Mammary adenosis

This type of mastopathy is characterized as a highly differentiated enlargement (hyperplasia) of the lobules of the mammary gland.

Adenosis of the mammary gland is a benign tumor disease. At the same time, it refers to mastopathy, which has a fibrocystic form, with a predominant amount of glandular tissue.

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Causes mammary adenosis

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

• Hormonal disorders that the female body has been subjected to. After such a failure, the breast tissue begins to undergo transformations that threaten the woman's health.
• This is the first and main reason why tissue changes occur in a woman's 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 breast adenosis are caused by severe stress and negative situations in which the woman experienced many negative emotions.
• In addition, hormonal problems cause a decrease in the body's immune defense, which can happen for a very wide range of reasons.
• The production of a large amount of hormones by the female body in the first weeks and months of pregnancy, which leads to its strongest hormonal restructuring. At the same time, the amount of estrogen and prolactin in the blood increases, but the level of progesterone decreases.

Mastopathy develops precisely for this reason – hormonal imbalance, but with adenosis of the mammary glands, this hormonal imbalance is very long-term.

Quite often, the stimulus for the development of the disease is pathological processes in the woman’s pelvis and in the endocrine system, which are hyperplastic in nature, namely:

• hyperplastic processes in the endometrium of the uterus, when an increase in estrogen levels and a decrease in progesterone are also observed,
• dysfunctions in the ovaries that lead to the formation of cysts of a functional nature,
• pathological processes that characterize the thyroid gland, such as hypothyroidism and hyperthyroidism,
• dystrophic manifestations of the liver of a fatty nature, which arise as a consequence of a woman’s excess weight, as well as the large amount of fatty foods or easily digestible carbohydrates that she often consumes.

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Symptoms mammary adenosis

There are five types of the disease: sclerotizing, apocrine, ductal, microglandular, adenomyoepithelial. There is also focal adenosis of breast tissue. The signs of the disease vary depending on the type of problem. Each of the varieties will be discussed below in the relevant section.

Symptoms of mammary gland adenosis vary depending on its two main forms – local and diffuse. This division depends on the location of the tumor.

Common to all types of adenosis is pathological transformations that affect the tissues of the myoepithelial tissue. Each specific type of disease has its own changes in the tissues of the mammary gland that are specific to this type.

Periodic painful sensations in the chest are also characteristic, which occur quite often. The pain can be either bursting or pulling. The level and frequency of pain begin to increase before the onset of menstrual bleeding. Such painful sensations do not depend on the degree of the disease, as well as its form. In addition to the above pains, there are signs of breast engorgement, which are observed in the luteal phase of the menstrual cycle.

At first, there are no visual signs. There is no discharge from the breast, and the nipple does not undergo any transformations in its size and shape. The gland increases in size with periodic engorgement either over the entire area of the breast, when tissue changes are diffuse, or increases and engorges only part of the mammary gland. This depends on the form of the disease.

In the tumor type of the disease, a mobile node is found in the breast tissue. It can be different in its structure: it can include several lobules or have a disc-shaped appearance. At the same time, the woman does not experience discomfort, which does not suggest an early visit to specialists for diagnosis and treatment.

In some cases, breast adenosis develops in parallel with another form of mastopathy, but such a picture of the disease does not affect the symptoms and development of the main problem.

During a specialist examination, some signs of a disorder in the structure of breast tissue can be detected. In this case, it will be necessary to resort to palpation to detect compactions affecting some parts of the mammary gland. It happens that these tissue transformations affect the entire breast. In this case, there is no change in the skin or the shape of the breast. The lymph nodes are also not enlarged during the disease and visually function normally, except in the local form of the disease.

Let us consider the specific manifestations of some subtypes of the pathological process:

• In apocrine adenosis, the contours characteristic of the breast lobules are affected.
• In the tubular form, the formation of retracted tubes of the same size is observed in the mammary gland. These tubes are multiple, so they are easy to detect during examination.
• In the microglandular type, the fibrous tissue of the gland begins to be penetrated by small, round glands, and their number is quite large and they are located frequently.
• In the adenomyoepithelial form, the symptoms are similar to the previous type, with glandular manifestations, but this form of the disease is very rare.

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Forms

Lesions of the mammary glands that affect the epithelium and are benign in nature can be divided into several categories, taking into account their histological type:

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

Glandular adenosis of the mammary glands, which is discussed in this article, belongs to the first group of tissue damage. Therefore, it is considered the safest manifestation of various forms of mastopathy. At the same time, the disease applies only to the glandular tissue of the breast and does not cause invasive breast cancer. Although with the disease, fibrous tissue is formed to a hypertrophic degree, that is, excessively, while mixing and including healthy glandular cells. This process leads to damage to the lobes of the mammary glands, which is not a positive phenomenon for a woman's health.

