Every third or fourth woman of childbearing age from 30 to 45 years old is faced with a common pathology affecting the mammary glands, with a long and incomprehensible name. Therefore, you should find out in time what fibrocystic mastopathy is from a medical point of view.

Fibrocystic disease or fibrocystic mastopathy of the mammary glands (FCM) is a focal formation with a non-malignant condition of the tissue of the mammary glands, which is formed against the background of an imbalance of hormones produced by the body, in which cystic formations and nodes of various shapes, structures and sizes appear. In this case, there is an abnormal relationship between the epithelium and connective tissue in the gland, both due to proliferation (growth) and atrophy (reduction).

To understand what fibrous mastopathy and cystic mastopathy of the mammary glands are, you need to understand the structure of the gland.

The mammary gland is formed by three types of tissue, the ratio of which is directly affected by age, hormonal fluctuations, and the condition of the reproductive organs. What kind of fabric is this?

1. Parenchyma is the glandular tissue itself, divided into lobes.
2. Stroma is a connective framework tissue that is located between the lobes and lobules.
3. The stroma and parenchyma are enveloped and protected by adipose tissue.

Most often, cystic and fibrous changes in the mammary glands are observed in the parenchyma; less often, stromal fibrosis occurs under the influence of hormones.

A diffuse process is defined in medicine as extensive, affecting a large mass of mammary gland tissue.

Fibrous - means abnormal growth of connective tissue of the mammary glands. Such stromal fibrosis can disrupt the structure of the lobes and ducts, leading to the appearance of abnormal structures in them.

The term cystic refers to the characteristic appearance of mastopathy.

Causes

The main causes of fibrocystic mastopathy of the mammary glands are due to imbalance of hormones - lack of progesterone, abnormally high production of estradiol, prolactin, somatotropin and prostaglandins. Deviations from the normal ratio between the amounts of these hormones lead to fibrocystic changes in the mammary gland.

Glandular mastopathy appears after a fairly long period of time, since it requires a combination of provoking factors of hormonal disorders and their long-term influence.

Similar provoking factors for fibrocystic changes include:

• premature puberty in girls, since early (before 11–12 years) menarche (first menstrual cycle) gives too high a hormonal load on the body, which also affects the condition of the mammary glands;
• menopause after 55 years due to prolonged exposure of hormones to fibro-adipose tissue;
• frequent abortions and miscarriages (due to sudden hormonal changes);
• absence of childbirth and pregnancy at all;
• gynecological diseases dependent on hormonal disorders (endometriosis, menstrual dysfunction);
• a short period of feeding the baby with breast milk, refusal of breastfeeding at all;
• hereditary factor (on the mother's side);
• age over 35 – 38 years;
• frequent or prolonged stressful situations, often provoking endocrine disorders;
• obesity (hormonal activity of adipose tissue leads to hyperproduction of estrogen);
• neoplasms in the hypothalamus (these tumors can disrupt the proper production of estrogens, FSH and LH);
• diseases of the liver, genitourinary organs, thyroid gland (hypo- and hyperthyroidism, thyrotoxicosis), diabetes mellitus;
• trauma, compression, inflammation of the mammary glands;
• uncontrolled use of hormonal drugs, birth control pills;
• iodine deficiency;
• sluggish intimate life, lack of orgasms (blood stagnation occurs in the vessels of the reproductive organs, causing ovarian dysfunction and subsequent changes in hormonal levels).

General symptoms

The severity of the symptoms of fibrous mastopathy is determined by the form of the pathology and concomitant internal diseases.

In diagnosing mastopathy of the mammary glands, the following main signs dominate:

1. Mastodynia (breast pain).

At the first stage of the disease, every tenth woman experiences pain in the mammary glands before menstrual bleeding, and this manifestation is falsely considered as a sign of premenstrual syndrome.

The pain can be moderate, intense, and has a different character (stabbing, aching, tugging), which is associated with the depth and activity of the process. With severe pain, it is sometimes impossible to touch the chest. After menstruation, the pain subsides, but as the mastopathy deepens, it becomes permanent, and its degree depends on the phase of the monthly cycle.

1. Swelling of the mammary glands (engorgement), associated with stagnation of blood in the veins.
2. Discharge from the mammary gland.

This characteristic symptom of the disease manifests itself only in half of the patients, indicating damage to the milk ducts by the fibrocystic process.

Most often, the amount of discharge from the mammary gland is insignificant, and the fluid appears spontaneously or when the nipple is squeezed. The contents resemble watery colostrum. Greenish or yellow color indicates the development of infection. A threatening symptom is the appearance of a brownish bloody fluid from the nipple, which raises suspicion of possible damage, capillary damage, tumor development and requires immediate examination.

1. Enlargement, tenderness and tension of the lymph nodes closest to the chest. This symptom is usually mild.
2. Depression, tearfulness, emotional instability, irritability (especially often manifested in pain).
3. The appearance of movable and fixed compactions, nodes in the thickness of the mammary gland, upon palpation of which the diagnosis of fibrocystic mastopathy is made during a routine examination by a mammologist.

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Forms and types of mastopathy

The classification of glandular mastopathy of the mammary gland involves the identification of the main forms of pathology: and nodular.

Initial stage for both forms

The primary stage of the disease is characterized by the development of limited processes in the chest.

