Breast dysplasia
Medical statistics are disappointing and sound quite frightening figures of diseases affecting the mammary gland of a woman. And with each year, these indicators are increasing. One such pathology is mammary dysplasia, the varieties of which affect from 30 to 63 percent of the fair sex.
But if in a woman's history there are pathologies and a gynecological character, then this figure is frighteningly approaching 95%.
Causes of the dysplasia of the breast
So why does the disease appear and how does it manifest itself symptomatically? To avoid such a defeat or take adequate therapeutic measures, you need to know the causes of breast dysplasia, and pay special attention to your health. This disease behaves quite podstupno.
And it's not that ignoring his symptoms allows her to transform into a malignant tumor. Even in its benign form, dysplasia of the breast (also called fibrocystic mastopathy) delivers a significant discomfort to the woman.
- One of the main causes of dysplasia of the breast is the failure of the hormonal background. If the quantitative component of progesterone and / or estrogen changes in greater or lesser side, the probability of development of this disease sharply increases. In addition, mainly to this imbalance can be attributed:
- Decrease in the production of the thyroid enzyme (hypofunction).
- Hyperandrogenism - an increase in the level of male sex hormones (androgens) in women.
- Hyperprolactinemia is a condition of the body in which an excessive amount of the prolactin hormone is produced by the pituitary gland.
- The impetus to the development of the disease is apoptosis (the kind of cell death in which the cell itself actively participates in the process of its self-destruction). This disease is accompanied by an inflammatory process that worsens the structural and physiological position of the glandular tissues and the capillary system of the mammary glands. The consequences of such a metamorphosis can be very deplorable.
- Emotional long-term stress:
- Conflict situation of domestic character.
- Heavy psychological atmosphere in the work team.
- Sexual dissatisfaction. Other factors of a sexual nature.
- In many respects the origin of mammary dysplasia depends on the condition in which the female reproductive organs are located. And this applies not only to the breast, but also to the pelvic organs.
- Not the last place is taken and the time when the woman began the first menstrual cycle, the subsequent its natural course and the presence or absence of failures. The greater risk of getting anamnesis of breast dysplasia is experienced by the fair sex, in whom the menarche (the first menstrual bleeding) is observed quite early.
- The term of arrival of menopause is also important. If the climacterium has come already after fifty, such woman has more chances to get this disease.
- The probability of defeat increases with the increase in the number of abortions, both spontaneous and artificially induced.
- Inflammation occurring in the pelvic organs:
- Myoma of the uterus.
- Hyperplasia of the endometrium.
- And others.
- The source of dysplasia of the breast can be hepatopathy (liver pathology), as well as problems with metabolic processes in the body of a woman.
- If a woman in the family already had precedents of defeat, then her chances of getting this disease increase tenfold.
Symptoms of the dysplasia of the breast
The clinical picture of the disease shows such symptoms of mammary dysplasia:
- A woman suffers from pain symptoms in the chest, increasing her intensity in the premenstrual period.
- Pain symptomatology is observed in various strengths and manifestations.
- In most cases, it falls off at the end of the bloody discharge.
- If you do not stop the problem in the "embryo," the pain intensity increases and begins to capture all the larger areas. The axillary, humeral and shoulder areas fall into the area of pain.
- You can observe problems with sleep.
- Gradually develops carcinophobia - the fear of further transformation of a benign tumor into a malignant tumor.
- There are depressive moods.
Forms
Benign breast dysplasia
If the proliferative changes in connective, epithelial tissues (their abnormal ratio) begin to flow in the chest area, which are regressive in nature, then the formation of fibro - matic - cystic lesions proceeds, the doctors diagnose benign breast dysplasia (DDM). Diseases of this group dominate among all the pathological changes taking place in the mammary gland.
This category includes mastopathy and fibrocystic breast disease. According to unverified data, this type of disease occurs from 60 to 90 percent of women. Such figures are based on histological studies of the mammary glands of women who have died from various causes.
