks the woman to undress to the waist in order to conduct examination and palpation ( palpation) mammary gland and local lymph nodes ( they increase with cancer or mastitis).

Examination and palpation of the mammary gland is carried out in a standing and lying position ( For this purpose, there is a couch in the mammologist’s office). In both positions, the symmetry and size of the gland are visually assessed. The mammologist palpates the mammary gland with the palmar surface and the pads of four fingers folded together ( the thumb is slightly retracted).

The mammologist uses the following models for palpating the breast:

• by quadrant– the mammary gland is conventionally divided into four quadrants ( equal areas), which are examined in turn, starting from the upper-outer quadrant, after which the upper-inner, lower-outer and lower-inner quadrants are palpated;
• in a spiral– palpation is carried out in a circle, starting from the center ( pacifier) in conventional circles;
• along radial lines– the mammary gland is palpated along conventional lines running from the nipple in the form of spokes in a wheel;
• up and down movements- the mammologist feels the gland along imaginary vertical lines from bottom to top and top to bottom.

Palpation is carried out in the following positions:

• the patient's hands are located on the hips, relaxed in the shoulder joints– in this position, the pectoral muscles relax, and it is easier for the doctor to palpate deep-lying formations and lymph nodes;
• the patient's hands are raised and placed behind the back of the head– in this position, the ligaments of the mammary gland are stretched, and you can notice areas of retraction of the skin over the gland ( is a sign of cancer, but can also be observed in non-cancerous processes).

Both positions are used when examining standing and lying down.

The mammologist describes the following features of a tumor or breast node:

• Size. The size is assessed not subjectively, but using a measuring tape or a plastic compass.
• Localization. Descriptions of the location of pathological changes are carried out according to the diagram of a watch dial ( for example, at 6 o'clock, at 12 o'clock) or indicate the name of the quadrant of the mammary gland where the formation is palpable ( upper inner, upper outer, lower outer, lower inner).
• Soreness. If the pathological focus “hurts,” then most likely it is benign in nature ( early stage cancer does not cause pain).
• Consistency and compaction. The cancerous tumor is considered to have a rocky consistency, but in some cases it may appear as a lesion with a jelly-like consistency. If a soft, easily compressible formation is palpated, then most likely it is a cyst.
• Form. To describe the shape, the mammologist evaluates the evenness or unevenness of the contours of the formation. The more irregularities around the edges, the more likely it is that the node is malignant.
• Connection with surrounding tissues. The connection is determined by the mobility of the node, that is, the ability to move it during palpation. Malignant nodes are characterized by immobility.
• Changes in the skin over the breast. Changes such as redness, cyanosis, swelling, retraction, or ulceration of the skin are described.

The duration of palpation does not depend on the experience of the mammologist. A good mammologist always spends a long time and carefully palpating the glands and lymph nodes, since small formations are not always easy to feel.

The mammologist prescribes the following tests:

• General blood test. Using this analysis, a mammologist can suspect a latent malignant process in the mammary gland. The presence of cancer may be indicated by changes such as a marked increase in the number of leukocytes, an increase in the erythrocyte sedimentation rate ( ESR) or anemia ( low hemoglobin and/or red blood cell levels). These are nonspecific signs, that is, they can be observed in various pathologies.
• Biochemical blood test. The mammologist pays special attention to the activity of liver enzymes, the level of bilirubin and blood proteins. A change in these indicators may be a consequence of liver pathology, and it is not only involved in regulating the activity of female sex hormones, but is also the first to “take the hit” in breast cancer ( Breast cancer primarily metastasizes to the liver).
• Blood test for hormone levels. Almost all hormones secreted in the body act on the mammary gland. Some act on the gland directly, since it has receptors for these hormones, while others act indirectly, that is, through an increase or decrease in the level of those hormones that can directly affect the mammary gland. The basic information about hormonal diseases of the mammary glands is provided by estrogen, progesterone and prolactin, but it is important to exclude any endocrine pathology, so the mammologist may prescribe tests for other hormones. The level of sex hormone binding globulin is also important ( sex steroid-binding hormone), which is produced in the liver.
• Analysis for mutations in the BRCA1 and BRCA2 genes ( Breast Cancer - breast cancer). Normally, these two genes are responsible for inhibiting the processes of excessive division of breast cells, especially during puberty and pregnancy. When these genes “break down,” cell division is poorly controlled, and the process of natural death of obsolete cells is disrupted. As a result, cells with “broken” chromosomes are not removed from the gland. This chromosomal instability leads to breast cancer.
• Serological blood test. The analysis reveals the presence of antibodies to pathogens of specific mastitis, that is, mastitis caused by syphilis, tuberculosis and actinomycosis.
• Bacteriological study. Bacteriological analysis is the culture of material obtained during a diagnostic or therapeutic puncture ( puncturing the gland with a needle), on a nutrient medium. The study allows you to identify a specific causative agent of mastitis and determine its sensitivity to antibiotics.