This problem is mostly found in women who have reached the age of thirty or forty. But in some cases, teenage girls who have already reached the end of puberty may also be susceptible to the disease. All women who have not yet reached the age of childbearing are no exception: both young and older. Sometimes, after conception, expectant mothers may experience signs of adenosis of the mammary glands in the first few weeks. In some cases, the symptoms of the disease bother the pregnant woman throughout the first trimester of expecting the baby, and then disappear on their own by the beginning of the second trimester.

Sclerosing adenosis of the mammary gland

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

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

• The most localized proliferation (growth of pathological tissue) that affected the acini of the breast, which are the structural units of the mammary gland.
• At the same time, the epithelial and myoepithelial layers of the acini are preserved, since they are surrounded by a basement membrane.
• Fibrosis of pathological tissues can quite strongly constrain the acini of the lobules that it surrounds. Therefore, the outlines of the lobules and their location remain intact. Standard examinations for adenosis can state a clearly visible configuration of the lobules of the mammary gland.
• Fibrous tissue forms very quickly and in its growth necessarily alternates with glandular cells of the mammary gland tissue.
• In terms of symptoms, this type of disease is characterized by the presence of small nodules with sufficient mobility and density.
• There is enlargement of the axillary lymph nodes in some cases of the disease.

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Diffuse adenosis of the mammary gland

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

• The lumps in the breast do not have clear shapes or any boundaries.
• The neoplasm grows unevenly, that is, diffusely, over the entire area of the mammary gland. That is, tissue enlargements are observed throughout the entire breast, and not in some particular area.
• As the disease progresses, the boundaries of the compaction grow, affecting the glandular tissues that surround this pathological formation. In this case, the changes occur uniformly over the entire area of the mammary gland.
• In this case, there is a risk of damage not only to the breast tissue, but also to the gland ducts, which leads to the formation of papillomas. Papillomas are benign tumors that appear on the skin or mucous membrane and begin to protrude under the surface of these integuments, resembling a papilla.

Diffuse adenosis of the mammary gland is distinguished by the classification of the disease according to the place of its spread.

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Focal adenosis of the mammary gland

With this form of the disease, the following changes in the chest are detected:

• One of the mammary glands increases in size to a greater extent. The so-called asymmetry of the mammary gland occurs.
• When palpated, the tissues of the enlarged breasts reveal compactions.
• Seals can be either single or multiple.

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

• The tumor surrounds several mammary ducts.
• The inner surface of each duct is lined with columnar epithelium. And on the outside, the ducts are surrounded by hyperplasmic myoepithelium.
• Therefore, with this type of disease, the outlines of a mobile seal with a clear shape can be observed in the chest.

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Localized adenosis of the mammary gland

Local adenosis of the mammary gland is characterized by the following manifestations:

• In the affected breast, lumps begin to form, which are characterized by a lobular structure.
• The resulting lobules are quite large in size.
• Each lobule is surrounded by a fibrous capsule.
• Between the lobules are located myoepithelial cells, which are yellow in color. They are very clearly visible when diagnosing the disease.
• The grouping of seals occurs only on a certain segment of the breast tissue, that is, it affects a specific area and does not spread to the entire breast.
• There may be an increase in regional lymph nodes, which are located in the armpits and above the collarbones.

Diagnostics mammary adenosis

It happens that changes in glandular tissues of a fibrous nature begin to grow strongly. In this case, it is possible to affect the ducts of the breast, which sometimes entails the development of oncological processes in the gland. To exclude such complications, specialists can prescribe histological, immunological and cytological studies to the sick woman.

Diagnosis of mammary gland adenosis is carried out as follows:

If a woman experiences any symptoms that bother her, she should consult a gynecologist or mammologist. The examination primarily includes an examination of the patient's breasts and their palpation. If the woman's concerns are shared by doctors, they will prescribe the following procedures:

• ultrasound examination, which should be performed on the mammary glands, as well as the axillary lymph nodes if they are enlarged,
• mammography, which involves exposing the mammary gland to low-dose X-rays to produce an image,
• clinical research,
• biochemical analysis,
• blood tests for TT, LH, FSH and other hormonal ratios.

Mammological and ultrasound examinations allow the doctor to see the location of the problem, as well as to find out what its shape and boundaries are.

Sclerosing adenosis of the mammary gland is manifested by nodules that are very similar in appearance to cancer. Palpation of the breast allows one to identify mobile seals that have a clear shape and increased density. An examination and mammological study performed by a specialist can reveal these seals, but not distinguish them from oncology. Therefore, in order to exclude malignant processes in the breast, it is important to perform a biopsy of the mammary gland tissue.

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Treatment mammary adenosis

If a single node or nodes that do not progress to growth are detected in sclerosing adenosis, then surgical intervention is not performed. In this case, an examination by a mammologist and ultrasound diagnostics are prescribed once every six months.