Benign dysplasia of the breast is divided into two categories:
- The proliferative variety of benign dysplasia is the predominant division of myoepithelium and the epithelium of ducts or lobes. Less often, it occurs when connective tissues are involved in this process. In the case of proliferative processes in the breast, the probability of degeneration into cancer cells increases two to five times, and in particularly difficult cases and in 14.
- In the case of non-proliferative varieties of benign dysplasia, the proliferation mainly affects the fibrotic cells, and the ducts increase according to the cystic variant. In this case, one node or conglomerate of nodules is formed, mainly this process takes place in one gland. There are fewer cases when the neoplasm developed from a hyalineized (fiber thickened) cicatrical connective matter, which is localized around the atrophic lobes. In this case, the risk of developing cancers is small enough.
A benign seal consisting of proliferating connective and glandular matter (fibroadenoma) is represented by a capsule of fibrous invoice and is considered as the proliferation of the epithelial layer of the alveoli, connective cells and the duct of the intralobular zone. According to statistics, fibroadenoma degenerates into cancer according to different data from 20 to 50% of cases. Although there are also such experimenters who categorically deny any risk of malignancy of the neoplasm of this category.
Another benign neoplasm is the intraprostatic papilloma. It is diagnosed as having papillary formations, formed from the epithelium of the protocol. There are fewer cases when this symptomatology is accompanied by a cystic enlargement of the ducts themselves. If the papilloma is one, it is not susceptible to malignancy, in the case of multiple neoplasms, the possibility of degeneration into cancer increases four to six times.
Dyshormonal dysplasia of mammary glands
Mastopathy of the breast includes a wide list of heterogeneous diseases that differ from each other both in etiological and morphological characteristics, are represented by different clinical pictures, but all of them are associated with disorders occurring in the structural structure of various breast cells.
Dyshormonal dysplasia of the mammary glands (or as it is called, mastopathy) is a fibro-cystic disease, defined as a failure in the proportionality of the fusion of the connective and epithelial cells, burdened with all sorts of proliferative regressive processes that radically alter the tissue component of the breast.
Representatives of medicine distinguish several types of dyshormonal dysplasia.
- Primarily it is necessary to stop at the nodal mastopathy, the parameters of which are single or multiple neoplasms of the nodular type. They, in case of diagnosis, are defined as local fibrosis, fibromatosis, adenosis, fibroadenomas, cysts and adenofibromas.
This type of pathology is difficult to diagnose, because very often the clinical picture of the disease is similar to both benign and cancerous pathologies. Definitely put the diagnosis, sometimes even cytology, x-ray study, sonography does not help. Having received ambiguous results of the examination, the doctor has clear indicators, which determine his further actions. The doctor, using relative and absolute indicators, accepts or rejects the decision about a surgical intervention, forms a protocol of treatment.
- The second type of pathology can be called diffuse mastopathy, which has its own subspecies.
- Adenosis is diffuse mastopathy with a predominant glandular component. This disease is more common in women of childbearing age, but not yet become mothers (that is, nulliparous). Symptoms of the pathology - pain in the area of the mammary glands, arising when pressing on the chest. At the end of the menstrual period, the pain symptomatology somewhat stops or completely ceases to disturb. Radiography shows a high contrast of formations, heterogeneity of the structure of glandular tissues. There are small seals with blurred edges with a diameter not exceeding one and a half centimeters.
- Fibroadenomatosis - diffuse mastopathy with an advantageous fibrous component. Pain symptomatology is quite moderate. When palpation of the breast tissues, fibrotic seals, differentiated on the roentgenogram by uniform darkened areas, are differentiated.
- Diffuse mastopathy with an advantageous cystic component. The clinical picture of the disease is represented by bursting pains in the region of the mammary glands. With pressure, numerous lumps of elastic texture with clearly defined boundaries are probed. Cysts of large sizes are well seen on the roentgenogram - areas of oval or round form of uniform texture, multiple small - polycystosis - on mammograms are almost indistinguishable. To confirm or refute the diagnosis of pathology of this type will help ultrasound examination of the mammary glands (ultrasound MF). It is this examination that gives the doctor the opportunity to specify the problem.