When painful changes are limited to a certain area, focal breast fibrosis is diagnosed. In this case, compactions measuring 20 - 30 mm (usually single) of a round, oval shape are usually formed in the upper outer and inner quadrant (zone) of the gland.

It is in this area that the thickness of fibro-adipose tissue is especially pronounced, a large number of lymph nodes and large vessels are located around which inflammatory and tumor processes occur. Such local fibrosis of the mammary gland is considered as the initial stage of deep proliferation of fibrocytes (stromal cells).

The leading causes of this pathology are considered to be excessive estrogen release and progesterone deficiency, as well as a violation of neurohumoral regulation (the relationship between metabolic processes and neurogenic activity).

Fibrous form and its types

Adenosis, in which hyperplasia (proliferation) of the glandular epithelium of the lobes and milk ducts is pronounced. At the same time, the organ tissue retains its structure, and excessive growth of parenchyma is characterized by a significant increase in breast size.

Manifestations of mammary gland adenosis can be moderately acceptable (in girls) and pronounced, which manifest themselves in the development of a sclerosing type of adenosis. It is characterized by damage to the breast by accumulations of microcalcifications (salt deposits), with a certain degree of probability of the appearance of potential foci of cancerous cell degeneration.

Fibroadenomatosis is a fibrous mastopathy of the mammary glands, in which the fibrous component predominates. It is characterized by stromal proliferation, and in a later stage - multiple appearance. This benign cystic formation of the mammary gland is round, mobile, with a fairly clear contour and density, the appearance of which means that the disease has turned into a nodular form.

Fibrous pathology includes periductal fibrosis (plasmacytic), which is more common in women during menopause. With it, growths form in the form of infiltrates (clusters) of plasma cells around the milk ducts. Perivascular fibrosis is a type of periductal fibrosis in which abnormal stromal growth in the form of compactions of collagen fibers is observed around the milk ducts, blood and lymphatic vessels.

Separately, the state of fibrofatty involution (reverse development) should be highlighted. This is a physiological (not pathological) process in the mammary glands when a woman reaches menopause at normal age. The essence of the structural changes that occur is the replacement of parenchyma cells with connective and adipose tissue cells.

Leading signs of fibrous mastopathy:

• change in color and sensitivity of the skin over the affected area;
• heaviness, distension;
• discharge from the nipple similar to colostrum (from colorless to colored);
• moderate nagging pain, intensifying before “menstruation” with possible return to the armpit and shoulder;
• identification by palpation of enlarged, tense mammary glands with noticeable allocation of lobes and fine granularity.

Cystic form

With cystic mastopathy, small cavity structures form in the mammary gland.

The main signs of fibrocystic mastopathy in this form are:

• single and multiple small neoplasms in the form of dense blisters, clearly visible when palpated in a vertical position;
• tension in the mammary glands;
• sometimes – significant soreness of the seals when palpated;
• a slight increase in formations in this type of mastopathy and axillary lymph nodes before monthly bleeding;
• formation of dense strands (linear strand fibrosis).

According to the intensity of changes, fibrofatty and glandular-cystic mastopathy is divided into degrees: minor, moderate and severe, and its types depend on the nature of structural changes in the tissues.

The cystic form often includes fibroadenomatosis with a dominant cystic rather than fibrous component, as well as linear (interlobular) fibrosis, in which nodes and cord structures are formed against the background of stroma growth between the lobes and inside the ducts. In this case, ultrasound reveals clear echo signs of fibrocystic mastopathy.

Mixed form of fibrocystic mastopathy

This type of mastopathy often occurs in a mixed form, characterized by a combination of fibrofatty and cystic forms of the disease and their characteristic symptoms. Fibrous breast disease is well defined independently and can be seen on images during mammography.

Nodular mastopathy

Nodular mastopathy or localized adenomatosis in most cases is a further development of the disease. This type is a focal form of the disease, which in oncology is considered as a precancerous process. Nodes in tissues are easily palpable.

The types of nodular mastopathy include:

• cystic formations;
• fibroadenoma with a dominant cystic component;
• papillomas inside the milk ducts;
• leaf-shaped tumors;
• hamartoma, lipogranuloma, lipoma, angioma.

Features of nodular formations

1. If the nodes are of cystic origin, then they have a dense elastic structure, clear contours and shape, delimited from adjacent tissues.
2. Nodes in the form of foci of compaction are palpated as formations with pronounced lobes without obvious boundaries.
3. The dimensions of compaction areas reach 60 – 70 mm.
4. The pain syndrome is either insignificant or absent.
5. They can be single, multiple, detected on one or both sides (bilateral FCM).
6. Before the menstrual cycle, the lumps may enlarge, swell, and become painful.
7. Difficult to palpate if the patient is in a horizontal position during examination.
8. Peripheral lymph nodes do not enlarge.

Bilateral mastopathy

Damage to the fibro-fatty and glandular tissue of both glands means that bilateral fibrocystic mastopathy develops, indicating a persistent and serious hormonal disorder. Therefore, treatment requires mandatory normalization of the level and ratio of hormones, as well as identifying the cause of such an imbalance, including dysfunction of the ovaries, pituitary-hypothalamic system, thyroid gland, and adrenal glands.

The two-way process almost doubles the risk of cancerous degeneration of diseased cells.

Why is fibrous mastopathy dangerous?

