Adenosis of the breast

This type of mastopathy is characterized as a highly differentiated increase (hyperplasia) namely the lobules of the breast.

Adenosis of the breast is a benign tumor disease. This applies to mastopathy, which has a fibrous-cystic form, with a predominant amount of glandular tissue.

[1], [2], [3], [4], [5]

Causes of the adenosis of the breast

Each disease has its own prerequisites. The same applies to adenosis of the breast, the causes of which are as follows:

• Hormonal disorders that the female body has undergone. After such a malfunction, breast tissue begins to undergo transformations that threaten the health of women.
• This is the first and main reason why tissue changes occur in the female breast.

Hormonal problems do not arise on their own, but as a consequence of various problems:

• Various diseases of the female body, problems with the endocrine system and so on.
• In many cases, both hormonal problems and adenosis of the breast are caused by strong stresses and negative situations in which the woman experienced a lot of negative emotions.
• In addition, hormonal problems cause a decrease in the body's immune defenses, which can happen for a very wide range of reasons.
• The production of a large number of hormones by the female body in the first weeks and months of pregnancy, which leads to its strongest hormonal reorganization. In this case, the amount of estrogen as well as prolactin in the blood increases, but the level of progesterone decreases.

Mastopathy develops precisely for this reason - an imbalance of hormones, but with adenosis of the breast gland this hormonal failure is very long.

Quite often, the stimulus to the onset of the disease is pathological processes in the woman's small pelvis and in the endocrine system, which are of a hyperplastic nature, namely:

• hyperplastic processes in the endometrium of the uterus, when there is also an increase in the level of estrogen and a decrease in progesterone,
• dysfunction in the ovaries, which lead to the emergence of cysts that are of a functional nature,
• processes of a pathological nature that are different for the thyroid gland, for example, hypothyroidism and hyperthyroidism,
• dystrophic manifestations of the liver fatty character, which arise as a consequence of the excess weight of women, as well as a lot of fatty foods or easily digestible carbohydrates, which she often uses.

[6], [7], [8]

Symptoms of the adenosis of the breast

Five types of the disease are distinguished: sclerotizing, apocrine, protocol, micro-glandular, adenomyoepithelial. There is also focal adenosis of breast tissue. Symptoms of the disease vary depending on the type of problem. Each of the varieties will be described below in the corresponding section.

Symptoms of adenosis of the breast differ depending on its two main forms - local and diffuse. This division depends on the location of the tumor.

Common to all varieties of adenosis is the pathological transformation that affects the tissues of myoepithelium. In each specific form of the disease there are their own, only this kind of inherent changes in the tissues of the breast.

Also, periodic pain in the chest, which occur often enough. Pain can be either bursting or pulling. The level and frequency of pain begin to increase before the appearance of menstrual bleeding. Such pain sensations do not depend on the degree of the disease, and also on its form. In addition to the above pains, there are signs of breast engorgement that are observed in the luteal phase of the menstrual cycle.

No visual signs at first are observed. Discharge from the breast is absent, and the nipple in its size and shape does not acquire any transformations. The gland increases with periodic engorgement, either over the entire breast area, when the changes in the tissue are diffuse, or only a part of the mammary gland is enlarged and engorged. It depends on the form of the disease.

With a tumor type of disease in the breast tissues, a mobile node is found. It can be different in its structure: include several lobules or have a disc-like appearance. At the same time, the woman does not experience uncomfortable sensations, which does not imply an early appeal to specialists for diagnosis and treatment.

In some cases, adenosis of the breast is formed in parallel with another form of mastopathy, but this pattern does not affect the symptomatology and development of the underlying problem.

When examined by a specialist, you can identify some signs of a violation of the structure of breast tissue. In this case, it will be necessary to resort to palpation to detect seals affecting some parts of the breast. It happens that the data of tissue transformation affect the entire breast completely. This does not change the skin, as well as the shape of the breast. The lymph nodes in the disease are also not enlarged and visually function normally, except for the local form of the disease.