An appointment with a mammologist, in addition to examining women with specific complaints, takes place as part of mammological screening. Screening is a preventive measure that allows you to identify women who require special attention from a mammologist.

Mammological screening has its own characteristics depending on the age of the patient. Until 2012, age groups were divided into women before and after 40 years of age, however, cancer is getting “younger” every year, so caution has begun to be exercised even among young women, especially if they have risk factors for breast cancer. Women with risk factors should be examined by a mammologist 2 times a year, in the absence of risk factors under 35 years old - once a year or once every 2 years. For women over 35–40 years old, a visit to a mammologist once a year is required, even if there are no complaints.

Activities carried out by a mammologist during mammological screening

What does breast screening include for women under 35?	What does breast screening include for women over 35 years of age?
manual ( manual Ultrasound if there are risk factors, but there are no changes in the mammary gland; Ultrasound and mammography if changes in the mammary gland are detected during a manual examination.	questioning women to identify risk factors for breast cancer; manual ( manual) examination of the mammary glands; mammography every 1.5 years, even if there are no changes in the mammary gland; DNA blood test to detect gene mutations if there is a history of breast cancer in the family; development of an observation and treatment plan if mutations in the BRCA1 and BRCA2 genes are detected.

What symptoms do you see a mammologist with?

Not only women who have complaints from the mammary glands turn to a mammologist, but also those who have no pain. The latter group of patients makes up the vast majority of women seen by a mammologist. This is precisely the specific work of this specialist - to identify the disease before symptoms appear. The fact is that the presence of obvious manifestations of breast tumors basically means that the disease has already “taken root.” In addition, many tumors, both benign and malignant, “do not give away” themselves, that is, they proceed without complaints.

It is important to know that you can and should contact a mammologist not only at the age of 35–40 years and if there are problems, but also during puberty, since the mammary gland requires the same attention as the menstrual cycle.
The fact is that the mammary gland reacts to any hormonal change in the body, especially in women in whom this organ has not yet fulfilled its main function - feeding the baby. From this point of view, going to a mammologist is equivalent to going to a gynecologist.