- Fibrous-cystic mastopathy is a mixed form of this pathology, most often diagnosed by mammologists, especially the high percentage of lesions are given by the fair-sex representatives aged 35 to 40 years. The disease is capable of capturing both one and both breasts. On the roentgenogram it is represented by a pattern in the form of mixing of large loops with compact spots with a diffuse contour. In addition to pain symptoms, there may be minor discharge from some ducts, regressive changes are seen in the structure of the gland. The doctor assigns a pictogram, which shows the changes in the milky ducts and the size of the cysts formed. Quite often in the subareolar milk ducts, one can observe an inflammatory process that leads to an expansion of the ducts.
- Other benign neoplasms:
- Papilloma inside the ductal zone.
- Cyst.
- There are also special types of benign tumors - phyloid or leaflike neoplasms.
The main reason for the transformations taking place in the gland is the reaction of the epithelial cells and the stroma that has arisen in the woman's body against the background of hormonal imbalance.
Severe dysplasia of the breast
Pre-cancerous condition is a congenital or acquired in the process of life-drunk deforming of tissue layers, which later becomes the basis for transformation into cancerous tumors.
Severe mammary dysplasia is stage III dysplasia, when atypism of the epithelial layer captures 2/3 or more epithelial cells. In their multilayered appearance, foci of growth with a heterogeneous structure arise. Proliferation affects the entire cell: hyperchromatosis of the cell nuclei and growth of its size, polymorphism and basal cell hyperplasia are observed.
In the layers of glandular epithelium, the severity of dysplasia is determined in the disorganization of the structural features of these neoplasms. The glands are located chaotically or take a branched character, while they differ in atypical characteristics. There is a glitch in the secretion. You can diagnose both the increase and the weakening of this function.
In most cases, severe mammary dysplasia is malignant in malignant tumors. At the same time, the reasons that become the catalyst for transformation are still completely unclear.
The mild and middle stage of dysplasia is partially or completely reversible in its morphology, with a severe degree of pathology tissue regeneration is no longer possible and the only treatment is complex therapy combining surgical intervention with medication support. Primarily pathological changes begin to capture the cambial regions, subsequently dispersing along the line of maturation of the same tissues.
The severe stage of dysplasia is considered by some to be an "imperfect cancer." In the chain of progressive development of the disease, malignancy is the final stage in cancer degeneration.There is a term such as carcinoma in situ that determines the condition of cancer tumors that are devoid of infiltrates, epithelial cells replaced by atypical ones the basal membrane is differentiated and the mag- alized cells do not penetrate into the underlying tissue layers.
Proceeding from the foregoing, severe dysplasia of the breast is a dangerous enough pathology capable of transforming into cancer, while the causes of degeneration and the catalyst of the process are unknown. Therefore, timely access to a specialist and the establishment of a diagnosis at an early stage becomes very important.
Fibrous dysplasia of the breast
Fibrosis is the proliferation of connective tissue, accompanied by the development of scarring, due to chronic inflammation. Any disease of this localization is very dangerous, because, for unknown reasons, it can degenerate into a cancerous tumor. Fibrous dysplasia of the breast mainly develops against the background of imbalance of hormones: there is a deficit of progesterone and excessive production of estrogens. This condition of the body occurs in almost half of women.
At an early stage of the pathology, it is impossible to recognize the disease, since it passes almost asymptomatically. It can only be diagnosed by accident during a preventive examination. Over time, the symptoms begin to manifest more clearly.
- During the period of the monthly breast "poured" and becomes painful when touched.
- A woman feels an uncomfortable condition in her chest, she is simply "bursting" from the inside.
- The symptoms of premenstrual syndrome become more pronounced.
- As the pathology worsens, the manifestations of fibrous dysplasia of the breast become more vivid.
- Pain loses its connection with the menstrual cycle and becomes more intense and permanent.
- When palpating, the painful seals are already clearly identified. Pain symptomatology increases with pressure on the mammary gland.
- From the nipple, serous discharge is observed.
If a woman observes a similar symptomatology, she should not postpone the trip to the doctor - a mammalogist or gynecologist - this is fraught with aggravation of the situation and an increase in the probability of degeneration into cancer.