Consider the specific manifestations of some subspecies of the pathological process:

• With apocrine adenosis, the contours characteristic of the lobule of the breast are affected.
• In the tubular form in the mammary gland, the formation of retracted tubules is noted that are of the same size. These tubes are multiple, so they are easy to identify when viewed.
• In the micro-glandular form of the fibrous tissue of the gland begin to pierce small glands of round shape, and their amount is large enough and they are often located.
• With adenomyoepithelial form, the symptoms are similar to the previous form, with glandular manifestations, but this form of the disease is very rare.

[9], [10], [11], [12], [13]

Forms

Damage to the mammary glands, which affect the epithelium and are benign, can be divided into several categories, given their histological type:

• processes of tissue damage that are not characterized by active proliferation, that is, proliferation of pathological cells,
• processes of tissue damage that have active proliferation, but do not have atypical cells,
• processes of tissue damage with active proliferation and atypia in the structure of cells, also called atypical hyperplasia.

The glandular adenosis of the mammary glands, referred to in this article, refers to the first group of tissue damage. Therefore it is considered the safest manifestation of  various forms of mastopathy. In this case, the disease refers only to the glandular breast tissue and does not cause invasive breast cancer. Although the disease, fibrous tissue is formed in a hypertrophied degree, that is, excessively, while mixing and including healthy glandular cells. Such a process results in damage to the lobules of the mammary glands, which is not a positive development for a woman's health.

This problem in most cases is found in women who have reached the age of thirty or forty years. But in some cases, adolescent girls who have already reached the end of the puberty period may also be prone to the disease. No exception, and all women who are not out of childbearing age: young and older. Sometimes after conception in expectant mothers, the first few weeks may show signs of adenosis of the mammary glands. In some cases, the symptoms of the disease disturb the pregnant woman during the first trimester of expectation of the baby, and then go by themselves by the beginning of the second trimester.

Sclerosing adenosis of the mammary gland

The causes of this particular form of the disease include the disturbed balance of estrogen and progesterone in the body, as well as problems with the functioning of the thyroid gland, namely hypothyroidism.

Sclerosing adenosis of the breast is one of the forms of the disease that affects the lobules of the breast. It has the following manifestations:

• The most localized proliferation (proliferation of pathological tissues) to which the breast acinus, which is the unit of the structure of the breast, has undergone.
• In this case, the epithelial and myoepithelial layers of the acini are preserved, since they are surrounded by the basement membrane.
• Fibrosis of pathological tissues can sufficiently strongly restrict the acinus of the lobules that surround it. Therefore, the outlines of the lobules and their arrangement remain intact. Standard tests for adenosis can state a well-seen configuration of the lobules of the breast.
• Fibrous tissue is formed very quickly and in its growth necessarily alternates with glandular cells of the breast tissue.
• In the form of symptoms, this type of disease is characterized by the presence of small nodules, with sufficient mobility and density.
• There is an increase in axillary lymph nodes in some cases of the disease.

[14], [15], [16], [17]

Diffuse adenosis of the mammary gland

This form of the disease is characterized by the following manifestations:

• Seals in the chest do not have clear shapes and no boundaries.
• The neoplasm develops unevenly, that is, diffusely, across the entire area of the breast. That is, the increase in tissue is observed throughout the chest, and not in any particular area.
• During the progression of the disease, the compaction boundaries expand, affecting the gland tissues that surround this pathological entity. In this case, changes occur evenly over the entire area of the breast.
• In this case, there is a risk of damage not only to the breast tissue, but also the ducts of the gland, which leads to the formation of papillomas. Papillomas are benign tumors that occur on the skin or mucous membrane, and begin to protrude beneath the surface of these integuments, reminiscent of the papilla.

Diffuse adenosis of the mammary gland is distinguished due to the classification of the disease relative to the place of its spread.

[18], [19], [20], [21], [22], [23]

Focal adenosis of the mammary gland

With this form of the disease, the following changes in the breast are found:

• One of the mammary glands increases to a greater extent. There comes the so-called asymmetry of the breast.
• In the tissues of the enlarged breast, palpation reveals seals.
• Seals can be either single or multiple.