Initially, glandular mastopathy was not considered a condition with a high risk of cancer.

But medical practice and research have revealed that breast fibrosis should be considered and treated as an intermediate pre-tumor condition, which can, with varying degrees of probability, lead to malignancy (the acquisition of malignant tumor properties by cells).

At an early stage, the disease responds well to therapy, so it is recommended that all diagnostic procedures be performed by a mammologist as early as possible and begin treatment for fibrocystic mastopathy without waiting for complications.

Nodular pathology can be proliferative (progressive) or non-proliferative in nature.

The most unfavorable form is the proliferative form, when the tissue actively grows with the formation of neoplasms in the milk ducts and on the internal walls of the cavity structures, with the further development of cystadenopapillomas. Such changes carry the threat of malignant degeneration.

Diagnostics

Before prescribing diagnostic measures, the doctor will examine, palpate the breast and collect an anamnesis. Already during the initial examination, the patient can be diagnosed with asymmetry of the mammary glands, swelling, venous pattern, change in the position and shape of the nipples.

Palpation of the breast must be carried out in the first phase of the monthly cycle. Palpation is carried out in two positions - standing and lying down. This is due to the fact that some neoplasms can be detected only in one of the body positions. Also, during the examination, the doctor may squeeze the nipples to determine the presence or absence of discharge.

To confirm the diagnosis, the following studies may be prescribed:

• mammography;
• Ultrasound of the mammary glands and pelvic organs;
• puncture. A puncture biopsy is necessary to differentiate FCM from cancerous tumors and other formations. During this procedure, the specialist will take a fragment of the tumor, which will later be sent for histological examination;
• determination of hormone levels;
• biochemical blood test;
• ductography;
• pneumocystography;
• thermography;
• MRI or CT.

Drug treatment of FCM

In order for mastopathy treatment to be as effective as possible, it is necessary to conduct a thorough diagnosis, based on the results of which the doctor will prescribe complex therapy. Conservative treatment can be carried out using non-hormonal or hormonal drugs.

Non-hormonal agents used to treat FCM:

1. Vitamins. Vitamin A has an anti-estrogenic effect, vitamin E enhances the effect of progesterone, vitamin B6 reduces the concentration of prolactin, vitamin P and ascorbic acid strengthen the walls of blood vessels, relieve swelling of the gland, and improve blood circulation in it. All of these vitamins have a positive effect on the functioning of the liver, namely, it inactivates estrogens.
2. Iodine preparations normalize the functioning of the thyroid gland and also participate in the synthesis of its hormones. In this connection, doctors prescribe Iodine-active, Iodomarin.
3. Sedatives and adaptogens. Sedatives – valerian, motherwort, peony tincture improve a woman’s psycho-emotional state and minimize the impact of stress on the body. Adaptogens (Rhodiola rosea, Eleutherococcus) increase immunity, have a positive effect on metabolism and normalize liver function.
4. Herbal medicines (Mastodinon, Remens, Cyclodinone) stabilize hormonal levels, reduce prolactin production, and stop pathological processes in the mammary gland.
5. Nonsteroidal anti-inflammatory drugs (Nise, Indomethacin, Diclofenac) relieve swelling and reduce pain by reducing the concentration of prostaglandins.
6. Diuretics (kidney tea, lingonberry leaf, or Lasix) relieve pain by removing excess fluid from the body, which leads to a decrease in swelling.

Hormonal therapy:

1. Gestagens (Pregnil, Utrozhestan, Norkolut, Duphaston). Drugs in this group reduce the production of estrogen in the second phase of the menstrual cycle. Experts recommend taking these medications for at least 4-6 months. Also, gestagens are prescribed for local use (Progestogel gel). This gel must be applied to the mammary glands for several months. This use ensures 90% absorption of progesterone and eliminates possible side effects observed with oral administration.
2. Prolactin production inhibitors (Parlodel). It is prescribed for obvious hyperprolactinemia.
3. Androgens (Danazol, Methyltestosterone, Testobromlecite). They are prescribed to older women.
4. Antiestrogens (Tamoxifen).
5. Combined oral contraceptives (Rigevidon, Marvelon). These medications are recommended for women under 35 years of age who have disorders of the second phase of the menstrual cycle.

Methods for removing tumors in the breast

Surgery to remove fibrocystic mastopathy is rarely prescribed. Surgical intervention is advisable in the absence of a positive effect from conservative treatment or in cases where there is a suspicion of a malignant process in the mammary gland.

Also, removal surgery cannot be avoided in the following cases:

• a woman or girl has been diagnosed with nodular fibrocystic mastopathy in a late stage;
• the presence of painful sensations that bother the patient;
• inflammatory process;
• suppuration of tumors in the chest or their rupture.

Operations to remove fibrocystic mastopathy are carried out in the following ways:

1. Enucleation. In this case, surgeons remove the tumor itself, leaving healthy breast tissue unaffected.
2. Sectoral resection. Along with the formation, part of the affected tissue is removed.
3. Radical resection (the mammary gland is completely removed).

For fibrocystic mastopathy, enucleation is often used. This intervention lasts no more than an hour, after which the woman is left in the hospital for several hours for medical supervision. If no complications arise during this period, she is discharged home. After 10-12 days, postoperative sutures are removed.