Diagnostics of the dysplasia of the breast
Not all clinics are equipped with modern diagnostic equipment capable of recognizing pathological changes in the human body at an early stage. This is especially true for this disease. It is necessary that the diagnosis of dysplasia of the breast passes using the latest modern equipment and innovative methods of examination. After all, the reliability of the diagnosis depends on the intended therapy. If a specialist has even the slightest doubt about the correctness of the result, a duplicating study is assigned, but the patient passes it in another medical institution. This allows the doctor to get a more objective and reliable picture of the disease, which allows you to assign the most effective treatment.
The complex of diagnostic measures includes:
- Screening of patient complaints.
- Analysis of anamnesis of the patient.
- Clinical examination of the mammary glands of a woman.
- Physical examination by means of palpation of the breast. The examination is carried out both in a supine position and standing. Feeling is carried out carefully, without missing a single millimeter of chest.
- The mammologist necessarily examines and probes the lymph nodes of the supraclavicular, subclavian and axillary zones.
Inspection of the patient is carried out at a strictly defined time of the menstrual cycle. For menstruating women - this is the period from the seventh to the tenth day of the cycle. In addition to visual inspection during diagnosis, the X-ray scanning method is used. In this situation, it is the most informative. He is also known as the bilateral mammogram. Thanks to this technique, it is possible to recognize the disease in 95% of a hundred, determine its location and the extent of the lesion, and examine other glands. This approach to research allows us to select the most effective therapeutic tactics.
Here are just some of the advantages that a mammography examination has:
- The possibility of obtaining a multidimensional image of the mammary glands.
- The estimated information reaches 95%. This is especially true in case of nepalpable neoplasms.
- This study is widely used for both diagnosis and treatment of certain diseases.
- Possibility of dynamic examination of the organ.
Doppler ultrasound scanning is also used, which makes it possible to observe the organ under study in a color format. This study is also performed during the period from the seventh to the tenth day of the natural menstrual cycle and is an additional diagnostic method. Having high resolution, it allows to specify some details, supplementing the clinical picture of the disease, makes it possible to assess the level of quality of silicone implants. This diagnostic method is considered one of the safest in light of the dose loading.
In the case of presumed focal nodular dysplasia of the breast, a specialist, after analyzing the results of mammography, performs a biopsy, which is performed by taking a puncture with a very thin needle. Can appoint a doctor and magnetic resonance imaging (MRI), which allows you to get high resolution and contrast pictures.
Each of the above survey methods has its advantages and disadvantages, but in the complex it is ready to give an exhaustive clinical picture of the disease, which is very important for further treatment.
It is not superfluous to consult specialists of a different orientation, for example, an endocrinologist and / or gynecologist.
Treatment of the dysplasia of the breast
The main goal of any therapy is to remove the source, causing pathology and eliminate the factors that support its progression. Treatment of mammary dysplasia involves adjusting the hormonal balance in the body of a woman. For this purpose, successfully used drugs such as danol (danazol), a derivative of synthetic ethynethon, which work to suppress the function of the pituitary gland, which produces gonadotropic hormones that have luteinizing and follicle-stimulating characteristics.
Danazol is available in capsules, which are taken in a dosage of 0.2 to 0.8 g divided by two to four doses. Duration of therapy and dosage of the drug is prescribed exclusively for each clinical picture of the disease.
Do not prescribe a drug to pregnant women and those who are breastfeeding. Contraindicated in the case of porphyria. Particular care should be taken in the case of dysfunctional abnormalities in the work of the kidneys and the heart, with diabetes.
If the analysis showed a shortage of progesterone or estrogen, the doctor can assign the selective estrogen receptor modulators to restore normal levels: estroprogestin, linestrenol, progestin, tamoxifen or progestogen genes (dyufaston, progestogen, morning).
Linestrenol is taken internally. The dose of the drug is prescribed individually in the range from 5 to 15 mg daily. The duration of therapy is at least six months.
Contraindicated in the use of linestrenol, if in the patient's history there is an individual intolerance of the components of the drug, severe form of liver dysfunction, thrombophilitis, arterial hypertension, insulin-dependent diabetes mellitus, uterine bleeding of unknown origin, with congenital bilirubin metabolism during pregnancy.