Symptoms for which you should contact a mammologist

Symptom	Mechanism of occurrence	What tests are performed to diagnose the causes of a symptom?	What disease might this symptom indicate?
Pain or tenderness in the breast	swelling of the mammary gland caused by inflammation or fluid retention due to hormonal imbalance; with a high level of estrogen in the mammary gland, the number of ducts increases, which easily transform into cysts; the process of disintegration of a cancerous tumor in the mammary gland is accompanied by the release of substances that cause an inflammatory reaction in the form of edema; The growth of a cancerous tumor into the skin causes ulceration.	examination and palpation of the gland; Ultrasound of the mammary glands and local lymph nodes; mammography; tomosynthesis; ductography ( X-ray contrast examination of the ducts); mammoscintigraphy ( radioisotope research); diagnostic puncture; biopsy ( taking a piece of pathological tissue); blood test for tumor markers; blood test for mutant breast cancer genes; general blood test and biochemical blood test;	fibroadenoma; mastodynia ( Cooper's disease); intraductal papilloma; mastopathy; ductectasia; cysts; breast cancer ( in later stages); breast injury; mastitis; Mondor's disease.
Breast lump	thickening of the entire mammary gland most often occurs due to the proliferation of connective tissue in the mammary gland due to hormonal imbalance, less often due to advanced cancer.	feeling the mammary gland; mammography; Ultrasound of the breast; mammoscintigraphy; tomosynthesis; diagnostic puncture; cytological examination; tomosynthesis; hormone analysis; analysis for tumor markers.	mastopathy; breast cancer.
Presence of a formation in the mammary gland (according to palpation)	malignant process in the mammary gland in the form of a node; proliferation of glandular or connective tissue with the formation of cavities filled with fluid and dense nodules; limited destruction of the fatty tissue of the gland or accumulation of blood due to injury; inflammation of the mammary gland in a limited area.	Ultrasound of the breast; mammography; ductography; tomosynthesis; diagnostic puncture; cytological examination; biopsy; histological examination; mammoscintigraphy; analysis for tumor markers; analysis for mutations in the BRCA1 and BRCA2 genes; hormone analysis; serological blood test; bacteriological analysis; analysis for BRCA1 and BRCA2.	benign tumors ( fibroadenoma, lipoma); lipogranuloma; breast cysts; breast cancer; mastopathy; mastitis; breast injuries.
Asim- mammary gland measurements
Discharge from both nipples that resembles milk	When prolactin levels are high in non-pregnant women or men, the breasts stimulate the production of breast milk or a fluid that resembles milk.	feeling the mammary gland; Ultrasound of the breast; mammography; ductography; diagnostic puncture; cytological examination of nipple discharge; general and biochemical blood test; blood test for hormones; tumor markers.	gynecomastia; galactorrhea; breast injury; mastitis; breast cyst; metastatic breast tumor ( for lung cancer, kidney cancer).
Discharge from one or both nipples (colorless, yellowish, green, brown)	temporary hormonal changes in the body in the second phase of the menstrual cycle; hormonal changes in the mammary gland, causing expansion of its ducts and the formation of cysts; increased contraction of the ducts during sexual arousal; inflammatory process in the mammary gland, with the formation of pus.	palpation of the mammary gland; Ultrasound of the breast; diagnostic puncture; cytological examination of discharge; mammography; tomosynthesis; ductography; general and biochemical blood test; analysis for tumor markers; hormone analysis; serological blood test; bacteriological analysis of secretions; analysis for BRCA1 and BRCA2.	mastopathy; ductectasia; mastitis; breast cancer ( inflammatory form).