Consequences and recovery after surgery

During the recovery period after surgery, it is recommended to strictly follow all recommendations of the attending physician:

1. Regularly change the bandage and treat postoperative sutures to speed up the healing process of wounds and prevent their infection.
2. Take all medications prescribed by your doctor. These can be antibiotics, hormonal drugs, agents to accelerate tissue regeneration, anti-inflammatory drugs.
3. Keep calm. Bed rest must be observed for at least 4-5 days to prevent the stitches from coming apart.
4. Eat properly and nutritiously, follow the diet prescribed by a specialist.

At the time prescribed by the doctor, the patient must undergo a medical examination, during which her sutures will be removed and a further course of therapy will be prescribed.

As a rule, the recovery period after removal of fibrocystic mastopathy passes without complications. The mark after the operation remains barely noticeable, it can be quickly eliminated with the help of modern medical cosmetology.

But even after surgery, it is necessary to undergo regular examinations with a mammologist, since the risk of cells degenerating into a malignant tumor still exists.

Since the removal of fibrocystic neoplasms in the breast is still an operation, it can provoke the following complications:

• bleeding;
• the appearance of a hematoma in the chest cavity;
• inflammation and suppuration of the wound;
• asymmetry of the mammary glands;
• atrophy of the pectoral muscle;
• nerve or vascular damage.

Relapse of the disease can occur in the presence of foci of pathologically altered tissue, which can occur if the surgical margin is incorrectly defined.

If the disease is not treated promptly, the consequences of FCM can be very serious. The most dangerous complication of the disease may be breast cancer. The initial stages of the malignant process are usually non-invasive, and important organs are not affected, so the early stages are treated quite successfully. But in medicine there have been cases when cancer is invasive in nature, and then the following forms of oncology may occur:

1. Ductal cancer, which is localized in the wall of the duct. Characterized by rapid growth. The tumor can spread beyond the milk duct in a short time.
2. Lobular cancer initially affects the breast tissue, but gradually spreads beyond it.
3. Inflammatory cancer is rare. It has a similar clinical picture to mastitis, which is why differential diagnosis is so important.
4. Ulcerative form of cancer (Paget's cancer).

Prevention and contraindications

First of all, the prevention of fibrocystic mastopathy consists in eliminating the underlying diseases that give impetus to its development. It is also necessary to exclude external provoking factors.

Every woman must regularly conduct an independent examination of the mammary glands and if the shape of the breast changes, pain, discharge from the nipples and other alarming signs appear, immediately seek advice from a mammologist.

It is important for girls to choose the right bra - preferably it is made from natural fabrics, and also that it does not deform or strongly compress the mammary glands.

Good prevention of fibrocystic mastopathy is childbirth and a long period of breastfeeding. It is necessary to avoid abortions, live a full sex life, try not to react to stressful situations, eat right and lead an active lifestyle. Patients are advised to give up coffee, strong tea, flour and sweets. Many doctors associate the appearance of fibrous structures in the breasts with abnormalities in the intestines, so girls should eliminate constipation and normalize the bacterial flora.

If you have fibrocystic mastopathy, it is not recommended to drink alcohol, smoke or warm the mammary glands (visit saunas and steam baths).

Fibrocystic mastopathy is a pathology that requires immediate treatment. Delay and uncontrolled use of medications can only worsen a woman’s condition and lead to the transformation of a benign neoplasm into a malignant one.

Mastopathy is a very general diagnosis, which includes all benign neoplasms in the mammary gland. They are not dangerous for a woman’s health, but they cause a lot of inconvenience, from pain and heaviness to changes in the shape of the breast.

Timely treatment of fibrous mastopathy of the mammary glands, which is prescribed by the attending physician, will help get rid of unpleasant symptoms. The choice of therapy depends on the severity of the condition and the type of tumor.

In the article we will talk about fibrous mastopathy of the mammary glands, what it is, treatment of the disease.

In combination with external agents, tablets and capsules help correct hormonal levels using the body's own defenses. If this is not enough, it is prescribed.

Patients are often prescribed the latest generation of contraceptives, which have virtually no contraindications. The only restriction for taking them is pregnancy. For diffuse forms, long-acting contraceptives implanted under the skin work well.

For fibrous mastopathy, medications not only promote the resorption of fibroids and relieve pain, but also prevent neoplasms in the ovaries or uterus.

Tablets, creams and vaginal suppositories containing natural prolactin or its analogue have a good effect.

It acts very gently; preparations with prolactin are used even by pregnant and nursing mothers. To relieve pain symptoms, heaviness and swelling, a variety of products are used, the application of which is combined with a light massage.

More severe forms with large nodular fibroids are treated with injections of testosterone or steroids. Such therapy has a number of contraindications; they cannot be used for problems with the thyroid gland, pregnancy, or frequent miscarriages.

Surgery is rarely used; usually partial resection is indicated if tumor degeneration is suspected. In this case, the tissues are sent for a biopsy, and depending on the results, the patient may be prescribed chemotherapy.

IMPORTANT! For the treatment of fibrous mastopathy, drugs should only be prescribed by a doctor!

Taking medications for fibrous mastopathy can be supplemented with home recipes. Typically, mammologists recommend herbal teas for brewing as tea, compresses and lotions to relieve pain.

To reduce swelling, applications made from a mixture of rye flour and honey are useful; they cope well with small fibroids and can also be used for nodular forms.