The drug vobenzym taken no later than half an hour before meals or after two hours after eating. The starting dosage of the drug is three tablets three times throughout the day. The duration of treatment is prescribed from two to five weeks.
With a moderate disease, five tablets are taken three times a day. If severe pathology is diagnosed, the dose of vobenzima increases to seven tablets administered to the body three times a day, and when the therapeutic effect is achieved, the amount of medication taken is reduced to three tablets.
If surgery is planned to avoid complications or reduce their intensity, the patient starts taking three tablets three times a day five days before the proposed operation.
Contraindications of the drug include individual intolerance of individual components of the drug, in the case of thrombocytopenia or hemophilia, during the period of hemodialysis.
Appoints the attending physician and antiprolactin medicines. For example, bromocriptine, nor-prolak, parlodel. Do not be superfluous and vitamins.
Bromocriptine tablets are injected into the body of a woman in conjunction with food. The starting amount of the prescribed drug is represented by a figure of 1.25 mg. The best time to enter is the evening before bed. After two to three days, the dosage of the drug is increased to 2.5 mg. The next stage, again after two to three days, there is an increase in the amount of the drug to a figure of 1.25 mg, and so until the day when the daily amount of bromocriptine will correspond to 2.5 mg taken twice a day.
The drug is not recommended for people suffering from hypersensitivity to bromocriptine, the components of the drug or the derivative of ergocryptine, in the case of arterial hypertension, coronary heart disease, other cardiovascular pathology and severe psychological disorders.
In the case of severe pain symptoms, the patient is prescribed a homeopathic preparation of mastodinone, which has excellent tolerability, has virtually no contraindications, except for increased individual intolerance of the constituents of the drug.
The drug is taken two tablets twice a day. The course of treatment is from two weeks to three months.
In the treatment protocol, antihistamine and anesthetic drugs are often administered.
Diazoline in a dosage of 0.05-0.2 g is used one to three times a day immediately after ingestion. The maximum daily dosage of the drug should not exceed 0.6 g. It is very cautious to take in case of pathological changes observed in the digestive tract and with increased sensitivity to the components of the drug.
Codeine or tramadol (narcotic analgesic) or spasmolytic and anti-inflammatory drugs: phenazol, ibuprofen, ketoprofen, indomethocin, piroxicam.
The non-steroidal anti-inflammatory and antirheumatic drug ibuprofen is administered in strictly individual dosages, which are determined depending on the intensity of the pain symptoms. The drug is administered one to two tablets, which correspond to a dosage of 0.2-0.4 g, applied three to four times during the day after a meal. In case of medical necessity, the amount of the drug can be increased and make up 3 tablets (0.6 g) three to four times during the day. The maximum daily dosage should not exceed 2.4 g.
Categorically prohibited taking the drug with increased individual intolerance to the components of the drug, in case of erosive and ulcerative lesions of the digestive tract, dysfunction of the kidneys, heart and liver, with arterial hypertension, pathology of the optic nerve.
To raise the human immune forces, immunostimulants containing a complex of vitamins and microelements are introduced into the protocol of treatment. If a woman has obvious signs of emotional arousal, then it is not superfluous to drink tonic and sedative drugs or herbal decoctions (hops, valerians or motherwort).
Surgical treatment for mammary dysplasia is rarely prescribed. One of the operative methods of therapy is biopsy, which is effectively used for large volume cysts with liquid contents inside. A thin needle sucks up the contents, and in its place is introduced a special sclerosing substance that "glues" the cystic walls, preventing the re-accumulation of fluid. This procedure is carried out at the dispensary. If the content of the cyst differs increased viscosity with blood veins, regardless of the results of cytology, a sectoral resection of the affected breast is assigned. Relapses, in this case, are not observed.
If mammary fibroadenomatosis is diagnosed, in particularly severe cases the patient is hospitalized and subjected to sectoral resection or breast cancer. Mostly it is not removed, but long-term monitoring of its dynamics is carried out. In the case of puncture, resection or vyluschivaniya received material is mandatory sent to the cytological study.