Bloody discharge from the nipple	ulceration or rupture of blood vessels of a cancerous tumor that has formed in the ducts of the mammary gland; trauma to the skin of the nipple during breastfeeding and damage to small skin vessels; ulceration of a wart that has formed in the mammary duct.		intraductal papilloma; breast injury; mastitis; cracked nipples; breast cancer.
Nipple retraction	the growth of scar tissue around the nipple disrupts its anatomical structure and draws it inward.	Ultrasound of the breast; mammography; ductography; tomosynthesis; mammoscintigraphy; diagnostic puncture; biopsy; cytological and histological examinations; hormone analysis; analysis for tumor markers; general and biochemical blood test; serological blood test; analysis for mutations in the BRCA1 and BRCA2 genes.	congenital feature; mastitis ( for tuberculosis and actinomycosis); mastopathy; breast cancer Paget's cancer; long-term breastfeeding; breast injury.
Retraction of the skin over the breast ("orange peel")	The ligaments of the mammary gland, shortened as a result of a pathological process, “pull” and fix in this position the area of ​​skin with which they are connected.	examination and palpation of the mammary gland; mammography; ductography; ultrasound examination of the breast; tomosynthesis; mammoscintigraphy; diagnostic puncture; breast biopsy; cytological and histological examination; analysis for tumor markers; bacteriological examination; serological blood test; analysis for BRCA1 and BRCA2.	breast cancer; lipogranuloma; Mondor's disease; mastopathy; mastitis.
Change in breast skin color	cyanosis of the skin may be a consequence of compression of blood vessels and poor circulation; redness occurs when blood flow to the breast skin increases.	examination and palpation of the mammary gland; ultrasound examination; mammography; diagnostic puncture; breast biopsy; histological and cytological examination; general and biochemical blood test; serological blood test.	mastitis; breast cancer; Paget's cancer; benign skin tumors; breast injury.
Thickening, ulceration of the skin of the breast and/or nipple area	a chronic pathological process in the mammary gland or on the skin that covers it causes either destruction of the skin or its thickening.
Increase in breast size in women	swelling and venous congestion in the mammary gland, caused by a tendency to retain fluid during the premenstrual period ( bilateral magnification); an increase in the amount of glandular component of the mammary gland or the formation of cysts due to hormonal imbalance ( unilateral or bilateral enlargement); inflammatory swelling of the mammary gland ( unilateral increase); hemorrhage into the mammary gland ( usually unilateral enlargement).	examination and palpation of the mammary gland; Ultrasound of the breast; blood test for hormones; general and biochemical blood test; serological blood test.	mammalgia; mastopathy; mastitis; breast injury.
Breast enlargement in men	high levels of female sex hormones in men stimulate the growth and development of glandular tissue and ducts in the male mammary glands.	examination and palpation of the mammary glands; ultrasound examination; hormone analysis; general and biochemical blood test; analysis for tumor markers.	gynecomastia; breast cancer in men.

