Hence it is clear that the excessive amount or lack of sex hormones disrupts the regulation of the activity of the glandular epithelium of the mammary glands and can lead to pathological processes in them.
Mastopathy is one of the most common diseases among women: its frequency is 30-45%, and among women with gynecological pathology - 50-60%. The most common cases are women aged 40-50 years, the incidence of mastopathy decreases, but the incidence of breast cancer increases.
Forms of mastopathy.
- Diffuse fibrocystic mastopathy:
- With the predominance of the glandular component;
- With the predominance of the fibrous component;
- With predominance of the cystic component;
- Mixed form.
- Nodal fibrocystic mastopathy.
Fibrous-cystic mastopathy with a predominance of the glandular component is clinically manifested by soreness, engorgement, diffuse densification of the entire gland or its site. Symptoms intensify in the premenstrual period. This form of mastopathy is often found in young girls at the end of puberty.
Fibrous-cystic mastopathy with predominance of fibrosis. This form of the disease is characterized by changes in connective tissue between the particles of the breast. With palpation, painful, dense, arched areas are identified. Such processes predominate in premenopausal women.
Fibrous-cystic mastopathy with predominance of the cystic component. With this form, many cystic formations of an elastic consistency are formed, well-bounded from the tissues. A characteristic symptom is pain, which intensifies before menstruation. This form of mastopathy occurs in women in menopause.
Calcification of cysts and the presence of bloody contents in them is a sign of a malignant process.
Nodular fibrocystic mastopathy is characterized by the same changes in gland tissue, but they are not diffuse, but localized as one or more nodes. Nodes do not have clear boundaries, increase before menstruation and decrease after. They are not connected to the skin.
The diagnosis is made on the basis of subjective symptoms (patient complaints) and objective examination, which includes palpation of the breast, in the supine position, standing with a sequential examination of all its quadrants.
Seals that are found during palpation, in most cases, are localized in the upper-external sectors of the gland. Sometimes the seals have a non-uniform consistency.
When pressing on the nipples may appear allocation - transparent, light or cloudy, with a greenish tinge, sometimes - white, like milk.
Special studies use mammography, which is performed in the first half of the menstrual cycle. Ultrasound is also done in the first phase of the cycle. Especially well, ultrasound determines microcystic changes and education.
Magnetic resonance imaging with contrast enhancement makes it possible to differentiate benign and malignant lesions of the mammary glands, as well as more clearly define the nature of lesions of axillary lymph nodes, which are often accompanied by not only malignant, but also benign processes in the mammary glands.
A puncture biopsy is performed followed by a cytological examination of the aspirate. The accuracy of the diagnosis of cancer with this method is 90-100%.
Women with menstrual disorders often suffer from fibrocystic mastopathy, and such patients are at risk for developing breast cancer. Therefore, a gynecological examination must necessarily include palpation of the mammary glands.
A woman who has found a tightening in the mammary gland is sure to be referred to an oncologist.
Treatment is prescribed only when all diagnostic methods have made sure that the patient does not have malignant formation. Fibroadenoma is to be removed surgically. Other forms of mastopathy are treated conservatively.