Focal adenosis of the mammary gland has the following manifestations of the disease:

• The tumor surrounds several ducts of the breast.
• The internal surface of each duct is lined with a cylindrical epithelium. And outside the ducts are surrounded by hyperplasic myoepithelium.
• Therefore, with this type of disease, it is possible to observe in the chest the outlines of a movable seal with a clear shape

[24]

Local adenosis of the mammary gland

Local adenosis of the breast is characterized by the following manifestations:

• In the affected breast begin to form seals, which are characterized by lobular structure.
• The formed lobules in size are large enough.
• Each lobule is surrounded by a fibrous capsule.
• Between the lobules is myoepithelial cells, which have a yellow color. They are very clearly visible in the diagnosis of the disease.
• Grouping of seals occurs only on a certain segment of the breast tissue, that is, affects a particular area and does not extend to the entire breast.
• It is possible to increase regional lymph nodes, which are located in the armpits and above the clavicles.

Diagnostics of the adenosis of the breast

It happens that changes in the glandular tissues of a fibrous nature begin to expand greatly. It is possible to affect the flow of the breast, which sometimes entails the development of oncological processes in the gland. To exclude such a complication, specialists can assign a histological, immunological and cytological study to a woman who is ill.

Diagnosis of adenosis of the breast is as follows:

With any symptoms that worry the woman, she turns to a gynecologist or mammologist. The examination, in the first place, includes examining the patient's breast and her palpation. If the anxiety of a woman is beginning to be shared by the doctors, then they assign her the following procedures:

• ultrasound examination, which should be exposed to the mammary glands, as well as axillary lymph nodes, if they are enlarged,
• mammography, which consists of x-ray exposure in small doses to the mammary gland for the purpose of obtaining a snapshot,
• clinical research,
• biochemical analysis,
• blood tests for TT, LH, FSH and other hormonal relationships.

Mammologic and ultrasound examination allows the doctor to see the localization of the source of the problem, as well as to find out what its shape and boundary are.

Sclerosing adenosis of the breast is manifested by nodules that outwardly resemble cancer. Palpation of the breast allows us to ascertain mobile seals, which have a clear form and increased density. Examination and mammological examination, which the specialist will do, can reveal the data of the densification, but not distinguish them from oncology. Therefore, in order to exclude malignant processes in the chest, it is important to conduct a biopsy of breast tissue.

[25], [26]

Treatment of the adenosis of the breast

If sclerosing adenosis reveals a single node or nodes that do not progress to growth, then surgery is not performed. At the same time, the examination is scheduled for a mammal and ultrasound is diagnosed once every six months.

Treatment of sclerosing adenosis of the breast is performed with the help of surgical intervention, during which sectoral resection is used. Anesthesia is chosen in general or local. Her appearance is determined by the number of nodes and their size, as well as the age characteristics of the patient and the history of the disease, in which this type of anesthesia is prohibited.

To make the operation cosmetically correct, specialists cut the areola along the edge, not paying any attention to the site localization. This is important in aesthetic considerations, so that the mammary gland after the operation has a decent appearance. The node that was cut during resection is most often sent for histological examination to clarify the diagnosis and exclude the presence of atypical cells.

After surgery, the patient can be sent home. At the same time, oral analgesics are prescribed to alleviate the pain after the operation.

Therapy for other forms of the disease depends on the type of adenosis and the nature of its course.

• Diffuse form requires the use of conservative treatment, which uses hormone therapy. Are appointed to receive combined oral contraceptives and gestagens.

At an easy stage of the disease, oral contraception is used for at least six months. Among the drugs shown Lindinet 30, which positively affects the glandular tissue, reducing its growth. In this case, women observed the disappearance of symptoms of adenosis, as well as the normalization of the menstrual cycle within a short period of time in two months.

The gestagens are shown when the disease has moved to a more serious stage. In this case, there is an increase in the symptoms of the disease, mainly before the appearance of menstrual bleeding.

Of the drugs can be identified the positive effects of Norkolut, Pregnin, Duftplon, Progesterone in the oily solution. They are usually prescribed for use in the luteal phase of the cycle, namely from the sixteenth to the twenty-fifth day. The dosage is selected by the doctor, and the effectiveness is noticed after two months of the drug. Women note the disappearance of signs of breast engorgement and a reduction in pain. The discharge from the nipples also ceases, or they decrease greatly in quantity. The course of treatment with drugs should be according to the minimum recommendations from three months to six months.