Treatment of sclerosing adenosis of the mammary gland is performed by means of surgical intervention, during which sectoral resection is used. General or local anesthesia is selected. Its type is determined by the number of nodes and their size, as well as the age characteristics of the patient and the disease in the anamnesis, in which this type of anesthesia is prohibited.

To perform the operation cosmetically correctly, specialists cut the areola along the edge, without paying attention to the localization of the node. This is important for aesthetic reasons, so that the mammary gland has a decent appearance after the operation. The node that was cut out during the resection is most often sent for histological examination to clarify the diagnosis and exclude the presence of atypical cells.

After surgery, the patient may be sent home. Oral analgesics are prescribed to help ease the pain after surgery.

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

• The diffuse form requires conservative treatment, which uses hormonal therapy. Combined oral contraceptives and gestagens are prescribed.

At a mild stage of the disease, oral contraception is used for at least six months. Among the drugs, Lindinet 30 is indicated, which has a positive effect on glandular tissue, reducing its growth. At the same time, women observed the disappearance of adenosis symptoms, as well as the normalization of the menstrual cycle within a short period of two months.

Gestagens are indicated when the disease has progressed to a more serious stage. In this case, an increase in the symptoms of the disease is observed, mainly before the onset of menstrual bleeding.

Among the medications, the positive effect of Norcolut, Pregnin, Dufpstone, Progesterone in oil solution can be highlighted. 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 using the drug. Women note the disappearance of signs of breast engorgement and a decrease in pain. Nipple discharge also stops or is greatly reduced in quantity. The course of treatment with drugs should be, according to minimum recommendations, from three months to six months.

Sometimes, with this type of disease, specialists resort to prescribing oral contraceptives such as Janine, Silhouette, Genegest, which contain dienogest in the amount of two milligrams. The same medications are used to treat endometriosis, which can cause adenosis of the mammary gland.

In some cases, doctors resort to homeopathic treatment, for example, with Mastodyon. But only a temporary effect of alleviating the symptoms of the disease can be noted. If the drug is used in combination with hormonal agents, the effect will be long-lasting. Although nulliparous women, young girls, and also with a mild form of the disease, the drug is prescribed independently.

• Focal forms of adenosis are treated only by surgery. There is evidence that the local type of the disease is not prone to regression, even if the correct hormonal treatment was carried out. In this case, the surgical intervention is a resection, that is, excision of the enlarged node of the mammary gland. In case of fibroadenomatosis, an excisional biopsy can be used to exclude the suspicion of a malignant process. In this case, histological examination is carried out urgently.
• For any form of adenosis, vitamins A, B1, B2, B9, C, E and P are prescribed.
• Also important is a diet that includes a large amount of fiber, namely greens, vegetables, fruits, berries, and whole grains.

Prevention

First of all, prevention of mammary gland adenosis consists of timely regular visits to specialists. These include gynecologists, and, if indicated, mammologists. Starting from adolescence, gynecological examinations should be done regularly, at least once a year. If there are endocrine disorders, you should contact gynecologists twice a year, and also regularly visit an endocrinologist.

Such measures will help to detect the disease at an early stage and start its treatment in time. This will help to avoid serious complications for the body and will restore the woman's health.

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

A successful pregnancy is one of the factors preventing the disease. There is a direct connection with a good pregnancy and the absence of breast adenosis. Breastfeeding a child during the first year of his life is also an excellent prevention of fibrous changes in the tissues of the mammary gland. Undoubtedly, the absence of abortions is important, as factors leading to hormonal disruptions in the woman's body.

And of course, I would like to say about the absence of severe stress, a normal psychological environment at home and at work for a woman. Since it is known that many hormonal disorders in beautiful ladies arise precisely because of shattered nerves and a negative environment for the psyche.

Well, and finally, let's remember about proper nutrition, without which it is impossible to be healthy under any circumstances. It is better to exclude almost all fatty and smoked foods, and also be careful with salty products. But products containing fiber, as well as fresh plant foods, should be given preference.

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

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Forecast

I would like to remind ladies that this problem is not oncology, so there is no need to panic. The prognosis of mammary gland adenosis depends on its type and form, as well as the degree of hormonal disorders in a woman.

1. Expectant mothers who have been diagnosed with this disease can be happy that most of them will experience the disappearance of adenosis in the second trimester of pregnancy.
2. At the initial stage of the local or diffuse form, when a woman follows all the doctor’s instructions regarding a healthy lifestyle and has also undergone 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 for the hormonal problem that led to the development of adenosis. The same applies to gynecological prerequisites for the disease.
4. During surgical interventions that remove nodes of altered glands, it is possible to stop the processes of transformation of glandular tissue. Such progress depends on many factors, including the woman's transition to proper nutrition and a healthy lifestyle. Psychological stability and the absence of a stressful environment are also important, as are periodic measures to maintain hormonal levels in an optimal state.

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

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