What kind of research does a mammologist conduct?

The mammologist carries out instrumental and laboratory research methods not only if he detects changes during examination and palpation, but also as part of mammological screening. If a mammologist has identified obvious symptoms of breast cancer in a woman or manifestations that raise suspicions of cancer, then the mammologist must conduct a full examination of the woman within 8 to 10 days. What kind of examination the mammologist will prescribe depends on the age and the presumptive diagnosis that needs to be clarified or excluded. The mammologist may prescribe several instrumental studies.

Tests prescribed by a mammologist

Study	What pathologies does it detect?	How is it carried out?
Mammography	fibroadenoma; lipoma; intraductal papilloma; breast cyst; ductectasia; mastopathy; breast cancer.	Mammography is an X-ray examination of the breast. Mammography is carried out in the first phase of the menstrual cycle somewhere between 5 – 6 and 12 days of the cycle, since in the second phase the mammary glands swell and become painful. The study is carried out with the woman in an upright position ( standing or sitting). Each mammary gland is alternately pressed between two mammography plates ( mammography machine). The image can be saved in two forms - film ( the image is immediately printed onto film) or digital ( the image is sent to the computer).
Ultrasound examination of the breast	fibroadenoma; lipoma; intraductal papilloma; lipogranuloma; breast cyst; mastopathy; mammalgia; ductectasia; breast cancer; gynecomastia.	Ultrasound examinations are best performed in the first week of the menstrual cycle to avoid false-positive results associated with hormonal changes in the mammary glands after ovulation ( to the second phase). During the examination, the woman lies down on a couch and a gel is applied to the mammary glands to facilitate the sliding of the ultrasound sensor. An ultrasound probe is placed above the skin of the breast and moved to obtain images of different parts of the breast. Ultrasound also allows you to assess the condition of local lymph nodes.
Ductography	ductectasia; intraductal papilloma; mastopathy; breast cancer.	Ductography is an X-ray examination of the mammary gland ducts after the injection of a contrast solution into them through the nipple. Before administering the substance, the area of ​​the areola and nipple is treated with alcohol. Using a drop of secretion from the nipple, the opening of the milk duct is found and a needle is inserted to a depth of approximately 5 mm. A contrast agent is injected through the needle ( verografin or urografin), after which a series of x-rays are taken, which show the entire path of the substance through the ducts.
Tomosynthesis	fibroadenoma; breast cysts; breast cancer.	Tomosynthesis is an x-ray examination in which x-rays irradiate the mammary gland in an arc. As a result, after computer processing, the mammologist receives thin sections of the gland. During the examination, the woman stands or sits, each breast is alternately pressed between the glass and the signal receiver, while the discomfort from compression is much less than during mammography.
Diagnostic puncture	fibroadenoma; intraductal papilloma; cysts; breast cancer; Paget's cancer; mastitis; mastopathy; breast injuries; gynecomastia.	A diagnostic puncture is a puncture of breast tissue under ultrasound guidance. The purpose of the puncture is to obtain material for cytological examination. The resulting material is squeezed onto a glass slide and sent to the laboratory.
Cytological examination		Discharge from the nipple or punctate can be used as material for cytological examination of the mammary gland ( fluid obtained during a diagnostic puncture). To collect nipple discharge, the mammary gland in the areolar ( pigmented) areas are squeezed with one hand between the thumb and index finger. With the other hand, hold a glass slide at a short distance near the nipple. To take a swab impression, a glass slide is applied to the ulcerated surface of the nipple. The purpose of the study is to identify the composition of the resulting liquid. In case of malignant formation, atypical ( cancerous) cells and erythrocytes, with intraductal papilloma - erythrocytes, with mastitis - leukocytes and fibrocytes.
Breast biopsy	breast cancer; Paget's cancer fibroadenoma; lipoma; intraductal papilloma; lipogranuloma; breast cancer; mastopathy; mastitis.	A biopsy is an intravital tissue sampling for histological examination. A biopsy can be performed using a scalpel or scissors under local anesthesia if the tumor has grown into the skin ( incisional biopsy). If the formation is located deep, then the skin and subcutaneous tissue are dissected, and after isolating part of the tumor, sutures are applied ( open biopsy). A biopsy can be performed with a special thick needle ( trephine needle), which is injected with rotational movements until the tumor ( trephine biopsy). The resulting material is placed in formaldehyde and sent to the laboratory.
Histological examination		For histological examination, you can use material obtained during a biopsy ( biopsy) or the tumor itself, which was removed during surgery. Histological examination can be urgent if carried out within 30–60 minutes ( during the operation) or planned, if the conclusion is received in 7–10 days ( more informative).
Magnetic resonance examination (MRI)	breast cyst; lipoma; ductectasia; breast cancer; mastopathy.	During the examination, the woman lies face down on the diagnostic couch. A special coil is placed under the mammary glands, which has holes, thanks to which the mammary glands hang down and are not pressed. MRI is used to determine metastases ( secondary tumors) breast cancer or to diagnose the nature of tumor formation. Tissue contrast enhancement with intravenous gadolinium is often used to distinguish different types of breast tumors.
Tumor markers	breast cancer; mastopathy ( low level); pregnancy ( in the third trimester).	Tumor markers are substances that are secreted by a malignant tumor or are its protein fragments ( antigens). Tumor markers for breast cancer are carcinoembryonic antigen ( REA), ferritin, CA 15-3 antigen ( serum mucin glycoprotein) and mucin-like cancer antigen ( M.C.A.). To detect these tumor markers, a blood test is taken.
Mammoscintigraphy	mastopathy; breast cancer; benign breast tumors.	Mammoscintigraphy is a diagnostic method using radioisotopes, which tend to accumulate in cancer cells, enhancing their glow on the screen. The drug is administered intravenously. During the study, the woman lies on the couch, and a gamma camera is brought to her chest, which records the radiation of the drug. The study is carried out 5–7 days after menstruation.