Sometimes, for this type of disease, specialists resort to the appointment of oral contraceptives of the type of Jeanine, Silhouette, Gengest, in which there is dienogest in the amount of two milligrams. The same medicines are also used for the therapy of endometriosis, which can cause adenosis of the breast.

In some cases, doctors resort to homeopathic treatment, for example, with the help of Mastodion. But we can note the appearance of only a temporary effect of relief of the symptoms of the disease. If you use the drug in combination with hormonal drugs, the effect will be long. Although nulliparous women, young girls, as well as with a mild form of the disease, the drug is prescribed independently.

• Focal forms of adenosis are treated only with the help of surgery. There is evidence that the local form of the disease is not inclined to regress, even if the correct hormonal treatment was performed. In this case, surgical intervention is a resection, that is, excision of an enlarged node of the breast. In fibroadenomatosis, an excisional biopsy can be used to exclude a suspicion of a malignant process. In this case, histological examination is carried out urgently.
• In any form of adenosis, the administration of vitamins A, B1, B2, B9, C, E and P.
• Also important is a diet that includes a large amount of fiber, namely greenery, vegetables, fruits, berries, whole-grinded cereals.

Prevention

First of all, the prevention of adenosis of the breast is the timely regular visits of specialists. These include gynecologists, and by indications and mammology. Starting from adolescence, a gynecological examination should be performed regularly, at least once a year. With existing endocrine disorders, gynecologists should be consulted twice a year, as well as regularly visit the endocrinologist.

Such measures will allow to identify the disease at the initial stage and start its treatment on time. This will help to avoid serious complications for the body and restore the woman's health.

It is also important to diagnose gynecological and endocrine diseases in time to prevent their development, as well as the appearance of unpleasant complications, such as adenosis.

Successful pregnancy is one of the factors preventing disease. There is a direct relationship with a good course of pregnancy and the absence of adenoses of the breast. Breastfeeding a child during the first year of his life is also an excellent prevention of fibrotic changes in the tissues of the breast. Undoubtedly, the absence of abortions is important, as the factors that lead to hormonal failures in the woman's body.

And of course, I want to say that there are no strong stresses, a normal psychological situation at home and at work for a woman. Since it is known that many hormonal disorders in beautiful women arise precisely because of shaken nerves and negative for the psyche environment.

Well, and finally, we remind you of the proper nutrition, without which it is impossible to be healthy under any circumstances. It is better to exclude almost all fat and smoked food, and also be careful with salty foods. But the products containing fiber, as well as fresh plant foods should be given preference.

Also feasible are feasible exercise - morning exercises, walking, swimming. In addition, it is necessary to perform exercises that involve the pectoral muscles, for example, push-ups.

[27], [28]

Forecast

I want to remind the ladies that such a problem is not an oncology, so you should not panic. The prognosis of mammary adenosis depends on its type and form, as well as the degree of hormonal disorders in a woman.

1. Future mummies who have this disease diagnosed can be happy that most of them adenosis will disappear in the second trimester of pregnancy.
2. At the initial stage of local or diffuse form, when a woman complies with all the prescriptions of the doctor regarding a healthy lifestyle, and also underwent appropriate treatment, the disease can be stopped forever.
3. With the progression of endocrinological problems, remission of adenosis is possible, even if it was successfully treated some time ago. Therefore, it is important to begin therapy of exactly the hormonal problem that led to the onset of adenosis. The same applies to the gynecological prerequisites of the disease.
4. In surgical interventions that remove nodes of altered glands, it is possible to stop the transformation of glandular tissue. Such progress depends on many factors, including the transition of a woman to proper nutrition and a healthy lifestyle. Also important is the psychological stability and the absence of a stressful situation, as well as periodic measures to maintain the hormonal background in an optimal state.

Adenosis of the breast is the easiest form of mastopathy, in which, however, it is very important to choose the right treatment for a successful recovery. To maintain health for many years and avoid the occurrence of more serious consequences for women of any age.

[29], [30], [31]