Not the last place in the treatment of dysplasia of the breast is occupied by the advice of alternative medicine. But firstly it is worth mentioning that they can be used only with the permission of the doctor and only after all the planned examination. Without a clear diagnosis and treatment appointed by a specialist, you can lose valuable time, exacerbating and so difficult situation with your health.
So, recipes that can help in the treatment of dysplasia of the breast.
- Cabbage leaves and burdock have an effective resorption effect, which are superimposed in fresh form on the mammary glands (burdock is applied with a darker, shiny side).
- Well showed itself in the treatment of dysplasia and tea, cooked on the basis of grass biloba. Take until the symptomatology is gone.
- You can make a collection, taking in equal parts the flowers of chamomile, dill seeds, valerian root and peppermint leaves. A tablespoon of the collection to insist on a glass of boiling water. Drink half a cup three times throughout the day.
- It is possible to smear glands with burdock oil. Already ready-made ingredients are sold in any pharmacy, but there is an opportunity to cook it yourself. To do this, it is necessary to grind the root of the mug and take olive oil in the proportions of one to three. (1 - burdock, 3 - oil). Ten days to let it brew in a warm place. After that, you can express and use. Keep it in the refrigerator.
Therapeutic therapy also presupposes a diet. In case of diagnosing mammary dysplasia, it is necessary to correct the diet by removing fat and spicy food from it, increasing the consumption of vegetables and fruits, beans, soy. It is necessary to limit the intake of chocolate, carbonated products, coffee and coffee drinks.
Prevention
Any prevention is the best way to avoid the disease or recognize it in the early stages of manifestation. Prevention of dysplasia of the breast is, above all, a healthy lifestyle, as well as:
- A full sexual life.
- Maintaining psychological comfort.
- It is worth to take responsibility for the consequences that can arise after the artificial termination of pregnancy.
- Timely detection and full-fledged therapy of diseases of the reproductive system of women.
- Remove their lives from all bad habits.
- Carefully apply to taking medications and any other factors that can provoke a failure of the hormonal balance.
- Full, healthy and balanced nutrition.
- Maintaining your immune status at a high level.
- Do not ignore preventive examinations and examinations from specialists.
- Conduct regular self-examination of the mammary glands, evaluate the symmetry of both breasts, and their shape, the condition of the lymph nodes in the armpit, the shade of the skin, the presence of seals and discharge from the nipples.
- At the slightest suspicion, without delay, ask for advice and for examination to a qualified specialist: gynecologist or mammologist. Timely therapy can reduce the risk of progression of breast dysplasia by half.
- Watch your body weight. Overweight, and especially obesity - is a failure of the hormonal balance and a stimulus for the development of pathology.
- Prevention of early obesity (concerns toddlers and adolescents) is able to save from early menarche (the beginning of the first menstrual cycle), which, in turn, makes it possible to reduce the likelihood of premenstrual dysplasia of the breast.
- Active lifestyle and moderate exercise.
Forecast
Given the early diagnosis and timely passed adequate therapeutic treatment, the prognosis of mammary dysplasia is very favorable. But it is impossible to completely exclude relapses of the disease, it concerns and surgical excision of cystic education, because until the end the mechanism of hormonal background influence and its instability on this pathology, and many others, has not been thoroughly studied yet. If a woman's medical history is diagnosed with mastopathy, then it is necessary to regularly be shown for examination to a doctor - a mammalogist. This approach to your health will make it possible to avoid multiple problems and re-development of pathology.
On the quality of life of a woman, dysplasia of the breast does not significantly affect, but if left untreated, there is a real danger of transformation of benign tumors into malignant tumors. This is what should become an incentive for early diagnosis and timely and full treatment. Do not forget that the earlier any disease is diagnosed, the easier it is to stop it and the less severe further consequences.
Beautiful breasts - this is the pride of women, as representatives of the fair sex, the body of the subsequent generation. Therefore, the mammary gland requires special treatment. Continuous self-examination, preventive observation by a gynecologist or mammologist, adherence to a healthy lifestyle and recommendations of specialists will help to protect yourself from such an unpleasant disease as dysplasia of the breast.
Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"
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