For diffuse mastopathy, compresses from mashed leaves of white cabbage and burdock, homemade ointments based on propolis, celandine, calendula, and hop cones are used.

A very important point in the treatment regimen is. To successfully get rid of fibroids, you need to reduce the amount of fat in the body.

Subcutaneous fatty tissue provokes an increased release of estrogen, which not only slows down the treatment of benign fibroids, but also serves as a favorable background for the generation and proliferation of malignant cells.

To avoid the risk, reduce your total daily caloric intake to 2000 kilocalories.

The diet is based on avoiding fatty foods: whole milk, cream, red meat, lard, hydrogenated vegetable oil. For tumors, a variety of canned foods are contraindicated: meat, fish, vegetables.

Products containing high amounts of salt, which retain fluid and increase swelling, are prohibited..

To improve digestion, include in your menu low-fat fermented milk products, fresh vegetables rich in natural sodium, selenium, magnesium and potassium: potatoes, carrots, cabbage, tomatoes, cucumbers, eggplants, zucchini, legumes.

Products containing iodine have an excellent antitumor effect: seaweed, shellfish, river or freshwater fish.

Instead of store-bought sweets, eat fresh or baked fruits and red berries, rich in vitamins C and A.

When treating fibrous mastopathy, you need to carefully monitor your health.

The growth of tumors and increased pain symptoms are a good reason to change the treatment regimen.

The doctor may make adjustments, suggest more effective hormonal therapy, or order additional tests.

What can’t be done with fibrous mastopathy?

If mastopathy is diagnosed, it is necessary:

• give up alcohol and smoking;
• avoid stress;
• do not visit the bathhouse and sauna, refuse warming compresses and other thermal procedures;
• Avoid tanning and use sunscreen with an SPF of at least 30;
• All treatment options should be agreed with your doctor;
• Monitor your response to medications so you can quickly stop those that are not appropriate.

Now you know what fibrous mastopathy is and how to treat the disease. It is important to remember that fibrous mastopathy is a disease that can be successfully combated.

The joint efforts of the patient and the attending physician will give the desired result as quickly as possible. Treatment usually takes 3-6 months, but earlier diagnosis will significantly speed up recovery.

You can find additional information on this topic in the section.

Fibrous mastopathy is benign dysplasia of breast tissue, a disease characterized by the formation of a fibrous node. For fibrous mastopathy, treatment takes a very long time and is not always effective. Upon palpation, a woman feels a dense, round-shaped formation with clear boundaries in her chest, which easily moves when pressed.

Fibrous mastopathy most often affects women of reproductive age; in terms of prevalence, it occupies one of the first places among tumor pathologies. Some forms of fibrosis can degenerate into transient cancerous forms. This is the main reason that fibrous mastopathy must be taken very seriously and promptly undergo treatment for this disease.

No specialist can say exactly why the disease occurred. The mammary gland is an organ sensitive to external and internal factors. The most common cause of fibrosis is an imbalance of sex hormones. During puberty, during pregnancy and breastfeeding, a woman’s body synthesizes estrogens, progesterone, prolactin and testosterone in different percentages.

Thanks to this, he quickly adapts to new living conditions. However, if under the influence of internal factors - illness or external - stress, smoking, excessive tanning, poor nutrition, an imbalance of sex hormones occurs, then the breast and uterine tissues are the first to suffer from this. The connective tissue located between the lobules of the mammary gland receives an impetus for growth. Its growth becomes the cause of the formation of a fibrous node.

Modern life with its stressful loads, unhealthy environment and high career pressures contributes to an increase in the number of diseases of breast fibrosis. Every woman should learn to self-examine the condition of the mammary glands and do it regularly on days 10-12 of the menstrual cycle. In addition, it is necessary to undergo a medical examination once a year with a mammologist and have a mammogram of the mammary glands.

What symptoms are characteristic of the disease?

Fibrous mastopathy of the mammary glands does not cause any pain, so a woman can live with it for years without noticing that there is a problem. But if you pay close attention to your body, you will notice that during the premenstrual phase of the cycle, the breasts become very distended (the knot compresses the swollen glandular epithelium and enlarged milk ducts), and pain appears that is stronger than usual. With advanced fibrosis, pain may radiate to the shoulder or shoulder blade. Quite rarely, liquid begins to come out of the nipple - clear or cloudy. As fibrous mastopathy develops, the mammary gland can visually change its shape due to a growing tumor. Because of this, the skin of the breast becomes thinner, stretch marks appear on it, and the areola and nipple darken. The disease can provoke general malaise - lethargy, fatigue, depression and insomnia.

The main symptom of the disease is the presence of a lump in the chest, although it is also characteristic of other pathologies. In order to make an accurate diagnosis, diagnostic studies will be required.

How is fibrous mastopathy diagnosed?

Most often, the disease affects one of the mammary glands, although there are cases of mastopathy in both breasts. The fibrous node can grow into the lumen of the milk duct or cover it. There are also mixed forms of fibrous mastopathy. The greatest danger is the leaf form of fibrosis, which grows very quickly and reaches gigantic forms. It is also prone to degeneration and often becomes the cause of the development of mammary gland sarcoma - a very dangerous disease that is transient and difficult to treat.