If a woman is diagnosed with breast cancer, a HER-2 test is performed before starting treatment. HER-2 is a receptor ( cell wall sensory protein), which binds to growth factors - substances that can enhance cell division. This test is performed only on women who have been diagnosed with breast cancer. The material for analysis is a cancer cell, or rather its DNA obtained during a biopsy or after removal of the tumor. If a woman is found to have this protein, this is designated as “positive HER-2 status,” requiring the use of a drug that blocks this receptor.

What methods does a mammologist use to treat?

A mammologist uses both medical and surgical methods to treat breast pathology. Gynecologists and mammologists adhere more to the so-called conservative approach, that is, they use medications. This tactic is due to the fact that gynecologists and mammologists deal mainly with hormonal diseases of the mammary gland. Breast oncologists and breast surgeons actively use surgical methods. For some benign tumors, mammologists may not take therapeutic measures, observing the formation using regular breast ultrasound, intervening in case of tumor enlargement.

Treatment methods for breast pathology

Pathology	Treatment method	Mechanism of therapeutic action	Approximate duration of treatment
Fibroadenoma	Surgical removal	During the operation, the sector of the mammary gland in which the tumor is located is removed.	To perform the operation, it is necessary to be under the supervision of a doctor in the hospital for several days, since the patient can be discharged after receiving histological examination of the removed tumor.
Lipoma	Surgical removal	Small lipomas are removed under local anesthesia, and large ones under general anesthesia. An incision of the required depth is made on the mammary gland, after which the lipoma is cut off and removed along with the fatty membrane.	Depending on the scale of the operation, a woman can spend from several hours to a day in the hospital.
	Puncture-aspiration removal	The contents of the wen are drawn out using a needle, which is used to pierce the mammary gland up to the wen. With this method, no incision is made.	The manipulation lasts 15–20 minutes, after which the woman can go home.
Intraductal papilloma	Surgical removal	During the operation, the sector of the mammary gland in which the papilloma is located is removed.	To perform the operation, you need to be under the supervision of a doctor in the hospital for several days, during which data from a histological examination of the removed papilloma are obtained. If there is no indication of a malignant tumor, the patient is discharged.
Lipogranuloma	Surgical removal	To remove lipogranuloma, an incision is made and the affected sector of the mammary gland is removed under general anesthesia.	The hospital stay is several days. The patient is discharged if there are no signs of a malignant tumor according to histological examination.
Breast cysts		Under ultrasound guidance, the cyst is pierced with a needle and aspirated ( pull out) its contents into a syringe, after which a substance is injected into the cavity of the cyst, causing the walls of the cyst to stick together and scar it. The introduction of sclerosing substances is necessary to prevent the fluid in the cyst from re-forming.	The procedure is carried out under local anesthesia, so the woman is discharged after the procedure if no malignant cells are found in the fluid ( cytological examination).
	Surgical treatment	The cyst is removed along with the sector in which it is located.	The length of hospital stay depends on the number of cysts, but a minimum of 3 days is required.
Breast cancer, Paget's cancer	Radiation therapy	Irradiation causes the DNA of cancer cells to be destroyed, they stop dividing and die.	Radiation of the breast is carried out 5 times a week until the woman receives the total dose. The number of radiation therapy sessions to achieve the total dose depends on the single dose that is prescribed for each session.
	Surgical treatment	Depending on the size, shape and extent of the cancer, the tumor is removed within healthy tissue ( for small sizes) or together with the mammary gland and local lymph nodes.	After the operation, the woman must remain in the hospital for further treatment.
	Chemotherapy (antitumor antibiotics, taxanes, alkylating drugs)	All chemotherapy drugs disrupt the division of cancer cells, affecting either the genes that regulate this process or the structures of the cell ( microtubules), which are formed during division.	The drugs are taken every 3–4 weeks ( 1 cycle).
	Monoclonal antibodies	Monoclonal antibodies bind to the HER-2 receptors of cancer cells, which makes it impossible for this receptor to contact the tumor growth-promoting substance. As a result, cancer growth is inhibited.	The drug is administered every 3 weeks or once a week.
	Antihormonal drugs	Reduce the formation of estrogenic hormones, which stimulate the uncontrolled formation of new cells in the mammary gland ( effective in hormone-dependent forms of cancer).	The drugs are used for a long time.
Mammalgia (Cooper's disease)	Hormonal drugs	They normalize the balance of female sex hormones in the body, eliminating premenstrual swelling of the gland.	The drugs are taken for 3 months, take a break for 2 - 3 months, then repeat the course.
	Homeopathic medicines	Affects central organs ( in the brain) regulating the menstrual cycle.
		They reduce swelling of the mammary gland, thereby eliminating the cause of pain and bloating.	Nonsteroidal anti-inflammatory drugs are taken for 1 to 2 weeks before menstruation.
	Diuretics	Eliminates fluid retention in the body that occurs during the premenstrual period. As a result, swelling and tenderness of the breast are reduced.	Taken during the second phase of the cycle.
Mastopathy		Antihormonal drugs reduce the production of prolactin, estrogens, or pituitary hormones that stimulate the release of estrogens. Hormonal drugs replace the deficiency of progesterone and thyroid hormones. Normalization of hormonal balance eliminates pathological stimulation of the growth of mammary gland elements.	Treatment is carried out for at least 6 months.