The essence of diagnosis for fibrous mastopathy comes down to determining the exact location of the tumor, its size and histology. For this purpose the following is carried out:

• Mammography of the breast in different types of projection
• ultrasound examination, during which tissue is taken from the fibrous node for histology
• cytological and histological examination of the affected tissue to detect modified and cancer cells

If the attending physician is in doubt, he can prescribe additional blood tests for hormonal status, tumor markers and biochemistry, and refer the woman for a consultation with a gynecologist and endocrinologist.

Treatment tactics for fibrous mastopathy

What methods can be used to treat fibrous mastopathy? Experts believe that tumors with a predominant fibrous component, which are less than 1 cm in diameter, do not require treatment. Women who are diagnosed with them are registered at the dispensary, come for a consultation with a mammologist every six months and undergo diagnostic tests - mammography and ultrasound of the mammary glands.

Tumors larger than 1 cm require treatment. Depending on the nature of the disease and individual characteristics, the woman is prescribed:

1. conservative drug therapy
2. surgical treatment

Surgery is prescribed if conservative treatment has not brought the desired result, the tumor is prone to degeneration, and when examining histological samples, modified and cancerous cells were found.

Conservative drug treatment

How to treat the disease with conservative methods? Conservative treatment is selected for a woman individually, depending on the nature of the disease and the presence of concomitant pathologies.

It is aimed at:

• normalization of hormonal status
• destruction of the tumor
• elimination of inflammatory processes
• normalization of metabolism
• normalization of the thyroid gland and liver

At the same time, medications are prescribed according to symptoms, which relieve pain and discomfort in the chest, calm the nervous system, and stimulate the immune system.

Particular care must be taken when using hormonal medications. The selection of doses and course duration is solely the prerogative of the doctor. Uncontrolled use and self-medication can complicate the course of fibrous mastopathy and even provoke malignant degeneration of the tumor. As a rule, oral contraceptives are prescribed for treatment in small courses. Systemic treatment with hormonal drugs is effective in exceptional cases associated with complicated pathology. Depending on the nature of the problem, medications may be prescribed that contain therapeutic doses of estrogens, gestagens, testosterone, or that reduce the production of prolactin.

When prescribing hormonal drugs, the woman’s age is also taken into account. After 45 years, drugs with synthetic progesterone and diuretics that relieve excessive swelling, such as Danazol or Utrozhestan, are most often prescribed. Younger women are prescribed oral contraceptives with a different ratio of sex hormones, such as Marvelon, Jastin, Duphaston. Young girls are not prescribed hormonal drugs.

It should be noted that the disease can be cured only in 5% of cases. The fact is that mastopathy with a predominance of the fibrous component practically does not resolve.

Surgical treatment

Today, two tactics of surgical treatment of fibrosis are practiced:

• enucleation or enucleation of a fibrous node while preserving healthy tissue
• resection - sectoral or entire mammary gland, if there are signs of tumor degeneration into a malignant neoplasm

The operations are considered simple and are performed from 30 to 60 minutes under local or general anesthesia. On days 7-10, the woman's stitches are removed.

Modern enucleation technologies involve the formation of internal sutures, which become invisible over time. In case of total removal of the mammary gland, reconstructive plastic surgery is indicated, during which the woman is given a silicone implant and the outer skin is formed.

During the postoperative period, it is important to follow a diet - enrich the diet with high-quality proteins and unsaturated fatty acids (fish, lean meat, nuts), exclude strong tea, coffee and chocolate. It is useful to take leisurely walks in the fresh air, avoid stressful activities, and it is also absolutely necessary to choose the right underwear that will support the breasts well and not squeeze the skin.

Folk remedies in the fight against disease

Alternative medicine offers a lot of recipes for local treatment of the mammary gland, which help improve tissue trophism, normalize metabolism, strengthen the immune system, and contribute to the destruction of fibrous tumors. It is important to remember that infusions, compresses, lotions, and ointments based on herbal raw materials also belong to medications and, along with their benefits, can be harmful. Therefore, before starting to use folk remedies, you should consult your doctor.

In the treatment of fibrous mastopathy, the following have proven effective:

1. Herbal teas using burdock root, red brush grass, motherwort, chamomile, fennel, hops, pine cones, string, coltsfoot, mint, valerian.
2. Preparations based on propolis and other bee products.
3. Compresses made from salt, cabbage leaves, lemon juice and castor oil.
4. Alcohol tinctures of calendula flowers.

Treatment with folk remedies is carried out in courses of 2-3 months, after which a break is taken.

Can fibrous mastopathy occur again?

Unfortunately, if a tumor process has already started in the body, then the manifestation of fibrous components may recur. To prevent this, you need to reconsider your lifestyle - establish proper nutrition, avoid severe nervous overload, and engage in outdoor sports at least 2 times a week. The psychological attitude is also important - you need to enjoy life. Experts recommend thinking about having a child; pregnancy and childbirth change the balance of hormones and serve as a kind of prevention of tumor pathologies.

Fibrous mastopathy of the mammary glands is a pathological condition in which there is an unnatural proliferation of connective tissue of the glands with a predominance of the fibrous structure. Breast diseases should be taken very seriously, since any process in this localization can serve as an impetus for the development of more dangerous pathologies for health and life, in particular, the appearance of malignant tumors. In order to prevent the occurrence of the disease and, especially, complications, it is necessary to know as much information as possible about mastopathy.

ICD-10 code

N60 Benign breast dysplasia

Causes of fibrous mastopathy of the mammary glands

The main causes of fibrous mastopathy of the mammary glands are failure of hormone production, lack of progesterone and increased production of estrogens in the female body.

Hormonal balance is an important component of a woman’s physical and reproductive health. Its disorders can occur due to many factors:

• artificial termination of pregnancy (when hormonal changes in the body of a pregnant woman have already begun, the glandular tissues of the mammary glands are in preparation for an important mission - feeding the child; forced suppression of such a process most likely leads to the development of mastopathy;
• pathology of the reproductive system (inflammatory processes in the genital area, especially chronic and infectious etiologies);
• prolonged absence of sexual intercourse;
• disorders of menstrual function (during the normal course of the cycle, there is usually a decrease or increase in the level of certain hormones depending on the phase; menstruation disorders are usually associated with a discrepancy in the amount of hormones for a given period of the cycle);
• any endocrine pathology (thyroid dysfunction, diabetes, obesity) can affect hormone-sensitive organs such as the mammary glands;
• a woman’s natural purpose – giving birth to children – has a beneficial effect on natural hormonal levels; long-term absence of pregnancy, sexual activity, forced cessation of breastfeeding adversely affects the condition of the mammary glands;
• frequently recurring stressful situations also lead to hormonal imbalance and can trigger the development of mastopathy;
• bad habits (cigarettes, alcohol) do not contribute to normal hormonal function;
• abuse of solariums and tanning, especially topless sunbathing;
• hereditary factor.

Symptoms of fibrous mastopathy of the mammary glands

Fibrous mastopathy is a pathological condition that sooner or later occurs in almost every second woman. The initial signs of the disease are not particularly pronounced and are often ignored by patients. Such manifestations may be:

• breast tenderness during the luteal phase and during menstruation;
• engorged breasts, noticeable increase in volume;
• feeling of discomfort and pressure in the mammary glands.

Pronounced premenstrual syndrome should also alert a woman, as this may signal the presence of certain hormonal problems.

As the process progresses, more striking symptoms of fibrous mastopathy of the mammary glands appear:

• significant ongoing pain in the breasts, or one of them, and the pain no longer depends on the period of the menstrual cycle;
• painful lumps appear in the chest, the discomfort intensifies when palpating the glands;
• Serous secretion from the nipple may appear.

If these symptoms are detected, you must immediately see a gynecologist or mammologist.

Forms

Fibrocystic mastopathy of the mammary glands

Fibrocystic mastopathy of the mammary glands is characterized by excessive proliferation of lobular tissue and the formation of compactions that have clear boundaries within the glandular lobule. This form of breast disease is most common in middle-aged women and can manifest itself in one or two glands at the same time.

As a result of a hormonal disorder, the frequency of changes in the physiology of the gland tissue is also disrupted, which favors the development of the fibrocystic form of the disease. The disease can occur against the background of disturbances in the processes of ovulation, menstruation and reproductive function.

The fibrocystic nature of the pathology is manifested by the formation in the glandular organ of tumor-like formations of various diameters from 0.2 to several centimeters, located locally or distantly from each other. These formations are not fused with the surrounding tissues and have some mobility upon palpation. No enlargement of peripheral lymph nodes is observed.

With the end of menstruation, cystic formations usually do not disappear, increasing in size over time and causing more and more discomfort. These manifestations must be differentiated from cancer.

Diffuse fibrous mastopathy of the mammary glands

Diffuse fibrous mastopathy of the mammary glands is determined by fibrosis of the epithelial tissues of the organ and the formation of single or multiple intracanal cystic tumors, more often in old age. Sometimes one can observe various manifestations of proliferation and dysplasia of the lobular structure of the mammary glands, the phenomenon of connective tissue fibrosis (the formation of compactions with the development of scar tissue changes).

The diffuse form of the disease is characterized by severe pain when palpating the glands. By palpation, you can determine signs of diffuse tissue compaction, the presence of small cystic formations of a round or oblong shape, elastic consistency. Such cysts can practically disappear at the end of menstruation, appearing again with the beginning of the cycle. There is constant discomfort, regardless of the periodicity of the cycle, as well as symptoms such as a feeling of fullness in the mammary glands, the presence of uniform tissue compaction, and homogeneous oblong formations are felt upon palpation.

Diagnosis of fibrous mastopathy of the mammary glands

Diagnosis of fibrous mastopathy of the mammary glands begins with a visual examination and palpation examination. If necessary, mammography, ultrasound, puncture biopsy of fibromatous nodes, and cytology of the material taken are prescribed.

It is more advisable to carry out a visual examination in the first phase of the cycle after the cessation of menstrual flow, since the second phase, aggravated by premenstrual syndrome, can provoke erroneous symptoms.

External examination includes assessment of the symmetry of the contour of the organs and the uniformity of the skin. A visual examination is carried out from different angles with the patient lying and standing. Attention should be paid to the condition of the peripheral lymph nodes.

The ultrasound research method is quite informative regarding the tissue structure of the mammary glands, which makes it possible to determine the nature of the formations, their size and location, and also provides the opportunity for simultaneous examination of nearby lymph nodes.

The mammographic method is an X-ray of the breast taken from different angles.