	Nonsteroidal anti-inflammatory drugs	The drugs reduce swelling and pain in the mammary glands.	The drugs are taken in the second phase of the menstrual cycle before the onset of menstruation.
	Homeopathic medicines	Affects brain centers regulating hormone production ( hypothalamus-pituitary gland).	The course of treatment is 3 – 6 months. Longer use may be required.
	Iodine preparations	The drugs replenish the lack of iodine in the body, which helps increase the level of thyroid hormones.
	Aspiration and use of sclerosing agents	In case of cystic mastopathy, the cysts are punctured and their contents are suctioned, after which solutions are injected into the cavity of the cysts, causing their sclerosis, that is, scarring and gluing of the walls.	The operation is not complicated, so the woman is discharged within 1 to 2 days.
	Surgical treatment	Under general anesthesia, dense nodes and the sector in which they arose are removed.	After the operation, the woman remains in the hospital for 7 days until the results of the histological examination are received.
Gynecomastia	Hormonal and antihormonal drugs	Antihormonal drugs inhibit the formation of female sex hormones in the male body. Hormonal drugs restore testosterone levels.	Treatment is carried out for 1.5 – 2 months.
	Surgical treatment	The mammary glands are removed using open surgery or the endoscopic method ( insertion of a catheter with a camera through an opening in the armpit).	The length of the recovery period after surgery depends on the method used to remove the mammary gland.
Galactorrhea	Hormonal and antihormonal drugs	Antihormonal drugs inhibit the production of prolactin in the pituitary gland. Hormonal drugs replace hormone deficiency, thereby normalizing the functioning of the pituitary gland.	The duration of drug treatment is at least 6 months.
Ductectasia	Drug treatment (antibiotics, non-steroidal anti-inflammatory drugs)	Drug treatment prevents further dilation of the ducts when infection is present ( antibiotics) and inflammatory process ( non-steroidal anti-inflammatory drugs) in the mammary gland.	Antibiotics are prescribed if there is a bacterial infection ( according to nipple discharge tests) within 7 – 10 days. Non-steroidal anti-inflammatory drugs are taken until symptoms disappear ( breast pain and fever).
	Surgical treatment	Dilated ducts are partially excised within healthy tissue. If a malignant tumor is discovered along with the dilated ducts, the mammary gland is completely removed.	After the operation, the woman must remain in the hospital under the supervision of doctors for about a week.
Mastitis	Antibiotics	Antibacterial drugs destroy the cell wall of the mastitis pathogen or disrupt the process of microbial division.	The duration of taking the drugs depends on the severity of mastitis. For mild forms, medications are taken for 7-10 days, for severe forms - until signs of infection and inflammatory reaction disappear.
	Nonsteroidal anti-inflammatory drugs	These drugs, when applied topically in the form of ointments, eliminate inflammatory swelling and reduce pain. When taken orally, they also help normalize body temperature.
	Surgical treatment	In case of purulent inflammation, the purulent focus is opened, pus and dead tissue are removed and drained. In case of widespread purulent lesion, part of the mammary gland is removed; in very severe cases, the entire gland can be removed.	The length of hospital stay depends on the severity of the condition. For purulent mastitis, hospitalization is required for at least 1 to 2 weeks.
Congenital anomalies of breast development	Surgical correction	Additional nipples and lobes of the mammary gland are removed, and in the absence of one or both mammary glands, prosthetics or other types of plastic correction are performed.	The length of hospital stay depends on the extent of the operation.
	Drug treatment	It is used for additional lobules that enlarge according to the type of mastopathy. Prescribed treatment with hormones and antihormones reduces the volume of the lobules.	The duration of treatment is at least 6 months.
Breast injuries	Applying a bandage	A bandage placed on the chest fixes the injured mammary gland, reducing pain.	Complete resorption of the hematoma ( hemorrhages) lasts 1 – 1.5 months.
	Antibiotics	Antibacterial drugs are prescribed to prevent inflammation at the site of bruise and hemorrhage.
	Local treatment (compresses and ointments)	Dry heat and anti-inflammatory ointments help resolve accumulated blood.
	Surgical treatment	To remove accumulated blood from the gland, a closed aspiration method is used ( puncturing with a needle and drawing out blood) or open surgery.
Problems associated with lactation and breastfeeding	Compliance with feeding technique	After feeding, you need to express milk and massage your breasts to stimulate the formation of new portions of milk and prevent its stagnation.	These rules should be followed throughout the entire period of breastfeeding.
	Emollient ointments	Ointments containing vitamin B and lanolin help heal cracked nipples and prevent dry skin.
	Proper nutrition	Food should be high in calories, contain proteins and vitamins to stimulate milk production.
	Physiotherapy	Physiotherapeutic procedures improve blood supply and metabolic processes in the mammary gland, resulting in increased milk production.	Physiotherapy sessions are carried out over 5 – 10 days.
	Hormonal treatment	A woman is injected intramuscularly with the pituitary hormone prolactin, which stimulates milk production in the mammary glands.	Prolactin is administered for 7 days.
Mondor's disease	Anti-inflammatory drugs	Eliminate the inflammatory reaction in the vein wall, reduce pain.	Treatment is carried out for 1 month ( sometimes longer).
	Local treatment (compresses and ointments)
	Physiotherapy
	Surgical treatment	If the course is prolonged and the veins are blocked by blood clots, the affected veins are excised.