The method is quite effective, but has a number of contraindications for use: pregnancy and breastfeeding, as well as the young age of the subject. Mammography is not recommended more often than once every two years.

The diagnosis of fibrous mastopathy should be made only on the basis of a comprehensive examination of the patient.

Treatment of fibrous mastopathy of the mammary glands

Treatment of fibrous mastopathy of the mammary glands is usually carried out on an outpatient basis under the supervision of a doctor; therapeutic methods are prescribed taking into account the patient’s age, her hormonal state and the degree of development of the disease.

Taking hormonal medications is possible to stabilize the level of hormones in the body. Such drugs are prescribed after passing the necessary tests for the levels of progesterone, estradiol, prolactin in the blood at a specific period of the menstrual cycle:

• gel liniment progestogel contains progesterone and is applied topically (on the skin of the mammary glands);
• Livial is a hormone replacement therapy used during menopause;
• Utrozhestan, Duphaston - natural and synthetic analogues of progesterone;
• Tamoxifen is a strong anti-estrogen, used in the treatment of cystic, fibrous and other formations, including in oncology.

General strengthening therapy is aimed at increasing the body's immune defense. For these purposes, it is recommended to take complex preparations containing vitamins and microelements.

If there is a psychological factor in the development of mastopathy, they resort to prescribing sedatives and tonics (preparations of motherwort, valerian, hops).

Uncomplicated forms of the disease can be quite effectively cured by prescribing herbal medicines (phytolon, klamina, mastodinone).

In cases where conservative treatment does not bring a positive result, fibrous nodes are removed surgically.

Traditional medicine is a good support in the treatment of fibrous mastopathy:

• Effectively applying fresh cabbage leaves or burdock leaves (shiny side inward) to the affected breast promotes the resorption of formations;
• lubricating the mammary glands with burdock oil (mix 1 part of ground burdock root with 3 parts of olive oil, leave in a warm place for 10 days, then strain and store in the refrigerator);
• hemlock tea - drink constantly until symptoms disappear;
• an infusion of equal parts of peppermint, dill seeds, chamomile flowers and valerian root in a glass of boiling water, take half a glass three times a day.

Treatment of mastopathy also involves prescribing a certain diet with a limit on coffee drinks, chocolate and spicy seasonings; taking a large amount of liquid in the form of herbal teas and still mineral water is encouraged.

Prevention

Prevention of fibrous mastopathy of the mammary glands is the best way to avoid an unpleasant disease. It includes maintaining a healthy, fulfilling sex life, maintaining psychological balance, and timely treatment of pathological processes in the reproductive system.

A woman should take full responsibility for the possible consequences of forced termination of pregnancy, and also avoid any factors that provoke changes in hormonal levels in the body.

A healthy lifestyle, nutritious nutrition, avoidance of alcoholic beverages and smoking significantly strengthen the immune system and contribute to the opposition of protective forces in the onset of the pathological process.

Periodic self-examination of the mammary glands, carried out approximately from the sixth to the twelfth day of the cycle, allows you to detect pathology in time and begin treatment in a timely manner. During the examination, special attention should be paid to the symmetry of the glands, changes in the shape of the breast, the color of the skin, and the presence of enlarged lymph nodes in the axillary area. If suspicious lumps or secretory discharge from the nipples are detected, it is imperative to undergo further examination by a qualified gynecologist or mammologist.

Forecast

The prognosis of fibrous mastopathy of the mammary glands, provided timely treatment is carried out, is generally favorable, although repeated relapses of the disease cannot be ruled out, including after surgical removal of cystic formations. A history of mastopathy requires periodic examination by a mammologist in the future to avoid re-development of the pathology.

The manifestations of the disease do not pose a danger to the patient’s life, however, untreated mastopathy that has existed for a long time poses a danger of degeneration of the pathological focus into a malignant formation, which is why timely adequate treatment is an extremely important part of a successful prognosis.

In addition, it should be noted that the treatment of fibrous mastopathy in the early stages of development is much easier and more effective than the same treatment for an advanced form of the disease.

The mammary gland is a very delicate and vulnerable organ that requires caring and attentive treatment. Careful prevention and compliance with medical recommendations, regular self-examinations and medical consultations will protect women from such an unpleasant pathology as fibrous mastopathy of the mammary glands.

Before we begin treatment of fibrocystic mastopathy (FCM) of the mammary glands, we will explain in detail what this disease is.

The duration of the operation is 40 minutes.

Diet for mastopathy

When treating fibrocystic mastopathy, doctors pay attention to the patient’s nutrition. After all, products can affect the hormonal regulation of metabolic processes in the body.

Useful products:

• cabbage - it contains all the necessary vitamins needed for fibrocystic mastopathy. Blocks estrogen from entering tissues. It is better to eat cabbage raw;
• oranges, apricots, lingonberries and blueberries - contain many vitamins, macro- and microelements. In the summer you need to include fruits and berries in your diet.
• vegetables (especially tomatoes, dill and spinach) - rich in fiber, vitamins and minerals that affect the gastrointestinal tract.

For drinks, you should drink milk, tea or a fruit/berry drink.

If you have been diagnosed with fibrocystic mastopathy, then you need to be attentive to high-calorie foods.

Eliminate from your diet

• any types of meat;
• chips;
• sweet drinks;
• fast foods;
• foods containing cholesterol and sugar.